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

Covid-19 Routemap: Health and social care

Lockdown

Lockdown restrictions:

All non-urgent care health care services stopped and capacity focused on COVID-19 response:

COVID hubs and assessment centres.

Urgent care including dental and the creation of ICU capacity.

Joint working to reduce delayed discharges by over 60% and prioritising "home first" and prioritisation of safety and wellbeing of care home residents and staff.

Urgent and cancer care still available.

Phase 1

As with previous phase but with the following changes:

Beginning to safely restart NHS services, covering primary, and community services including mental health.

Phased resumption of some GP services supported by an increase in digital consultations.

Roll out the NHS Pharmacy First Scotland service in community pharmacies.

Increase care offered at emergency dental hubs as practices prepare to open.

Restart, where possible, urgent electives previously paused.

Resumption of NHS IVF treatment has now been approved in Scotland and we are working with the 4 centres to resume services quickly and safely.

Increase provision of emergency eyecare in the community.

We will consider the introduction of designated visitors to care homes.

Phase 2

As with previous phase but with the following changes:

Remobilisation plans implemented by Health Boards and Integrated Joint Boards to increase provision for pent up demand, urgent referrals and triage of routine services.

Reintroduce some chronic disease management which could include pain services, diabetic services.

All dental practices open to see patients with urgent care needs. Urgent care centres provide urgent aerosol generating procedures.

Prioritise referrals to secondary care begin.

Increase number of home visits to shielded patients.

Continue to plan with COSLA and Scottish Care to support and, where needed, review of social care and care home services.

Phased resumption of some screening services.

Expand range of GP services.

Phased safe resumption of essential optometry/ ophthalmology services.

Phased resumption of visiting to care homes by family members in a managed way where it is clinically safe to do so.

Phase 3

As with previous phase but with the following changes:

Emergency and planned care services delivered.

Expansion of screening services.

Adult flu vaccinations including in care homes and care at home.

All dental practices begin to see registered patients for non-aerosol routine care. Urgent care centres to provide aerosol generating procedures.

All community optometry reopens with social distancing safeguards.

Some communal living experience can be-restarted when it is clinically safe to do so.

Phase 4

As with previous phase but with the following changes:

Full range of health and social care services provided and greater use of technology to provide improved services to citizens.

Notes: Above examples are illustrations, and are not intended to be comprehensive. Each phase description should be viewed as a general description rather than precise definitions of permitted activities.

All decisions on phasing will be kept under review as the research evidence base on the impact of the virus and the effectiveness of different interventions builds.