NHS Scotland - winter preparedness plan: 2020 to 2021

Essential Services – Urgent Care

The continued access to urgent and emergency services will continue to be a priority in our health service, as they have been since the introduction of the lockdown measures, and we will continue to encourage the public to use these services as and when needed.

Outcomes

• Maintain and enhance the COVID Community Pathway with virtual hubs and Community Assessment Centres in all boards.
• Continue to prioritise treatment for cancer and other urgent/life threatening conditions.
• New urgent care pathway/access arrangements in place, ensuring people are seen in the most appropriate healthcare setting for their clinical need with as early access as possible to a senior clinical decision maker, as close to home as possible. This will reduce the need for attendance at A&E services and, where possible, avoid emergency admissions, keeping patients and staff safe from the risk of crowding in busy waiting areas.
• Provide professional oversight of care homes to protect our vulnerable people.
• Operating within a national framework, ensure clinical prioritisation of patients awaiting planned care is in place to ensure those in most urgent need receive treatment.
• Support Scottish Ambulance Service (SAS) to enhance their capacity to increase resilience to deliver more care at home or in a homely setting, reducing unnecessary A&E conveyance. SAS will also undertake work in partnership to improve clinical handover and reduce turnaround time at hospital particularly in those busy ED departments.

How We Will Deliver This

• There is no change to the emergency and life-threatening pathway, and the public should continue to see immediate care; from 0800-1800 on weekdays, the GP practice remains the default urgent care provider.
• Maintain 31 & 62 day cancer treatment targets by delivering the Framework for Recovery of Cancer via appropriate prioritisation.
• For those with a non-life threatening urgent care need, the first phase of urgent care redesign programme will be implemented at a pathfinder site by November, with national rollout in December.
• A public campaign will inform that an initial point of access will be available 24/7 through NHS 24 with early accesses to clinical triage optimising access to care such as: self care and NHSinform.scot; self help guides; pharmacy, optometry, dentistry and referral to GP practice if required. Local flow navigation centre will offer a clinical consultation supported by multi-disciplinary team to give early access to a clinical consultation. The team will have the ability to schedule out of hours face to face appointments. Utilising a quality improvement approach, teams will be supported to share best practice and develop pathways of care to support the local population need and clinical presentations.
• Delivery of community resilience plans to support admission avoidance and support most vulnerable in community to remain at home through provision of social care, e.g. enhancing hospital at home, care at home, community nursing and Allied Health Professional (AHP) services.
• SAS has been provided with up to £10.5m in additional funding this year to support their demand and capacity work which will allow them to put additional resources in place in key areas.