People across Scotland will have better access to NHS treatment through increased capacity, expanded primary care services, enhanced use of digital innovations and a range of other measures, First Minister John Swinney announced yesterday.
Speaking to representatives from across the health and social care sector, the First Minister set out action to drive down waiting times and reduce pressure on frontline services.
The First Minister was joined by Health Secretary Neil Gray and announced a range of actions including:
A substantial increase in capacity, with 150,000 additional appointments and procedures per year
Increased investment in primary care, making it easier for people to get appointments with their GP
Improved use of data and new digital innovations including the roll-out of a Scottish health and social care app – a ‘Digital Front Door’ to the NHS for patients
The First Minister said: “Protecting, strengthening, renewing our National Health Service – that is a goal I think we can all get behind. A real focus of common purpose.
“That requires action from me, as First Minister, from my Health Secretary Neil Gray, and from my Government. We can offer the leadership and direction – as the measures outlined today seek to do.
“So, today, we commit to a substantial increase in capacity in order to significantly reduce people’s waits.
“Our plan will ensure that a greater proportion of new NHS funding goes to primary and community care. GPs and services in the community will have the resources they need to play a greater role in our health system.
“This increased investment will result in GP services that are easier for people to access. That is important in terms of people’s confidence in the health service – but equally, it will make it more likely that health issues are picked up quickly and dealt with earlier.
“Our National Health Service is there when we need it. No other public institution supports us with so much care through life’s biggest moments. We must support it in return.
“The approach I set out today charts our course to do that. It addresses both the challenges and the opportunities. It sets the NHS on a path of modernisation and renewal.”
NHS Scotland is poised to make “major strides” across 2025 in its drive to reduce emissions through breakthrough innovation, a health service partner believes.
After pledging to become a net zero organisation by 2040, the NHS continues to make significant gains through a variety of initiatives including new technologies, new ways of working, and a deep focus on reducing emissions.
A formal partner of NHS Scotland, InnoScot Health says that innovative approaches for more environmentally sustainable care continue to be embedded at greater pace.
Innovation Manager Frances Ramsay said: “There have been some very positive developments across NHS Scotland in recent times which, looked at collectively, add up to a picture of the health service making major strides on the road to lower emissions – from new thinking in building and transport emissions to more reusables and greater upcycling at all levels.
“Its electric fleet is ever-expanding. As of April 2024, 45% of NHS Scotland’s vehicles were electric, representing a significant increase from the figure of 19% in October 2022, and that will only rise.
“Emissions from the energy used to heat and power NHS buildings continue to fall steadily, as do medical gas emissions, including the replacement of anaesthetic gas Desflurane with a less harmful gas which is now saving emissions equivalent to powering 1,700 homes every year.
“In fact, NHS Scotland won the European Sustainable Healthcare Project of the Year award in 2023 after becoming the first national health service in the UK to stop using Desflurane.
“It also means greater cost efficiency with the National Green Theatre Programme supporting health boards to achieve not only annual reductions of around 20,000 tonnes of carbon dioxide generated from surgery but also financial savings of around £6 million. These better practices significantly add up as we increasingly look to 2040.”
InnoScot Health continues to champion and encourage greener workforce innovation, recently helping to develop a breakthrough with midwives working at St John’s Hospital in Livingston which aids skin-to-skin contact while allowing birthing partners to keep newborns warm by utilising upcycled staff fleeces as a covering material altered onto new scrubs.
Alongside NHS Lothian’s Research and Development team, InnoScot Health helped protect and register the design, meaning that Cozy Cuddle Scrubs (by Stacey)™ are now well-placed to become more widely available through manufacturing partners.
Frances continued: “With so many projects coming to fruition, there is much to be proud of and so much innovation potential in the drive towards a net zero NHS Scotland.
“We want to inspire and encourage that vital push as much as possible by lending our support to the 180,000-strong workforce – and who better to deliver net zero than the people who are closest to the issues and can see first-hand how emissions-producing processes are contributing to climate change?”
Pioneering staff at the Golden Jubilee National Hospital recently announced their role in co-designing friendly and reusable theatre caps made from sustainable plant-based material as part of a research project led by the University of Strathclyde and Heriot-Watt University.
The project primarily aims to reduce waste created by the 800,000 single-use theatre cap products disposed of annually by Scottish hospitals, demonstrating the power of innovation-driven collaboration for sustainable design, as well as the potential for further rollout across the country.
InnoScot Health’s own sustainability call aims to inspire health and social care professionals to come forward with their ideas for greener ways of working that can help the health service adapt and strengthen.
New analysis indicating that healthcare treatment needs to be boosted by a fifth to eliminate COVID backlogs could represent ‘a huge incentive to ambitious innovators’, insists an NHS Scotland partner.
Researchers believe that the Scottish health service must aim to treat at least 20 per cent more non-emergency hospital cases over the next three years in order to return to pre-pandemic levels.
Experts from the Universities of Edinburgh, Strathclyde, and Oxford suggest in their Scotland-wide study – published in The Lancet – that successfully targeting an additional 32,300 cases per year by the end of 2026 could clear the COVID-19-related backlogs.
Formal NHS Scotland partner InnoScot Health insists that helping to accelerate workforce-led innovation represents a key facet in meeting that challenge, aligning with the study’s suggestion of adopting “broader system-level strategies” in tandem with additional capacity.
Regulatory Project Manager Paula Sweeten insists that it’s “a sizeable ambition, but an achievable one too if supported by incisive decision-making and the right encouragement of impactful innovation”.
She said: “We believe that inspiring and supporting the 180,000-strong NHS Scotland workforce to innovate in a major way can help to make the required difference to waiting lists which were significantly exacerbated by the pandemic.
“Indeed, this new research states that referrals waiting to receive non-urgent treatment rose by a huge 73 per cent over the four years from 2019 as services were placed under tremendous strain.
“Overcoming that legacy of having to focus health service resource on COVID-19 for successive years remains a massive challenge of course – and we need to be realistic about what can be achieved with current investment in Scotland – but innovation opportunities are undoubtedly part of the solution.
“Those working within NHS Scotland are well-placed to identify those opportunities, leveraging not only the daily insights of individuals who are closest to challenges, but the vast collective experience and knowledge across every health board to establish more efficient, forward-looking practices.”
Researchers found that the medical specialties where most patients waited more than 12 weeks for both inpatient and outpatient appointments were Ear, Nose, and Throat (ENT), General Surgery, Gynaecology, Oral and Maxillofacial Surgery, and Urology.
InnoScot Health has seen a growing number of innovations submitted by health and social care staff in the fields of gynaecology and surgery, and insists that the workforce is an important driver of not just adopting new innovations, but coming up with those initial ideas themselves.
Study lead, Dr Syed Ahmar Shah of the University of Edinburgh’s Usher Institute, noted that NHS Scotland requires “a holistic approach, including system-wide strategies like better demand management, prioritising cases by clinical urgency, and improving overall efficiency”.
A multifaceted approach is needed, the researchers concluded, combining capacity increases with other measures including improvement of waiting list management, promotion of preventive healthcare, and workforce strategies aimed at recruitment and retention.
Digital health solutions such as telemedicine may help to manage less urgent cases, while innovative scheduling practices could optimise resource use, they noted.
Dr Shah added that there is a need “to set realistic recovery plans and ensure adequate funding for their implementation”.
Paula continued: “InnoScot Health believes improved collaboration across the Scottish system, with empowered innovators at its heart, is vital in the push for more efficient approaches and smarter use of resource.
“We consider that to be a huge incentive to many of NHS Scotland’s most entrepreneurial-minded, ambitious innovators who have ideas to share and are keen to spearhead sweeping change.
“This country was founded on groundbreaking ideas, and our organisation is committed to ensuring dynamic healthcare innovation is very much to the fore at this vital time of transformation.
“By uniting our accelerative expertise with the workforce ideas and delivering real value from healthcare innovation, we can collectively aim to improve patient outcomes while finding tailored solutions to optimise clinical time as part of a more sustainable NHS Scotland.”
Evaluating the introduction of the Redesign of Urgent Care
Patients using a new service to direct people to the right urgent care service had a mostly positive experience, a new report has found.
An evaluation of the Redesign of Urgent Care, which was launched in December 2020, found that people given appointments at A&E or minor injuries via NHS 24 111 reported shorter waits than those who visited A&E without an appointment.
The report also found an increased use of NHS 24 111 service during weekday in-hours, reduced unplanned attendances to Emergency Departments and fewer ambulance callouts and trips to hospital, noting there are several factors that may have contributed to these changes.
The report recommends, supporting NHS 24 to reduce call waiting times calls, improving the availability and capacity of alternative services available via flow navigation centres– which direct people to the most appropriate service for their health and care needs- and continuing to provide public messaging on when to call 111.
The Scottish Government is working with boards to drive improvements in how health care services are accessed.
Health Secretary Neil Gray said: “I welcome this report which gives us some valuable insight into how we can improve the way the health service manages demand for urgent care services.
“We know there is still work to do, but it is encouraging that this evaluation found patient experience of the Redesign of Urgent Care was largely positive, and that people given appointments experienced shorter waits. I thank all the staff involved in this important piece of work.
“Work is already underway to implement the recommendations of this report, including increasing staff numbers at NHS 24. This winter there are a record number of NHS 24 call handlers available to direct people to the most appropriate care, helping reduce unnecessary A&E attendances.
“Our Right Care Right Place campaign, launched ahead of winter, is continuing to give guidance to the public on the best way to access services, and I thank everyone who is following that advice.
“The Scottish Government’s draft Budget, if passed by parliament, will provide a record £21 billion for health and social care, including £200 million to reduce waiting lists and improve capacity further.
“All of this will help to improve the flow of patients through hospital, and reduce pressures on urgent care. I urge parliament to back the Budget Bill.”
Sustainable reusable theatre caps made from plant-based material created for NHS Scotland
The Golden Jubilee University National Hospital has become the first hospital to co-design friendly and reusable theatre caps made from sustainable plant-based material as part of a research project being led by the University of Strathclyde and Heriot-Watt University.
The project aims to reduce waste created by single-use disposable theatre cap products used by NHS Scotland while alleviating patient anxiety and improving the identification of theatre staff roles.
Around 800,000 single-use disposable theatre caps are consumed every year in Scottish hospitals. The new caps are made from cellulosic fibre which is derived from plant-based material. They offer a sustainable alternative to traditional disposable options.
At the end of their lifecycle, the new reusable theatre caps will be biodegradable, reducing the environmental impact of medical waste. Some existing single use theatre caps contain materials that can take up to 300 years to decompose entirely.
Beyond their eco-friendly credentials, the theatre caps serve multiple practical purposes. They aim to relieve anxiety among patients, through the use of fabric colours and patterns and help staff to more easily identify each other in busy clinical environments, which is beneficial for patient care. Current headwear doesn’t differentiate between different roles in hospitals.
The theatre caps have been carefully designed with input from NHS Golden Jubilee theatre staff to ensure they meet practical needs while maintaining sustainability goals. Staff will now test and feedback on the innovative caps to assess their potential for wider adoption across NHS Scotland.
The theatre cap project is part of the broader Design HOPES project (Healthy Organisations in a Place-based Ecosystem, Scotland) which is led by Professor Paul Rodgers at the University of Strathclyde and Professor Mel Woods at the University of Dundee.
Design HOPES was recently awarded more than £4.6M by the Arts and Humanities Research Council (AHRC) as one of four Green Transition Ecosystem (GTE) Hubs in the UK, which aim to address distinct challenges posed by the climate crisis including, but not limited to, realising net zero goals.
Dr Euan Winton, Assistant Professor of Design at Heriot-Watt University, commented on the urgent need for innovations like the new theatre caps:
“NHS Scotland faces massive resource-driven issues, with millions of single-use disposable theatre caps going to incineration in Scotland annually. The new sustainable theatre caps represent a crucial step in addressing this significant wastage and demonstrating the power of design in tackling environmental challenges in healthcare.
“Our specialist School of Textiles and Design in the Scottish Borders is proud to be part of the Design HOPES GTE Hub tackling a broad range of global challenges, using our expertise to find new and innovative solutions to sustainability.
“Along with Professor Paul Rodgers of the University of Strathclyde, we are working closely with user groups to create new products that are fit for purpose.
“We’ve worked closely with theatre staff on the design of the new caps and feedback has shown they will have other benefits like reducing anxiety among patients.”
Carole Anderson, Director of Transformation, Strategy, Planning and Performance at NHS Golden Jubilee, expressed enthusiasm for the project:“NHS Golden Jubilee is proud to be at the forefront of this sustainable innovation in healthcare.
“These new theatre caps align with our commitment to reducing our environmental impact and also enhance our ability to provide safe and high quality patient care. By improving staff identification and potentially easing patient anxiety, these caps offer multiple benefits beyond their eco-friendly design.”
Professor Paul Rodgers from the University of Strathclyde’s Department of Design, Manufacturing and Engineering Management, said:“Working closely with our NHS Scotland partners, we will continue to support them on their green transition journey, developing collaboratively design-led solutions that will create positive change.
“This project showcases the power of collaboration between universities, healthcare providers, and design researchers. By bringing together expertise from various fields, we’ve been able to create a solution that is both practical and sustainable. Moreover, this project has potential for creating new green jobs across Scotland that will have socio-economic as well as environmental impact.
“The success of this project opens the door for further design-led innovations in health and social care. As we continue to face the realities of climate change, it’s crucial that we find creative ways to reduce our environmental footprint while maintaining and improving the quality of care. The new reusable theatre caps are a significant step in that direction.”
Dr Lisa Macintyre, Associate Professor in Textile Technology at Heriot-Watt’s School of Textiles and Design added:“The caps have been carefully developed at our facilities to establish the most sustainable and comfortable materials and most efficient printing methods.
“We will be ensuring they meet the high standards required for medical use while maintaining their eco-friendly properties.”
Design HOPES forms part of the wider Future Observatory programme, which fosters collaboration, research, and innovation within the design field. Funded by AHRC in partnership with Future Observatory at the Design Museum, the £25m multimodal investment aims to bring design researchers, universities, and businesses together to catalyse the transition to net zero and a green economy.
Design HOPES will present a new work-in-progress display, running at the V&A Dundee from 6 December 2024 to 17 February 2025.
This display marks an exciting milestone in the first year of Design HOPES, giving an insight on the people, processes and progress of this transformational initiative, and asks ‘How can design help us live healthier lives, for people and planet?’
The Royal College of Emergency Medicine has joined calls for the Scottish government to address ‘delayed hospital discharges’ in the upcoming budget announcement.
Delayed discharges are when people are considered medically fit enough to leave hospital but are unable to, often because the required social care support is not available.
This issue means that the whole system for admitting people grinds to a halt and people can end up stranded in A&Es often waiting hours and even days for a ward bed to become available.
The latest data release comes as the Auditor General of Scotland published a damning report into the state of the Scottish health system which concluded that the Scottish Government has no clear plan to reform the country’s NHS, or to address pressures on the service.
Auditors found:
commitments to reducing waiting lists and times have not been met
the number of people remaining in hospital because their discharge has been delayed is the highest on record
and NHS initiatives to improve productivity and patient outcomes have yet to have an impact and lack clear progress reporting.
The issue of delayed discharges has also been highlighted by the Royal College of Physicians Edinburgh (RCPE) which has written an open letter to the First Minister calling on him to address this ‘urgent issue’ in his Government’s budget which will be unveiled tomorrow (4 December 2024).
Dr Fiona Hunter, The Royal College of Emergency Medicine’s Vice Chair for Scotland said yesterday: “Delayed discharges are a key reason that patients get stuck in Emergency Departments, often on trolleys in corridors – often experiencing extreme waits which are dangerous.
“So we join, and fully support, the calls from RCPE, and the Auditor General to address this issue. It must be prioritised as a matter of urgency.
“Today’s data is another timely reminder of scale of the issue. Just think about what it shows. More than 2,000 people every single day stranded in in hospital when they are well enough to go home.
“People – through no fault of their own, lying in beds which could be used for other patients who need to be admitted – who themselves are probably on a trolley in the Emergency Department, waiting for that bed to become available.
“We have to be able to move patients through our hospitals and out again when they are well enough. To do that takes a functioning and resourced social care system working alongside a functioning and resourced health system. They are inextricable.
Dr. Hunter concluded:“Tomorrow’s budget is an opportunity for the Government to #ResuscitateEmergencyCare, ahead of the depths of winter which is shaping up to be a gruelling several months ahead, for both patients and staff alike. They must take it.”
The Scottish Government needs a delivery plan that clearly explains to the public how it will reform the NHS and address the pressures on services.
Despite increasing funding and staffing, the NHS in Scotland is still seeing fewer patients than before the Covid-19 pandemic.
Auditors found that:
commitments to reducing waiting lists and times have not been met
the number of people remaining in hospital because their discharge has been delayed is the highest on record
and NHS initiatives to improve productivity and patient outcomes have yet to have an impact and lack clear progress reporting.
Health accounts for about 40 per cent of the Scottish budget. Funding grew again in 2023/24 but has mostly been used to cover pay commitments and inflation. Costs are forecast to continue rising and making savings remains challenging. Work to build new healthcare facilities also remains paused.
The Scottish Government’s restated vision for health and social care is not clear on how these operational pressures on the NHS will be addressed or how reform will be prioritised. It needs to work with NHS staff, partners and the public to set out a clear delivery plan and make tough decisions about how it may change or potentially even stop some services.
Stephen Boyle, Auditor General for Scotland, said: “To safeguard the NHS, a fundamental change in how services are provided remains urgent. The Scottish Government needs to set out clearly to the public and the health service how it will deliver reform, including how progress will be measured and monitored.
“Difficult decisions are needed about making services more efficient or, potentially, withdrawing those services with more limited clinical value to allow funding to be re-directed. Taking those steps will require greater leadership from Scottish Government and NHS leaders than we’ve seen to date.”
Funding to help practices retain and recruit key staff
An additional £13.6 million will be invested in General Practice this financial year to support GPs to retain and recruit key staff, Health Secretary Neil Gray has announced.
Speaking at the annual conference of BMA Scotland’s Local Medical Committees, Mr Gray confirmed the immediate funding for 2024-25 will address known financial pressures, support staff costs and enable GPs to take on partners and salaried GP staff.
Mr Gray said: “I recognise the significant financial and workload challenges facing both the NHS as a whole and General Practice, especially during this period of high demand, and understand the significant strain this places on GPs.
“My focus remains firmly on finding ways to recruit more GPs, even within the constraints of the current financial climate, and that is why I am allocating an additional £13.6 million for General Practice this financial year to support staff costs. This additional funding will help GPs to underpin business decisions and provide high-quality patient care.
“Sustainable reform of the NHS means we must look to shift more care to primary and community care with a relentless focus on better outcomes for people.
The Scottish Government reform programme will develop the means to credibly restore, and further increase GP and wider primary care spend, within the overall health budget.
“This will be a long-term endeavour but this strategic shift is crucial. Our reform plans over the next period will look to explore this in partnership with key stakeholders including the GP profession.”
Addressing the separate issue of next year’s UK National Insurance contribution increases, Mr Gray added: “The UK Government’s decision to increase national insurance contributions will have a major financial impact on GPs.
“I have been very clear that this is completely unacceptable and the UK Government must fully cover the costs. Scotland’s GPs should not be paying the price for UK Government decisions.”
The Scottish Budget for 2025-26 will be published on 4 December.
An awareness campaign is underway to ensure people know the best place to access healthcare this winter.
Right Care Right Place helps the public decide the most appropriate service for their healthcare needs – whether they should contact their GP or pharmacy, call NHS 24 on 111 or use self-help guides on the NHS Inform website. Hospital emergency departments should only be visited for critical emergencies.
The campaign features targeted advertising on television, radio and online and aims to help alleviate pressures on the NHS and social care ahead of an expected seasonal increase in demand.
Health Secretary Neil Gray visited East Lothian Community Hospital to hear about work being undertaken to address delayed discharges. The hospital supports patients leaving acute hospitals who require intermediate care before returning home.
Mr Gray said: “We have been working closely with colleagues across the NHS and social care to make sure we are as prepared as possible ahead of winter.
“Public information and awareness of the treatment options and how to access them when needed is key to ensuring services are directed where they are most needed.
“This will help everyone to get the right care, in the right place as quickly as possible while helping alleviate pressures on the rest of the NHS. People can also help by making sure they receive their Respiratory Syncytial Virus (RSV), Covid-19 and flu vaccinations if eligible.”
Self-help guides can be found on NHS inform and include advice on the most common winter illnesses.
