The Urgent and Unscheduled Care Collaborative: An Essential Guide

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Frequently Asked Questions on the Unscheduled Care Collaborative

When was the National Urgent and Unscheduled Care Collaborative formed?

The new national Integrated Urgent and Unscheduled Care Collaborative was launched in June 2022. It retains focus on reducing emergency attendances and unscheduled admissions by developing alternative ways to care for people at home or in the community.

What is the aim of the Collaborative?

Since its creation, the national Unscheduled Care Programme has facilitated change, using a ‘collaborative improvement methodology’ and working closely with senior leaders across the whole system. This is to optimise the delivery of unscheduled care and ultimately improve health outcomes. Throughout, the national programme has retained a clear vision, delivery of the 4-hour Emergency Access Standard in acute settings, which is still seen as a barometer of safe and timely care, and whole-system effectiveness.

What is the 4-hour Emergency Access Standard and why is it important?

The 4-hour Standard for the majority of clinicians in Scotland remains a priority and is grounded in patient safety. The standard of 98% (95% target) of people admitted, discharged or transferred within 4 hours, is reliant on a whole system response with its delivery predicated on reducing variation in attendances, reducing admissions, reducing length of stay and increasing discharges, to ensure a balance between capacity and demand each and every day. However, it has never been more important to recognise that Urgent and Unscheduled Care requires a whole system approach and embrace the opportunities this brings.

Is there a distinction between the National Unscheduled Care programme and the Collaborative?

Yes. For the first time, this programme now brings together the wider health and social care system in a truly integrated and collaborative way building upon our firm foundations.  In line with the vision of the Care and Wellbeing portfolio, this new collaborative will facilitate change and improvement across a number of ‘horizons’, refocusing efforts on a few high impact levers for change in order to deliver some resilience ahead of winter, while developing new pathways and models of care from a patient and ‘place-based’ perspective focused on people, not hospitals, over the next 2 years.

In what other ways has the current context influenced The Collaborative?

Public research through the Healthcare Improvement Scotland Citizens Panel has also shown that people are receptive to continuing to access care and support in new ways. We need to be really mindful that the COVID-19 pandemic has brought health inequalities that exist in accessing care and prevention into sharp focus.  It is fundamental that we deliver a service that meets the needs of everyone, particularly those most in need, therefore preventing inequalities is the ‘golden thread’ that runs through all the whole collaborative programme.

Is there an ethos in the National Collaborative to support Boards and HSCPs?

Overall, the approach will remain a facilitative one, centred around working together to develop, test and share best practice across the country.  At the heart of this new Collaborative, is taking what we know works well, developing the evidence base, testing, and helping NHS Boards to adapt and adopt, considering local nuance.