Implementation of Agenda for Change recommendations
NHS Agenda for Change staff – including nurses, midwives, paramedics, allied health professionals, porters and others – will see a reduction of 30 minutes in their working week from 1st April this year.
The move follows a recommendation from a working group set up to implement a previous commitment to cut the number of working hours as part of the 2023/24 pay deal. It is one of a number of measures to modernise the NHS Scotland Agenda for Change system and has been agreed with trade unions.
If, due to service pressures, safe staffing or wellbeing issues, it is not possible for a staff member to receive their 30 minute reduction they will be recompensed accordingly, until such times as the reduction can be accommodated.
Other measures agreed include:
a consistent approach to Protected Learning Time across all NHS Scotland Boards, and
a defined process for undertaking a review of Band 5 nursing roles with any Band 5 nurse able to self-apply for a review of their role if they believe they meet the criteria.
The changes will support NHS Scotland workforce recruitment, sustainability and retention.
Health Secretary Neil Gray said: “Our Agenda for Change system recognises the value, dedication and hard work of our staff and makes NHS Scotland an employer of choice.
“We expect NHS Boards to work in partnership with trade unions and staff to reduce the working week. This presents an opportunity to modernise how staff are rostered and work, ensuring that NHS Scotland is a leader in flexible and family friendly working practices.
“I am grateful to both Trade Union and Employer representatives for working in partnership with us to develop these reforms to help modernise our service.”
UK patients want better access to early and accurate diagnosis of health problems, according to new survey data from the Patients Association.
Many patients would consider paying to get tests done privately if they faced a long wait for NHS tests.
Nine in ten (90%) of UK patients say it should be more straightforward to get the diagnostic tests they need
Three in five (60%) said they would be willing to pay to get a test done if they faced a long wait, or the test they needed was not available
More than three in five (61%) believed being able to test at home could help speed up diagnosis
Patients want to know how to get the tests they need, why they are having them, and when they can expect results.
The survey, undertaken in partnership with Roche Diagnostics UK and Ireland, represents the views of more than 1,000 patients from across the UK, who had received diagnostic support from the NHS in the preceding six months.
Nine out of ten (90%) of the people who completed the survey said it should be easier to obtain access to the diagnostic tests they need. They also wanted:
Better understanding of why they were being sent for a test
Increased speed and urgency
Improved access
A greater sense of empowerment when it comes to diagnostic tests, results, and subsequent treatment and care.
Access challenges
The findings demonstrated several challenges experienced by patients in gaining access to diagnostic tests.
One-third of respondents (33%) said when they tried to get a test, they found there were no appointments available locally. This reflects national data on the large numbers of patients unable to access diagnostic tests and services, even before consideration is given to any waiting lists for any treatment they may need.
Almost four in five (78%) patients felt testing facilities should be provided closer to patients’ homes to make access easier
Seven in ten (70%) wanted a clearer understanding of how to access tests. Some respondents highlighted that services are sometimes not available as advertised.
Speed and urgency of access to testing was another significant problem identified by survey. Only one in ten (11%) of respondent said they have never had any issues getting either a test or their results, or faced no consequences if they did.
For those living with long-term conditions, delays and difficulties in accessing diagnosis have had significant consequences. Nearly one in five (17%) respondents said their long-term recovery was set back significantly.
Many more reported consequences for their mental and physical health, and their wider work and family life.
Respondents were also unhappy about a lack of access to, and clear explanation of, test results. Almost nine in ten (88%) patients wanted a realistic timeline for their test results to come through and a similar number (87%) called for a better explanation of what those results meant for them and their treatment.
Patient-created solutions
The survey discovered patients are finding ways around the challenges they faced. For example, when asked whether they would be willing to pay to get a test done privately if they faced a long wait or if the test they needed was not available on the NHS, three in five (60%) of respondents said they would. This included patients who did not consider themselves to be ‘rich’.
The finding that so many patients would consider paying for tests shows the importance they place on getting a timely and accurate diagnosis, even if they had to pay.
Sustainable solutions
The survey’s results show many patients have a clear view on how diagnostic services in the UK could be improved.
Being able to test at home was seen as one way to make services more accessible. Nearly two thirds (61%) of respondents believed expanding opportunities to test at home could help speed up diagnosis.
When asked about specific examples, the numbers were even higher, perhaps building on our collective experience of testing at home during the COVID-19 pandemic. More than three quarters (77%) said they would be happy to test themselves at home.
Investing in diagnostics and new technology was supported by most respondents. For example, more than half (57%) the respondents felt the use of new technology such as artificial intelligence could speed up diagnosis and reduce pressures on the NHS – an important factor since nearly one-third (29%) said they delayed seeking tests to avoid wasting NHS time and resources.
Looking to the future
Almost nine in ten (86%) felt testing and diagnosing conditions more quickly would help reduce the NHS backlog. While patients want to feel more empowered in taking charge of their own health, they are also keen that solutions are sought to support NHS efficiency and sustainability in the longer-term.
Rachel Power, Chief Executive of the Patient Association, says:“Patients value diagnostic services – that’s very clear from the survey. Frustrations about access to tests came over loud and clear.
“Those taking the survey clearly value being partners in their care. And to partner with the professionals sending them for tests, patients need and want clear communication on how to get tests, why they need a test, and when they’ll get results. Healthcare professionals can improve patient-centred care when ordering diagnostic tests by explaining how, why and when.”
Geoff Twist, Managing Director, Roche Diagnostics, UK & Ireland says:“Tests that detect or diagnose disease early, or in some cases prevent it altogether, can play a vital role in the patient journey, and in helping the health system work efficiently.
“This report shows that patients themselves see and understand the importance of diagnostic tests, and that they will proactively seek them out to find the answers they need about their health.
“The message is clear. But to realise this we need a renewed policy focus, setting out how we can speed up getting existing diagnostic tests and innovations to the people who need them. Prioritising diagnostic services can help to relieve some of the pressure on our NHS today and protect it for generations to come.”
Health Secretary Michael Matheson met frontline A&E staff at the Royal Alexandra Hospital (RAH) in Paisley today to see first-hand how services are coping with peak winter demand.
Mr Matheson thanked teams for their ongoing efforts and met RAH staff working to keep the flow of patients moving through the hospital to help reduce pressures building up in the emergency department, and avoid people being delayed in hospital longer than necessary.
With hospitals across the country remaining extremely busy, Mr Matheson thanked the public for continuing to do their part to help ease pressure on A&E by considering if their condition is an emergency before attending.
Mr Matheson said: “Our health and care services are now dealing with peak winter demand. There is no doubt the situation remains very challenging so I am extremely grateful to all our highly skilled and committed NHS and social care staff for their continued hard work and dedication.
“The public have really played their part so far, by considering whether their condition is an emergency before going to A&E. To help relieve pressure on services it’s vital everyone continues to do that. Local GPs and pharmacies can be contacted during the day for non-critical care, NHS 24 is also available on 111 for non-emergencies, and the NHS Inform website is an invaluable resource.
“However, let me be clear – urgent care will always be available for those who need it. If someone needs emergency care they should call 999 or go straight to A&E.
“The NHS 24 service dealt with significant demand over Christmas and New Year and, although very challenging, the system handled the large volume of calls very well, which was down to all those involved in the implementation of months of pre-winter planning, which started in spring, to ensure services were available to those in need.
“I am especially grateful to those across health and social care who sacrificed their time and worked over the bank holidays.”
Mr Matheson remains under investigation by the Scottish Parliament’s Corporate Body over his explanation of £11,000 data roaming costs on his parliamentary i-Pad incurred during a family holiday.
As winter poses increasing demand on our healthcare system, NHSGGC is encouraging family members to help get their loved ones ‘Home for Lunch’.
Almost all patients that are ready to go home are discharged on the same day, but a number remain in hospital causing flow issues throughout the health care system.
Doctors are reminding families of patients who are ready to be discharged to help make the required arrangements to get them back to their own home or care setting, at the earliest opportunity.
NHS Greater Glasgow and Clyde ward staff and discharge teams work in parallel to create pathways for families to ensure that, when their loved ones are healthy enough to return home, they are supported in doing so.
As part of NHSGGC’s ABC winter campaign, the health board are attempting to ease pressure on our services and staff from the emergency department, through to patients being discharged.
Dr Scott Davidson, Deputy Medical Director for Acute Services, said: “Winter places increasing demands on our health care services and families play an important role in helping to ease those pressures.
“Our staff are working extremely hard to ensure we provide the best possible care for our patients and we are looking for your help to get loved ones home at the earliest opportunity.
“We do not want patients spending any longer than they need to within our hospitals and want people to be in the comfort of their own home, without the risks associated with lengthy hospital stays.
“I would like to thank families and members of the public who are doing their best to support our patients and staff as we continue to tackle winter pressures.”
If you suffer a strain, sprain, or suspected broken bone, wound, burn or other nasty injury this winter, you can be treated by one of our experts in the Minor Injuries Unit.
Call 111 to make an appointment or find more information:
If you’re looking for health advice this Hogmanay, please read this important information:
The 111 service is very busy today with almost 5000 calls already. This may mean a longer wait than usual for calls to be answered. Some mobile providers disconnect calls due to network capacity demand.
Here’s what you can do to help yourself, save time and help us care for those in the most need first.
Whether it is prescribed or non-prescribed medication, our guide to accessing medication can save you time. You might not need to call 111.
If you need general advice about seasonal ailments remember we have a lot of information on NHS inform, including a range of symptom checkers which you can use to help you decide what to do next: https://nhs24.info/symptom-checkers
The NHS 24 Online app also has handy health advice and can help you source your nearest open healthcare services, including pharmacies. The app is free to download on both iOS and Android devices. https://nhs24.info/NHS-24-Online
By using NHS resources wisely, we can keep well and get the care we need quickly, safely and as close to home as possible.
If you are using a mobile phone to call please switch to WiFi calling and ensure your device is charged. This should help to prevent your call being disconnected by a network provider.
NHS 24’s staff are working exceptionally hard to answer as many calls as we can, quickly and safely. Please be patient and we will answer. If you can try the above options first, it could save you time. We want to help you get the right care, in the right place.
If you suffer a strain, sprain, or suspected broken bone, wound, burn or other nasty injury this winter, you can be treated by one of our experts in the Minor Injuries Unit.
Call 111 to make an appointment or find more information:
‘We must not normalise crisis or celebrate small improvements – our patients and our members deserve more.’That is the response of the Royal College of Emergency Medicine to the latest A&E performance data.
Yesterday (14 December 2023) two sets of data published by NHS England, have been released: the latest Urgent and Emergency Care (UEC) Daily Situation Reports 2023-24 (also known as Winter Sitrep); and monthly A&E performance figures for November 2023.
While there have been some small signs of improvement in certain areas the overall situation remails extremely challenging with A&E departments declaring critical incidents this week, clinicians describing things as the worst they have experienced and ambulance chiefs expressing serious concerns about the pressure their service is under.
The most recent Winter UEC Sitrep data which covers the period 4-10 December 2023 paints a worrying picture with bed occupancy running dangerously high at almost 95% (the level considered ‘safe‘ is 85%) and two-thirds of ambulances not meeting the 15-minute target to hand over patients.
There was a small uplift in the number of beds available within hospitals, but these do not appear to have helped to ease pressure elsewhere in the system, and there remain thousands of patients, who are well enough to go home, but have not been discharged – occupying beds which are needed for other people.
The November performance data reveals that last month more than 144,000 people who visited an A&E within the month were there for more than 12 hours – the target is four hours.
Reacting to these figures, Dr Adrian Boyle, President of the Royal College of Emergency Medicine, said: “While the data suggest a marginal improvement compared to last year, it’s just deja-vu and we must not allow this permacrisis to become accepted as ‘normal’.
“Ambulances are queueing outside A&Es, Trusts are declaring critical incidents, patients are facing dangerously long waits in overcrowded and uncomfortable A&Es. Conditions are intense and difficult for staff, and the experience of patients is distressing and undignified.
“Clinicians are doing their very best, despite the circumstances, to deliver optimal and compassionate care, and mitigate any potential risks to patients but it is taking its toll on them too.
“It is welcome to see small increases in bed numbers, but it is not enough and patients continue to endure long waits.
“Significant and urgent action is required now to address these issues – this is what our members and their patients need and deserve.”
Data in detail:
The latest Urgent and Emergency Care Winter sitrep data for week ending 10 December (week 4 of publication for 2023/24) published today by NHS England show:
Bed occupancy levels at Trusts with a major A&E (Type 1 acute Trust) was 94.9%.
There were 99,497 beds open at Trusts with a major A&E, 1,521 more than the same week last year.
The Government promised that by winter 2023/24 there would be 5,000 more beds open when compared to October 2022 (97,287). For this week, there was an increase of 2,210 Type 1 beds compared with October 2022.
On average, one third of ambulance handovers involved a delay of over 30 minutes, while only one third of patients arriving at A&E were handed over within 15 minutes as per national guidance.
On average, 46,929 patients occupied a bed for more than seven days at a Trust with a major A&E.
On average, 384 beds were general and acute beds were occupied by patients with flu.
On average, 12,927 patients remained in hospital while no longer who were ready to be discharged.
There was an average of 49,020 daily staff absences at Trusts with a major A&E.
This is 7,547 fewer than the same week last year.
Published today (14 December 2023) by NHS England, the latest A&E performance figures for November 2023 show:
There were 1,385,701 attendances to major A&Es (Type 1 EDs) in November 2023. This is a 1.97% decrease compared with the previous month.
In November 2023, 144,085 patients waited 12-hours or more from their time of arrival. This accounts for 10.9% of all major A&E attendances in November. This means that more than one in 10 patients waited 12-hours or more.
The four-hour target at major A&Es stood at 55.4%, this is the fourth worst four-hour performance on record and the lowest so far in 2023.The aggregate four-hour target stood at 69.7%, the lowest so far in 2023. This is 6.3 percentage points lower than the Government’s intermediary threshold target of 76% to be hit by March 2024.
42,854 patients waited 12 hours or more from decision to admit (DTA) to admission. This is a 4% decrease when compared to the previous month. It is a 13.2% increase when compared with November 2022.
Beds data for October 2023 show bed occupancy stood at 94.8%.
Data show there were 98,844 Type 1 General & Acute beds available. This is an increase of 1,473 beds from October 2023 (97,371). And an increase of 1,636 beds from November 2022 (97,208).
Since it was announced in January 2023 that 5,000 new beds would be made available by winter 2023/24 compared with October 2022 (when there was 97,287 beds available), there has been an increase of 1,557 beds.
There were 396,755 emergency admissions at major A&Es. This is a 1.19% decrease since the previous month (401,523). This is the second highest number of admissions so far in 2023.
Victoria Atkins aims to make health and social care system faster, simpler and fairer for patients
Health and Social Care Secretary sets out intention to make the system faster, simpler and fairer for patients
Victoria Atkins thanks staff for a week of delivery, in which two manifesto commitments were met
Health and Social Care Secretary Victoria Atkins has thanked health, social care and research staff for delivering on patients’ priorities, as she set out her commitment to make the health and social care system faster, simpler and fairer for patients.
Her words came days after pharmacies across the country began offering new contraceptive services and additional blood pressure checks, and after a breakthrough in talks to end consultant strikes, which saw the British Medical Association Consultants committee agree to put an offer on contract reform to its members.
Health and Social Care Secretary, Victoria Atkins, said: “Since joining the department, I have been bowled over by the way health and social care staff just keep on delivering for patients. The important milestones we’ve reached this week – reaching 50,000 additional nurses and 50 million more GP appointments – demonstrate real progress.
“I have spent the past few weeks meeting doctors, nurses, GPs, pharmacists and other health workers and heard wonderful stories about how they have gone above and beyond to deliver outstanding care for patients and cut waiting lists.
“But I have also heard about their frustrations and where they feel they are not able to deliver the best possible care or where prevention or early intervention could have made a real difference. That is why I am committed to making health and social care services faster, simpler and fairer.
“We face a difficult winter ahead. And though our early winter planning is seeing some results we know there is much more to do. But having seen what our excellent staff can do I am confident that with the government’s support we can continue to deliver for patients over the coming months.”
The Health and Social Care Secretary has committed to making health and social care services:
Faster for patients, by making it easier to get treatment locally, improving A&E performance and cutting waiting lists
Simpler for patients, with joined up, integrated care, and simpler for staff, by reducing bureaucracy and giving them the latest technology to free up their time to care for patients
Fairer, ensuring children are protected from health harms, that health outcomes are not determined by where you live, that government supports older people to maintain their independence for longer, and that government delivers a more productive NHS that is fairer for taxpayers.
She added that she would continue to work with the NHS to manage the ongoing winter pressures. The government prepared for winter earlier than ever before and data released by the NHS on Thursday shows the government is making good progress.
Compared to the same time last year, ambulance handover delays have fallen by 28%, thousands more 111 calls are being answered within 60 seconds, and there were nearly 1,500 more hospital beds available.
The Secretary of State said: “We face a difficult winter ahead. And though our early winter planning is seeing some results we know there is much more to do.
“But having seen what our excellent staff can do I am confident that with the government’s support we can continue to deliver for patients over the coming months.”
The Health and Social Care Secretary was appointed on 13 November. She has now set out her priorities in a week in which the government and NHS hit a number of major delivery milestones:
NHS England data published on Thursday showed there were 51,245 additional nurses in September 2023 compared to 2019 – hitting the government’s manifesto commitment to recruit an additional 50,000 nurses six months early.
NHS England data also showed that for the year to October 2023, there were 51 million additional general practice appointments delivered when compared to October 2019, meeting another manifesto commitment.
On Monday the government announced that it had put forward an offer that will modernise the consultant contract and reform consultants’ pay structure, paving the way to end consultant strikes. The British Medical Association and Hospital Consultants and Specialists Association will put the deal to their memberships in the coming weeks.
On Wednesday the Secretary of State announced funding for a research project to evaluate the rollout of the hugely successful HIV opt-out testing programme to 46 new sites across England.
On Friday 1 December pharmacies across England began offering the new contraceptive services announced recently as part of Pharmacy First. This is part of the NHS and government’s Primary Care Recovery Plan, announced by the head of the NHS and the Prime Minister in May, which committed to making it quicker and easier for millions of people to access healthcare on their high street.
Latest data show that more than 4,000 patients faced 12-hour delays in Scottish A&Es as RCEM calls on the Scottish government to increase bed numbers and avoid ‘devastating winter’.
In September 2023, there were 113,864 attendances at major A&Es in Scotland.
66.50 % of patients were seen within four-hours at major A&Es (Type 1 EDs)
38,114 (33.5%) patients waited over four-hours in major Emergency Departments, this is a 1.7% increase from the previous month and a 2.3% decrease from September 2022.
This is a decrease of 1.4 percentage points from the previous month.
The number waiting more than four-hours has increased by 145.5% compared with September 2019 (15,526).
11,788 (10.4%) patients waited eight-hours or more in an Emergency Department
This is an increase of 1.1 percentage points from the previous month, and a 1.5 percentage point decrease compared with September 2022.
The number waiting more than eight-hours has increased by more than eight times (701%) compared with September 2019 (1471).
4263 (3.7%) patients waited more than 12-hours before being seen, admitted, discharged, or transferred.
This figure has increased by 0.4 percentage points from the previous month. And has decreased by 1 percentage point compared with September 2022.
The number waiting more than 12-hours has increased by 14 times (1307%) compared with 2019 (303).
There were 1,811 beds occupied due to delayed discharges, the second most for any September on record.
Commenting on these data, RCEM Scotland Vice President, Dr John-Paul Loughrey said:“As we head into winter, we expect many people to attend A&Es with a multitude of conditions and illnesses, and many of them will require admission to hospital for further care.
“It is vital that with this clear expectation comes the necessary winter planning to resource A&Es, and support both clinicians and their patients through the colder months.
“We are concerned that the Scottish government’s winter plan fell short of delivering what is needed ahead of what will likely be a difficult period for emergency care.
“We desperately need to see an increase in bed numbers. This will help to reduce the dangerously high levels of bed occupancy, reduce long and dangerous delays in A&Es, and help to ensure patients are admitted to a bed more promptly.
“We continue to engage with the Cabinet Secretary and his team in good faith and raise the concerns of our members.
“To avoid what could be a devastating winter, we again urge the Scottish government to heed our calls to adopt our priorities to #ResuscitateEmergencyCare.”
The data come as figures obtained through Freedom of Information requests revealed that nearly 4,000 people faced 24 hour waits in Scotland A&Es in the six months up to June this year.
As Dr Loughrey said: “24 hours in A&E belongs on TV, not in daily reality for patients and staff”.
If your call is related to medicines please visit
If you need general advice about seasonal ailments remember we have a lot of information on NHS inform, including a range of symptom checkers which you can use to help you decide what to do next: 
The NHS 24 Online app also has handy health advice and can help you source your nearest open healthcare services, including pharmacies. The app is free to download on both iOS and Android devices. 
By using NHS resources wisely, we can keep well and get the care we need quickly, safely and as close to home as possible.
