Robust plans are in place across NHS Lothian this winter to help patients receive the right health care in the right place.
The health board, which is already experiencing significant pressures, has geared up for the busiest time of the year.
The numbers of people who need healthcare surges every winter for a variety of illnesses and conditions, including winter bugs, such as flu, COVID, other respiratory illnesses and Norovirus.
NHS Lothian is working closely with the four health and social care partnership in the region – East Lothian, Midlothian, Edinburgh and West Lothian – to focus in on more community-based initiatives to reduce the need for hospital attendance and admission in the first place.
The move also means that more patients will be able to receive the care they need closer to home and if they do have to be admitted to an acute hospital, the length of their stay in hospital should be shorter.
In turn, the renewed focus on community programmes will help free up more hospital beds for patients who are acutely unwell.
Dr Tracey Gillies, Medical Director, NHS Lothian, said: “The pressures facing hospital and community teams, GPs and pharmacies regularly surge beyond levels of activity that some years ago would normally have been associated with winter.
“That level of demand will only increase as winter progresses, so we have worked with partnerships to bolster their capacity in the community to ensure that more hospital beds are available for those that need them most.
“Health care is there for everyone who needs it this winter and we want to make sure patients can receive their advice, care or treatment in the right place at the right time.”
Health and Social Care Partnerships (HSCPS) across Lothian are enhancing their “discharge to assess” programmes which helps support people to leave hospital as soon as it is safe and appropriate.
Single points of contact (SPoC) services are also being boosted. These systems are aimed at people who are at imminent risk of hospital care but can be safely managed in the community. They support GPs and other professionals to rapidly coordinate services.
Other streamlined assessment processes have also been put in place to expedite hospital discharges and help community teams to proactively identify people ready for discharge with their support.
People across Lothian are being reminded to seek care in the right place this winter – and that in many cases they may get help sooner and closer to home, without attending an A&E department.
The NHS Inform App is the first stop for self-care and advice, while local pharmacies, GP, or Minor Injuries Unit can provide expert care and treatment, usually closer to home. If patients are unsure where to get help or if they need urgent health care at night or at the weekends, they should call 111 day or night.
In Lothian, patients may be signposted on to other services if they turn up to hospital A&E when they don’t need to be there.
Preliminary Notice of Anti Cuts Conference – Saturday 18th January 2025
Augustine United Church – George IV Bridge Edinburgh
9.30 am – Doors Open – Tea/Coffee and Biscuits
10.00am – 1pm Conference
The Conference is being convened by Edinburgh Trade Union Council and the Scottish Trades Union Congress (STUC).
The purpose of the Conference is to consider how best to fight the social care and health service cuts that are being planned by the Edinburgh Integration Joint Board (EIJB).
Crucial budget decisions are going to be made by the Scottish Government and the City Council over the next two or three months which will determine the level of cuts.
The conference will discuss how best to lobby to obtain the resources needed to meet service demands. This will include the services provided by the 64 third sector organisations Edinburgh that are threatened with cuts and redundancies.
The conference is open to the public. The agenda will be an introductory session, workshops and a final plenary session. The conference will have input from speakers from the STUC. We will invite a speaker from amongst the Councillors on the EIJB and a speaker representative of Edinburgh community health organisations.
We hope the conference will be able to draw up a City wide plan for lobbying and campaigning.
More details of the conference will be circulated on Monday 6th January 2025. Any comments or queries in the meantime will be responded to on 23/12/24 and 27/12/24.
It has been six weeks since the decision by the Edinburgh Integrated Joint Board (EIJB) to retain the Third Sector Grants Programme, worth £4.5 million, until the end of this financial year.
While a much-welcomed reversal of the initial proposal to pull the grant from 64 charities from January 2025, the forecasted cuts have left many of these registered charities in Edinburgh in doubt over their long-term future.
Edinburgh Community Health Forum strategic development managerStephanie-Anne Harris,said: “Without the necessary funding, closures are inevitable. These community-led charities cannot afford to exist without long-term public funding, and the threat of this being removed is hanging over their heads, preventing future planning.
“Edinburgh Health Community Forum has heard from many member organisations that are expecting to have to start the process of shutting down in January due to the EIJB’s decision.”
One such organisation is the Murrayfield Dementia Project, which provides lunch clubs and day services for those who are elderly and frail or living with early-stage dementia.
The termination of the EIJB funding will remove this service from the 20 members who attend each week, with repercussions for their carers and families. It will also result in five members of staff being made redundant and eight voluntary opportunities being stopped.
Jenny Rowe, Project Coordinator at Murrayfield Dementia Project, said “The EIJB reprieve has only prolonged the inevitable. As a small, community organisation, we need to know whether future funding will be made available, and if not, we will be forced to close.
“The loss of vital services, such as Murrayfield Dementia Service will not only impact those who directly benefit from them. Without the support offered by Third Sector organisations, we will undoubtedly see an increased pressure on Scotland’s wider health and social care services, which are already at breaking point”.
This is exemplified in the case of Phonelink Edinburgh, a twice-daily check call service for the over 60s that offers social interaction, medication prompts, welfare and safety checks, and eating and drinking prompts.
Kellie Mercer, Manager of Phonelink Edinburgh, commented “Phonelink Edinburgh receives £89,000 in funding from the EIJB grant.
“Among other check-ins, we carry out 128 medication prompts twice daily, 7 days a week. The estimated cost for Edinburgh Health and Social Care Partnership (EHSCP) to do the same would be £256,960 – and that is without considering the other welfare and safety services Phonelink Edinburgh offers.”
A Therapy Assistant Practitioner from the Western General Hospitalgave a real life example of the importance of the Phonelink Service: “A patient was medically fit for discharge but needed medication prompts to allow this to happen.
“So Phonelink was contacted by email for a twice daily medication prompt. The email was received at 3.48pm, the service set up at 4.30pm, with the patient discharged that evening, and the service started at 7.30pm.
With unprecedented budgetary challenges facing the EIJB, and the necessary shifting in strategic priorities, the cessation of the Third Sector Grants Programme may well be unavoidable.
If this is to be the case, Stephanie-Anne Harris argues for a planned transition with interim support made available:
“Sufficient time and planning must be given to avoid devastating consequences for Edinburgh’s most vulnerable citizens.
“This requires a collaborative approach, including Third Sector representatives, NHS Lothian and the City of Edinburgh Council to establish a clear timeline and secure alternative funding to prevent the immediate loss of vital services which currently benefit over 50,000 people across Edinburgh.
“Without Edinburgh charities and Third Sector organisations, the fabric of the community collapses. It is imperative that together we carve out a sustainable future for the City’s Third Sector, one that delivers high-impact services, strengthens community resilience, reduces pressure on statutory services and achieves better outcomes for Edinburgh’s most vulnerable citizens.
“We urge Edinburgh City Council and the EIJB to step up, provide clarity, and commit to funding that ensures these vital organisations can continue their essential work beyond the end of March 2025. ”
Thanks to everyone who has given us feedback so far by completing our survey!
GIC are passionate about providing the best possible service to our clients and we are delighted with the results and the many positive comments we’ve received since April:
The financial situation of the Edinburgh Integration Joint Board (EIJB) is very challenging. In 2025/26, the IJB seek to realise around £51m of savings. Future years will see further savings required, currently estimated to be £76m in 2026/27 and £105m in 2027/28.
These savings will be difficult and their impact will be substantial. So, managing change, and ensuring key services are delivered to communities will require collaboration by the IJB and city partners, including the Third Sector.
Reference Group
On November 1 2024, Third Sector representatives presented deputations to the EIJB challenging proposals around the Third Sector Grants Programme and an in-year cut (2024/2025). The IJB did not approve the proposal for the in-year cut with an alternative proposal being approved.
Following that meeting, the IJB invited Third Sector representatives to talk through concerns and identify areas to work together. To inform those meetings, EVOC and their TSI partners collaborated with the Edinburgh Community Health Forum and representatives of other Third Sector interests across the city to create a Reference Group.
The purpose of the Reference Group is to:
inform governance and city partnerships
assert the value of the Sector
shape investment
support change
distil the voices of the Third Sector to effectively represent the sector on the IJB
EIJB Engagement and Proposals
The Reference Group has rapidly considered the short-term issues around funding, and the longer-term issues of future partnership models, sharing a briefing note with the IJB on issues and options in early December. The engagement with EIJB has been positive given the difficult circumstances, and this positive engagement has resulted in an EIJB paper to the December Board which recommends:
That the Health Inequalities grants programme, due to end on 31 March 2025 should be extended for three months into 2025/26 which will help provide time for the organisations affected to adapt.
The Board support work currently underway to undertake a series of collaborative workshops which will inform some of the savings proposals and invest-to-save opportunities that will be submitted for consideration by the EIJB in March 2025.
In the current landscape this is a positive outcome for the Third Sector, informed directly by the voice, needs and priorities of the Sector.
City of Edinburgh Council Engagement and Proposals
Given the challenges to funding for the Third Sector and the impact cuts will have to the viability of Third Sector Organisations, the Reference Group have also argued the need for a cross city partnership approach to investment.
Following the November 1 EIJB meeting, the TSI wrote to the Chair of the EIJB, the Chief Executive of City of Edinburgh Council and NHS Lothian asserting the need to [a] reset investment [b] reform ways of working [c] repair relationships. In the immediate term, a key priority is to secure a commitment from City of Edinburgh to invest to mitigate the risks to critical and anchor organisations.
On December 10 the Council Policy and Sustainability Committee considered and approved a proposal that recognised that the Council may need to provide core or foundational funding to stabilise vital third sector organisations. The TSI with ECHF collaborated to present a joint deputation, welcoming the Council proposal, and offering support.
Council officers were instructed to:
Work on a briefing paper for the Council’s political groups on what the Third sector needs now, specifically transitional funding, medium term, ahead of the Council setting its budget in February;
Undertake a review of all grant funding, exploring the provision of longer term, sustainable funding;
Work with the Edinburgh Partnership and Third Sector to co-design solutions, and agree terms of reference for a short life group and report back to Policy and Sustainability Committee in March.
Priorities: December EIJB meeting and Future Planning
The Reference Group will continue to meet and shape the next steps. An immediate priority is to agree on Terms of Reference and confirm representatives in the Group. We will be sharing a set of proposals before Christmas for your consideration.
A strong voice is essential to shape the long-term relationship with the EIJB and in particular the workshop series in spring 2025.
The Edinburgh TSI with EVOC and others from the Reference Group will support the paper to the EIJB on December 17 on progress on the Third Sector Grants Programme and the next steps in working collaboratively with the Sector, and also with the City of Edinburgh Council.
If you need any further information in advance of the IJB meeting tomorrow (Tuesday 17 December), please get in touch with us or reach out to any member of the Reference Group.
We will also provide regular briefings on progress, through the fortnightly EVOC E-news and targeted updates on key information as necessary.
We have some important advice for dealing with norovirus, also known as the winter vomiting bug, after a recent increase in calls to the 111 service.
Norovirus is a stomach bug that causes vomiting and diarrhoea. While it can be very unpleasant, it usually goes away in about 2 days. Symptoms include:
Feeling sick (nausea)
Diarrhoea
Vomiting
High temperature
Headache
Aching arms and legs
Unfortunately, norovirus spreads easily and quickly. If you catch it, here’s what you should do:
Stay off work or school until at least 48 hours after symptoms have stopped.
Avoid visiting anyone in hospital during this time.
Wash your hands frequently and thoroughly with soap and water, especially after using the toilet and before handling food.
Remember, alcohol-based hand gels don’t kill the virus.
To prevent spreading norovirus, maintain basic hygiene and cleaning:
Disinfect surfaces and objects that could be contaminated using a bleach-based household cleaner.
Wash clothes and bedding separately on a hot wash (60°C).
Don’t share towels and flannels.
Clean toilets and surrounding areas with a bleach-based household cleaner.
Dr. Ron Cook, NHS 24’s Medical Director, advises: “If you experience sudden diarrhoea and/or vomiting, stay at home until you’re feeling better.
“There’s no treatment for norovirus, so you have to let it run its course. Drink plenty of fluids to avoid dehydration and avoid giving fizzy drinks or fruit juice to children as it can make their diarrhoea worse.
“Babies should continue to feed as usual. You don’t usually need medical advice unless there’s a risk of a more serious problem. Alleviate fever or aches with paracetamol and get plenty of rest.
“If you or someone you’re caring for shows signs of dehydration, use special rehydration drinks from your local pharmacy. Once you feel like eating, try plain foods like soup, rice, pasta, and bread.”
Don’t let the festive rush catch you out—check your repeat prescriptions and make sure you have enough medication to last through the festive period. Order only what you need, in plenty of time.
Labour Lothians MSP, Sarah Boyack has written to Cabinet Secretary for Health, Neil Gray, seeking clarity over the next steps for the recently announced replacement eye hospital.
Last week’s budget brought the news campaigners have long been waiting for, that a new eye hospital is going ahead in Edinburgh.
This is after multiple U-turns from the Scottish Government and the current facility being not fit for purpose for 10 years.
Ms Boyack has been a long-time campaigner for the hospital and is now seeking more concrete next steps following the announcement.
In her letter, Ms Boyack highlights that patients and campaigners ‘need clarity’ and urges Neil Gray to lay out the timeline for delivering the hospital and when the construction work will commence.
She also seeks reassurances about whether Mr Gray will meet with stakeholders and campaigners to update them on the progress with the eye pavilion.
The fate of the current Princess Alexandra Eye Pavilion was thrown into the spotlight recently when it was revealed that it would have to shut for a minimum of 6 months due to urgent repairs.
These repairs were further complicated by the discovery of asbestos.
The disrepair and age of the current building is one of the main reasons cited by campaigners as to why a new hospital is so desperately needed.
Commenting on her open letter, Sarah Boyack MSP said: “I am incredibly relieved that this project is finally going ahead.
“However, we have seen multiple U-turns in the past on the eye hospital.
“We need urgent clarity on the next steps.
“This project must be completed as soon as possible so that patients finally get the facility they deserve and require.
“I want to work constructively with Neil Gray on this.
“Patients and campaigners deserve clarity and I hope The Health Secretary takes up my suggestion to meet with stakeholders.”
Four community nurses from across Lothian have received the prestigious title of Queen’s Nurse.
Fab Four Laura Miller, Mags Morrow, Ryan Bell and Louise Healey successfully completed the intensive programme to be awarded the Queen’s Nurse title at a special ceremony at the Grassmarket Community Project in Edinburgh.
They were chosen to participate in an intensive nine-month development programme, organised by the Queen’s Nursing Institute Scotland (QNIS).
The programme included residential workshops, online sessions, and one-on-one coaching to enhance their skills and expertise. Laura, works as the Clinical Team Lead for District Nursing and Mags is the Clinical Nurse Manager, Lead Advanced Nurse Practitioner, and CWIC Service Operational Lead in East Lothian Health and Social Care Partnership.
Ryan is the Team Lead at Midlothian Older Adults Mental Health and Dementia Team, while Louise is the Team Manager of the Midlothian Community Adult Mental Health Team and Intensive Home Treatment Team; in Midlothian Health and Social Care Partnership.
Alison Macdonald, Executive Director for Nursing at NHS Lothian, said: “Our nurses across Lothian consistently deliver outstanding care, and it’s wonderful to see their efforts celebrated through the prestigious Queen’s Nurse Awards.
“We are especially proud to have not one, but four exceptional individuals receive this esteemed recognition this year. Congratulations to each of them on this incredible achievement.”
The legacy of Queen’s Nursing in Scotland dates back to the late 19th century, when nurses underwent specialised training to serve as district nurses, providing essential care to the ‘sick poor’ in Scotland’s communities.
Until the late 1960s, the Queen’s Nursing Institute Scotland (QNIS) oversaw the training of District Nurses, who became known as Queen’s Nurses. These nurses played a vital role in delivering healthcare and health education directly to people in their homes, earning respect and trust within their communities.
The original Queen’s Nurse title was awarded until 1969, when the introduction of a national certificate for district nursing marked the end of QNIS’s training programs.
In 2017, the Queen’s Nurse title was reintroduced in Scotland. Each year, around 20 community nurses and midwives are selected to participate in the Queen’s Nurse Development Programme (QNDP). Upon completion of this rigorous program, they are awarded the title of Queen’s Nurse. Today, there are more than 170 contemporary Queen’s Nurses serving communities across Scotland.
Every year, the programme requires participants to choose an issue for development which will have a significant impact on those they care for, so that the learning during the nine months is applied in practice. There is an expectation that this work will have a focus on promoting equity and inclusion.
Community nurses and midwives play a crucial role in supporting their communities by delivering a broad range of services. Their work includes providing complex care for older adults, offering support for individuals struggling with substance misuse, and advocating for people with learning disabilities.
This dedicated group also encompasses professionals in community mental health, district nursing, school nursing, care home nursing, and health visiting, all of whom are essential to the health and well-being of the populations they serve.
Dr Sarah Doyle, QNIS Chief Executive and Nurse Director, said: “QNIS is delighted to award the Queen’s Nurse title to these fantastic nurses.
“Community nurses and midwives occupy a unique position in Scotland’s health service, working as they do in the heart of communities, championing the cause of those who are not heard, helping those facing real adversity.
“They do extraordinary work, every day. The Queen’s Nurse Development Programme supports participants to build their confidence, inspiring them to find and lead creative responses to the challenges faced by their colleagues and the communities they serve.”
Funding for NHS Lothian candidates to undertake the development programme was provided by NHS Lothian Charity.
I am writing to you to provide an update on Edinburgh TSI* activity since the EIJB Board meeting on November 1 and to invite your collaboration on the next steps.
Though it was welcome that the IJB agreed not to proceed with an in-year cut to the Third Sector Grants Programme, the process leading to that decision, and risks flowing from the meeting on November 1 remain very challenging.
Resolving the funding position for the Third Sector Grant recipients, and all third sector funding from the IJB for 2025/6 alongside co-designing the conditions of success for any future model of working in partnership is a key priority for the Sector, and as a consequence, for the Edinburgh TSI.
We believe the IJB proposals need to be part of a wider strategic conversation in the city about how we invest in the Third Sector, ensuring we have the right investment in the right places with the right capacity to deliver the most impact.
Edinburgh TSI letter following November 1
In the lead-up to the November 1 IJB meeting, we worked collaboratively with the Edinburgh Community Health Forum, and others across our sector to draw out information for briefings from affected TSOs through phone calls, questionnaires and meetings. This concluded with a detailed rebuttal of arguments in Paper 7.2, as presented to the IJB as well as a TSI deputation. The deputation sought to build on the arguments put forward by organisations for time to plan better and work differently.
Following that meeting, I wrote on behalf of the TSI to the Chair of the EIJB, the leader of the Council, the CEC Chief Executive and the NHS Lothian Chief Executive. I emphasised the need for:
Resetting investment: there is a need for a whole city conversation on a sustainable financial settlement for the Third Sector
Reforming ways of working: there needs to be a better approach to commissioning, valuing and supporting The Third Sector through change
Repairing relationships: recognising and valuing the value of the Third Sector contribution to communities is an important part of relationship development
Edinburgh IJB engagement on Third Sector Grants and contracts
Agreeing on a funding settlement for 2025/6 is a key objective for the Third Sector, both for the Third Sector Grants Programme and for the larger contracted services with Third Sector Organisations.
There are different possible scenarios. A best-case scenario might be a one-year continuation of the grants programme while time is dedicated to coherently and collaboratively designing a sustainable “replacement” which enables the IJB to purchase what they need and want from the Third Sector while providing foundational funding for the wider sector.
This will require a series of conversations, some sense of prioritisation and scoping of how to manage change. The big challenge is time. Initial discussions are progressing between Edinburgh TSI and the IJB on immediate priorities, and a meeting has been invited with CEC.
To inform the discussions on funding, the Edinburgh TSI met with a group of Third Sector partners to scope priorities. This includes articulating the real consequences of making any cuts on the Sector and its ability to deliver outcomes with communities; seeking confirmation on the priority focus for the IJB in 2025/6, and inviting discussion on options around the best use of our joint resources through a process of co-design. These conversations will need to be ongoing. We welcome your views as to how best to shape them.
Edinburgh IJB engagement on Public Social Partnership
Any change to a way of working to a Public Social Partnership or some other commissioning model by the IJB demands an investment of time up front.
This time is needed to confirm commitment to co-design to ensure that any partnership is a partnership, and any working relationship is founded on clear conditions for success.
This needs an investment in learning from other PSP’s in the city, what worked, and what didn’t, and it needs clarity on roles and responsibilities. In the meantime, a clear transition arrangement needs to be set out, describing how current commitments and contracts are to be managed.
Following the November 1 meeting, the IJB have been reviewing budget and partnership proposals. They have invited a group of Third Sector representatives to discuss how to progress partnership working together on shared issues and challenges.
The purpose of the meeting is to start a conversation about how best to work together, who to engage and what success looks like. The next steps will need wider conversations within the sector and between the sector and the IJB, and we invite your views as to how best to shape this.
Reference Group Proposal
The Third Sector has important Board roles on the EIJB and other city institutions. However, at the EIJB meeting, Cllr Pogson asked if there was enough Third Sector representation on the Board.
A reformed Board may be a future possibility, but meanwhile, it is critical to be able to support the people who occupy these Board seats so the voices of the sector feed into them, support and challenge them.
This is particularly the case in the next year or so where there will be very challenging issues and decisions to consider, with significant impact for the Sector.
To try and make sense of where to best put attention around these issues, we have convened a small, embryonic group of sector people. We aim to build this into a Reference Group with representation from across the Sector to distil and amplify the voices of the sector around priority issues. This will evolve over the next few months, and we invite your collaboration.
Our initial sense is that the areas of focus are about:
Asserting value: articulating the impact of the sector with fair methods of measurement
Supporting resilience: co-designing ways of working for sector sustainability
Shaping investment: making the case for ongoing investment around sector need
Informing governance: supporting Third Sector Board seats on city partnerships
We have developed Draft Terms of Reference for this Group, which builds on the current issues around the IJB but also focuses on the Third Sector as a whole.
Next steps
In sharing this context and background, it is my intention to work collaboratively to find a solution to the real risks we are facing as a sector.
In this context, I invite you to get in touch with initial feedback on the role of the TSI in shaping the Reference Group. In the meantime, Edinburgh TSI colleagues will continue to convene the sector through forums, networks and meetings, alongside the Edinburgh Community Health Forum.
Together, we can also continue to highlight the risks and impact of this loss of investment in the third sector, both individually and collectively.
Please get in touch and get involved. We recognise that our strength is in working together and supporting each other across our rich, diverse and talented Third Sector. I look forward to working with you.
How to Cope with the Winter Vomiting Bug 
Diarrhoea
Vomiting
High temperature
Headache
Aching arms and legs
Stay off work or school until at least 48 hours after symptoms have stopped.
Don’t let the festive rush catch you out—check your repeat prescriptions and make sure you have enough medication to last through the festive period. Order only what you need, in plenty of time.
