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.
Medical equipment and supplies will be sent from Scotland to Ukraine.
The shipment of over 500 items includes oxygen concentrators, electric height-adjustable beds with replacement batteries and mattresses, and ICU ventilators identified by NHS Scotland as surplus to operational requirements
The donation will not impact on services to patients using the healthcare services in Scotland.
It brings the total value of medical supplies donated from Scotland to Ukraine to £3.8 million.
First Minister John Swinney confirmed the latest donation during a meeting with the Ukrainian Ambassador to the UK General Valerii Zaluzhnyi in London. It follows a request from the Ukrainian Consulate in Edinburgh in May 2024 to contribute medical equipment on a humanitarian basis.
The First Minister said: “The people of Ukraine are suffering as a consequence of the illegal invasion of their country, and it is vital we do all we can to support them.
“These supplies, identified by NHS Scotland as being surplus to requirements, will provide direct humanitarian support to Ukraine at a critical time.
“Scotland stands in solidarity with Ukraine and offers unqualified support for its independence, sovereignty and territorial integrity.”
Ambassador of Ukraine to the United Kingdom General Valerii Zaluzhnyi said: “The act of generosity and solidarity demonstrated by NHS Scotland in extending a helping hand to Ukraine in its time of need exemplifies the true spirit of humanity and compassion.
“It serves as a powerful reminder that, in the face of adversity, solidarity and cooperation can transcend borders and make a meaningful impact on the lives of those in war. The Ukrainian people are deeply grateful for the support and assistance provided by NHS Scotland, knowing that these supplies will make a difference between life and death for many.
“The bonds of friendship and solidarity forged through this act of kindness will not be forgotten and will serve as a beacon of hope for a brighter future beyond the shadows of Russia’s war against Ukraine.”
Agenda for Change pay offer accepted by trade unions
Almost 170,000 nurses and healthcare workers in Scotland will receive a 5.5% salary increase this year, ensuring they have the best reward package in the UK.
Unions representing NHS Agenda for Change staff – which includes nurses, midwives, paramedics, allied health professionals, porters and others – unanimously agreed to an investment of more than £448 million for improved pay conditions.
The pay rise, backdated to 1 April 2024, will come into effect from next month.
Health Secretary Neil Gray said: “I am pleased that trade unions have unanimously agreed to accept this pay offer, which ensures that nurses and healthcare staff in Scotland, who are part of Agenda for Change, will have the best reward package in the UK.
“I want to express my thanks again to Scotland’s hardworking healthcare staff for the care they provide to patients, day in, day out. They are the very backbone of the NHS and we are committed to ensuring they feel supported and valued.”
