NHS recovery plan

Urgent & Unscheduled Care

The number of people attending A&E declined significantly during 2020 as people followed health advice and stayed home to protect the NHS and save lives.However, as restrictions have lifted urgent and emergency attendances and admissions to A&E departments have returned to pre-pandemic levels, which in 2019 were at historically high levels. This increase in attendances - combined with factors such as the reduced capacity resulting from infection control measures, and understandable staff absences as a result of self-isolation and annual leave -has contributed to the current pressures being experienced in A&E and unscheduled services.

The focus of our strategy for urgent and unscheduled care is on optimising safe and effective patient care. To this end, we are working closely with local teams and expert groups to develop appropriate alternatives to attendance at A&E, minimise the need for admission, and reduce length of stay and increase options and processes for timely and appropriate discharge. All of these actions will not just help reduce pressure in A&E - they also have the potential to increase bed capacity by 150 beds per day, which will in turn help to increase our ability to provide planned care.In addition we have already committed £3.6 million in funding in 2021 to support our ambition to roll out Hospital at Home across Scotland to deliver high quality specialist care in peoples own homes.

We are also implementing the Redesign of Urgent Care (RUC) Programme. A hub has been established in every health board to directly receive referrals from NHS 24, offering rapid access to a senior clinician, using a telephone or video consultation where possible and minimising the need to attend A&E. Since June 2021, these have expanded to include children aged 18 months – 12 years. Where people are referred to A&E, this is as scheduled as possible, for a specific day and time, reducing unnecessary waits. And, where appropriate, patients will be encouraged to contact their GP or community pharmacist as their first point of contact, keeping care as close to home as possible and avoiding the need to wait in A&E, helping keep everyone safe.The overall aim of the programme is to reduce attendances at Emergency Departments by 15% to 20%, and ensure faster access for those who do require to attend.