The Scottish Government is to provide local health boards across Scotland with an additional £8.4million to tackle issues over the winter period and in particular Christmas and New Year.

The total investment for health and social care services to deal with winter pressures and unscheduled care will now be a record high of £22.4 million this year.

The additional funding is in response to  “Improving Health and Social Care Service Resilience over Public Holidays” (Reslience Over Public Holidays)

Lewis D Ritchie chair of the reporting group states:

“There is ample evidence to confirm that there are significant additional pressures on health and social care services over public holiday periods. This includes both in-hours and out of hours (OOH) services, Accident & Emergency (A&E) services, acute and community hospitals, primary and social care services, NHS 24 and the Scottish Ambulance Service (SAS).

“These pressures are particularly pressing during prolonged public holiday periods – during the Christmas and Easter festivals. They include: reduced or lack of availability of some services, resulting in additional challenges and pressures, ultimately impacting on overall patient and staff experience.”

“The leadership role of Integration Authorities is of pivotal importance, in concert with Health Boards and other partners, including professional organisations, the Third Sector and Scottish Government.”

“During public holidays, those who provide health and social care services, forego the company of family and friends in order to help others. Getting urgent and emergency care right is of paramount importance for the people of Scotland and for those who provide care for them.

“Significant progress is already underway – however, further rapid and cohesive whole system action is essential. We will need to do this with resolve, to do this well, and to do this together.”

Key messages from the Report:

• Promote community pharmacies as a key resource for supporting self-care and to allow better urgent access to medicines

• NHS 24 should provide enhanced support for:
– self-management, where appropriate
– direction to attend and receive the right care service, where needed

• Develop quality assured integrated local crisis services for people with mental health difficulties, if not already in place

• Ensure that sufficient levels and numbers of senior decision makers from all sectors are duty rostered at all times

• Implement timely and continuous access to local infrastructure services within hospitals – including staff duty rotas, pharmacy, information technology, equipment stores and transport

• Instigate proactive discharge planning before public holidays

• Enable clear and timely social care support arrangements for hospitals, care homes and other community based services

• Improve arrangements for enhancing staff uptake of seasonal influenza (flu) vaccine – as well as promoting better uptake in population target groups 10

• Develop and evaluate timely, integrated health and social care urgent care resilience plans on a 24/7, 365 day basis – including winter planning arrangements

• Ensure that partnership and professional organisations are fully engaged in the design and delivery of all planned changes to the workforce

• Ensure that developing national social and primary care workforce plans fully consider the recommendations in this review – including sustainable resourcing

Shona Robison

Shona Robison, Health Secretary in the Scottish Government said:

“We expect challenges over winter and NHS boards are coping well with the demands placed on them so far. Thousands of NHS, social care, independent and third sector staff work extremely hard on public holidays and throughout the year, providing a lifeline of care and support to patients across Scotland.

The review found that demand for the Scottish Ambulance Service is  high over the festive period and particularly on News Year’s Day.   For those receiving home care the importance of workforce planning to ensure there are sufficient staff in place  was stressed.

Also highlighted was the need for good communication to avoid confusion across and between services.

It recommended that closer working is required between mental health and primary care out-of-hour services.

David Chung, Vice-President Royal College of Emergency Medicine Scotland (RCEM) said:

“RCEM Scotland would like to thank Scottish Government for its willingness to acknowledge, and attempt to moderate the effects of public holidays on health and social care in Scotland.

“This exercise has only been possible through the combined efforts of many collaborating to provide guidance for the system, and we are grateful to everyone for engaging and giving their time and expertise to this issue. We hope it will be one of many such collaborative efforts to provide the best health and social care for Scotland in times to come.”

Local Boards have already implemented many of the recommendations.

Parents of 2-5 year olds across Scotland are also being encouraged to take advantage of the free flu vaccine available from their local GP  in a bid to protect children from the virus this winter.

Reporter: Fiona Grahame