NHS Scotland - winter preparedness plan: 2020 to 2021

Context

The Challenge

The Health and Social Care systems are likely to come under severe pressure in the coming months due to the combined impacts of dealing with the current COVID-19 pandemic and the end of the EU transition period, and this is compounded by the end of the transition period coinciding with the winter flu season. While the response to COVID-19 is a key priority, we are also taking account of these other concurrent risks that could impact delivery across health and social care, ensuring that resilience is in place as part of the winter programme of work. The impacts of the end of the EU transition period, seasonal weather and flu are being continually assessed, including what mitigating actions and contingencies we have in place, to identify any further work that may be needed to strengthen our response.

We are drawing upon the best available evidence to develop planning scenarios against which to assess our collective preparedness. This suggests that we may experience further peaks in COVID-19 cases over the winter months, and we’re already beginning to see this in some areas. This information is being factored into contingency plans so that we can be as prepared as possible. We will be monitoring the situation to ensure that organisations are able to adjust the vital services we all rely on. Organisations need to be flexible and agile in their ability to respond to emerging challenges. If the path of COVID-19 deviates significantly from our expectations or there are changes to the other winter risks, we will reissue the planning assumptions accordingly.

On 23 October, we published a new five-level framework to support a strategic approach to COVID-19 outbreak management. This will allow for rapid but proportionate responses on both a local and national basis using a transparent range of measures and options. Pressure on the NHS, including a forecast of numbers of people needing to be hospitalised or in ICU against NHS bed use and capacity, will be included in the indicators that will help inform decisions about which levels to apply in which area and when to escalate if escalation is needed and when areas can move down to a lower level.

Working together

We have learnt a lot from the first wave of the epidemic, embedding significant innovation into our key services, e.g. use of online/telephone consultations and the COVID-19 hubs, and rapid implementation of Colon Capsule Endoscopy and Cytosponge to support diagnostic capacity. We are also much better prepared across the whole chain of response to the resurgence, from the resources now available in test and protect and contact tracing to securing the supply chain for PPE.

Notwithstanding what we have learned, it is important to acknowledge the suite of concurrent risks we face on staffing, including staff availability, wellbeing and resilience. Our staff have worked collectively to face the challenges presented by COVID-19 and to support service mobilisation over the summer; the reorientation of workloads and working priorities has been simply unprecedented. During the first phase of the pandemic, we were able to draw extensively upon final year students who moved into paid employment with the service to alleviate staffing pressures. It would not be appropriate to mobilise that group of students in the same way this time around, not least because it is earlier in the academic year, and current finalists have not yet substantially completed their studies. Nevertheless, we continue to look at the prospect of additional staffing from other sources and are working to provide additional wellbeing and psychological support to staff.