NHS Scotland redesign of urgent care: second national staging report

3. Purpose and approach

The purpose of this Second National Staging Report ('The Report') is to review the progress of the RUC pathway implementation, opportunities, challenge, lessons learned and to make recommendations to inform how the pathway is further developed.

The report brings together data, information and intelligence from a number of commissions, activities and sources including:

• Review the risks and mitigations from the NHS Ayrshire & Arran RUC Pathfinder Report^[7]
• Review progress with recommendations from the RUC First National Staging Report^[8]
• Management information using a structure of key touchpoints across the RUC pathway and health system
• Review of Public Heath Scotland (PHS) data on equity of access
• Listening exercise undertaken to understand the lived experience of the NHS Scotland staff involved in the RUC pathway
• The Redesign of Urgent Care Gathering Views Report, Healthcare Improvement Scotland^[9] (HIS, September 2021), to understand what matters to people more likely to experience barriers or disadvantage when accessing the RUC pathway via NHS 24 111
• Update on the national RUC public messaging campaign
• Review to gain greater insights and understanding of how the RUC pathway is working
• Care Opinion^[10]
• Reports to the RUC SAG
• Feedback from the RUC EAG

The report strives to provides as comprehensive a picture as possible. However, the timing of this report means that some information is not currently available:

Citizens Panel:

The RUC pathway will be included in the forthcoming Citizen's Panel led by Healthcare Improvement Scotland (HIS), which brings together a large, demographically-representative group of citizens to assess public preferences to inform and influence key decisions about Health and Social Care policy and services. The findings will be available early 2022.

Health Board Patient Experience data and information:

The RUC Programme, in collaboration with HIS is co-designing a national patient experience framework for RUC services. This aims to better understand the experience of service users and their carers. Lived experience data is a critical element to understand local pathways from a user's perspective and identifying where improvements are required.

Although most NHS Boards capture some user experience and/or satisfaction data, work is needed to standardise and provide more consistent and real-time data at a local and national level.

To note:

Children 18 months to <12 years:

All children 18 months to <12 years were only included in the RUC pathway from 1 June 2021. A short life expert working group reported on progress at the end of September 2021. This present report only provides very preliminary data.

People with urgent mental health needs:

This report does not include specific findings and recommendations about people with mental health needs accessing care via the RUC pathway. Other RUC management information activity data is provided. Work is proceeding on urgent mental health care and this is also being monitored by SAG.