The Scottish Government has unveiled a major push towards home-based care in a bid to ease pressure on hospitals, in order to free up time for emergency cases.
NHS bosses are being urged to speed up the delivery of community or home-based care services as winter approaches – with greater emphasis put on the role for GP walk-in services and pharmacies.
The Health and Care Improving Flow Plan will see more care delivered via ‘Hospital at Home’, virtual care, online and phone consultations, with remote monitoring and care at home services will continue to expand, enabling patients to receive high quality care in their own home.
Better self-management support and digital services will also help patients remain independent and manage your health and wellbeing more effectively.
The plan commits to a number of immediate, medium and long-term actions for the NHS in Scotland, including:
- making it easier for people to access the support they need at the first time of asking, 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
- increasing same day care provision so more people can receive tests and specialist assessment without the need to be admitted overnight to hospital
- patients receiving 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
- a clear focus for health boards to reduce corridor care with the Scottish Government clear it is unacceptable and should be eradicated
- expand home and community care significantly, with Hospital at Home services being provided to more than 10,000 patients this winter
- build on new GP walk-in services, healthy heart and lung checks, and mental health hubs to create consolidated health and care hubs in communities
- implementing the ‘discharge without delay’ approach in all health boards by this winter, which includes the increased use of Acute Frailty Units.
Health secretary Angela Constance said: “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. 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.”
She added: “While more care will be offered closer to home, via pharmacies, community-based hubs such as GP walk-in services and healthy heart and lung checks, some people may need to travel further to receive the most highly specialised care.
“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.”
Ms Constance urged people to take an active role in maintaining their health and wellbeing and to use services appropriately, only calling 999 in emergency situations where they felt they had to go to A&E, and dialling 111 for non-emergencies.
She added that government will be on hand to evaluate how the plan was being implemented, and where services were performing well, they would support learning by spreading good practice. Where it fell short, she said government would provide support and, if necessary, “take decisive action to improve outcomes for patients and communities”.
Details of the new national MyCare app for health and social care were also included in the 26-page plan.
‘We will continue to build on our new health and care app MyCare.scot to deliver the single biggest digital innovation in Scotland’s health and care system,’ the plan said. ‘This will give you a single point of access to manage your health and care journey. Over time this will enable you to book and reschedule appointments, review your records and access self-management and remote monitoring tools.
It added: ‘This will give you greater control to arrange appointments at a time that suits you, removing barriers to healthcare, preventing missed appointments and making your health and care journey work for you. For those unable to go online, in person and telephone services will still be available.’