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After a year of dreadful news, the Scottish government is trying to make a break with a plan that makes it easier and quicker for people to access the care they need.
The Scottish government has published its plans to deliver more healthcare at home and in the heart of communities, with hospitals focusing on emergency, life-threatening and specialist care.
The plans, called the Health and Care Improving Flow Plan 2026-2031, are deliberately targeting corridor care. The Scottish government has made it clear to health boards that it is “unacceptable and should be eradicated”.
“At its heart, improving hospital flow is not about targets, processes or organisational structures. It is about people and ensuring they can access the care they need, when and where they need it,” said health secretary Angela Constance.
“Our plan will help people access more care at their fingertips, in their homes and in their communities and these reforms are designed to support them to live healthier, more independent lives.”
The plan commits to a number of immediate, medium and long-term actions for the NHS in Scotland. An aim is to make it easier for people to access the support they need the first time they ask through an enhanced urgent care triage system, led by new Integrated Navigation Centres delivered jointly by NHS 24, the Scottish Ambulance Service and Health Boards.
Focus on community care
The plans include increasing same-day care provision, so more people can receive tests and specialist assessment without the need to be admitted overnight to hospital, and patients should receive a planned date of discharge on their first day in hospital, with the majority leaving within three days where clinically safe to do so, and barriers to weekend discharge removed.
At the same time, there is greater focus on community care and new GP walk-in services, healthy heart and lung checks, and mental health hubs to create consolidated health and care hubs in communities.
“Where people are experiencing a life-threatening emergency or requiring acute care, they will continue to be cared for in a hospital setting that prioritises dignity, privacy and experience,” Constance emphasised.
The response to news of the reforms has been cautious.
“The publication of the Scottish Government’s Improving Flow Plan is an important indication and a welcome recognition that Scotland needs reform across health and social care if people are to receive the support they need at the right time and in the right place,” said the Coalition of Care and Support Providers in Scotland, in a statement.
There was more caution from former NHS 24 Vice Chair Alan Webb. “Quite how ‘not national, but not local either’ planning spaces can drive place- and people-led change I’m not clear, but I’m open,” he said. “The worry is we might wait years to discover it wasn’t right. Why do we have such an issue with reform being led locally?”
Then there was outright scepticism from the Royal College of Nursing Scotland (RCN Scotland).
“The system isn’t working, and the levels of demand we are seeing are only going to increase. Too often the focus is on initiatives and pilots while funding to core services, such as district nursing, fails to keep pace with demand,” said executive director Colin Poolman.
Scandal after scandal
Certainly, some good news for the NHS in Scotland has been needed for a while. It has been a torrid year with scandal after scandal for healthcare in the country even though waiting lists have fallen.
In late June, Christine McCourt was appointed to lead a review into improving maternity services across Scotland following a series of problems in the country’s maternity services.
Maternity healthcare in Scotland has shown little sign of improvement, with a damning report published in June by Healthcare Improvement Scotland into Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde.
NHS Tayside is at the centre of a public inquiry over the professional practice of Muftah Salem Eljamel, who worked as a neurosurgeon at NHS Tayside’s Ninewells Hospital in Dundee between 1995 and 2014. And NHS Grampian suspended all paediatric surgery at Dr Grey’s Hospital in Elgin in August, following an unannounced inspection by Health Improvement Scotland.
There is an inquiry investigating the construction of the Queen Elizabeth University Hospital Campus, Glasgow, and the Royal Hospital for Children and Young People, and the Department of Clinical Neurosciences, Edinburgh. At the same time, the Queen Elizabeth University Hospital is also being investigated by prosecutors who are reviewing seven patient deaths for potential links to the hospital’s environment and water supply.
All of this is happening against the backdrop of the ruinously expensive tabloid fodder of the trans scandal facing NHS Fife.
