A letter from Helen Maitland

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A letter from the National Urgent and Unscheduled Director

Helen Maitland

In setting out the national Urgent and Unscheduled Care strategic direction, I’d like to take a moment to acknowledge the scale and pace of work across NHS Scotland in the most challenging of circumstances over the last few years.

COVID-19 changed the way we work, the way the public access services, and how we deliver care. It accelerated the pace and scale of innovation across NHSScotland and this is something we want to hold onto while we work together to build future models of care which better meet the changing demands in healthcare.

Over the last 2 years, the focus of the national Unscheduled Care Programme has been on reducing emergency attendances and unscheduled admissions by developing alternative ways to care for people at home or in the community. Our principle aim of ‘Right Care, Right Place’ has never felt more important as we move from a period of recovery into building resilience and shaping the future.

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, 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.

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.

For the first time, this programme brings together the wider health and social care system in a truly integrated, 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 ‘placebased’ perspective focused on people, not hospitals, over the next 2 years.

Throughout the programme we will engage with the Scottish Approach to Service Design to ensure people are at the heart of what comes next. We will continue to engage and collaborate widely as we welcome in the future of the Urgent and Unscheduled Care in NHSScotland, as this critical national collaborative programme works towards delivering the Right Care in the Right Place for Every Person Every Time.

In the Service of Scotland.

Helen Maitland

National Urgent and Unscheduled Care Director

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