Re-mobilise, Recover, Re-design: the framework for NHS Scotland

Introduction

On 11 March we wrote out to Health Boards requiring them to develop local mobilisation plans as an initial, whole system response to the COVID-19 emergency. In the initial mobilisation phase, the NHS created unprecedented surge capacity to treat and care for COVID-19 patients, both in hospitals and in the community, whilst protecting emergency, cancer, maternity and urgent treatment, where clinically appropriate. In recent weeks, NHS Boards' local health protection teams have also played an increasingly important role, alongside local government, in supporting care homes through the pandemic. Crucially, at no point to date in the outbreak has the NHS had insufficient acute or critical care capacity to deal with COVID-19 and emergency demand.

As we move forward into the next phase of mobilisation, we must continue to safeguard robust COVID-19 resilience and support for social care, whilst working with Health Boards and their planning partners on how paused services across the whole system will be safely and incrementally resumed. This move to the next phase, which will arguably be more challenging than the initial response, recognises the growing risk of rapidly rising waiting lists and potential non-COVID harms; particularly in the context of releasing COVID restrictions; and the need to have in place and operational other key, and interdependent, strands of our response, e.g. Test and Protect.

The response to the pandemic has also led to some remarkable and innovative developments in service delivery for the benefit of patients; particularly via the use of digital technology, to enable more services to be delivered at home or in the community. Whilst we will want to retain as much good practice as possible in the next phase, longer-term, wider reform of health and social care, will be taken forward separately, as part of the Renew programme.

The Framework for NHS Mobilisation sets out how Health Boards will safely and incrementally prioritise the resumption of some paused services, while maintaining COVID-19 capacity and resilience. The range of clinical and other priorities that underpin the Framework, and that are set out in this paper, will be kept under review in partnership with Health Boards, Integration Joint Boards, Local Authorities, Royal Colleges, professional bodies, unions and other key stakeholders. This will be taken forward under the Framework for Mobilisation Recovery Group, chaired by the Cabinet Secretary for Health and Sport.

We will continue to work closely with clinical networks, NHS boards and our partners in the Royal Colleges, unions and representative bodies and local authorities, informed by this framework and taking account of local circumstances so that local plans are as realistic and robust as possible. Whilst we remain on an emergency footing, implementation of these and subsequent Board plans will be contingent on the agreement of the Cabinet Secretary for Health and Sport.