Unscheduled Care Work Plan
Strategic Priority 3
Define best practice in key areas within Unscheduled Care (UC) and support Boards to improve the patient and staff experience and the timeliness and safety of patient care
Strategic Programme Development
Create a clear evidence basis for improvement planning, including identifying the most significant correlations with performance in each Board and setting out where there is greatest variation and therefore opportunity.
Engage with Clinical Leaders to increase understanding of the challenges and opportunities seen by front line teams.
Support the triangulation of strategic sponsorship with clinical and operational leadership to ensure that strategy is translated into actionable and sustainable change.
Set national definitions and minimum standards for core areas impacting on Unscheduled Care through Strategic Delivery Groups with clinical and operational representative experts.
Shape detailed operational change plans to deliver improvement aims aligned to best-practice recommendations from SDGs and leverage-point improvement plans.
Engage with operational delivery networks who will drive improvement in Boards.
Provide strategic, modelling, and impact advice to SG Policy colleagues to support development of national unscheduled care strategy.
Revise the Measurement Framework in line with the leverage points to model and monitor the impact of improvement activity.
Portfolio Workstreams
Support SDGs to provide recommendations around priority actions and changes.
Boards will be expected to implement these actions through their own local governance structures and improvement teams.
The specific projects that will be implemented over the year are still to be agreed. However the key areas of focus are expected to be:
Community Urgent Care
Continue to develop a map of services and sectors that can help support community urgent care.
Continue to establish a national matrix for frailty, falls, and end of life services within community urgent care.
Develop Health Board and Health and Social Care Partnership (HSCP) work plans to implement the care home optimal model.
Develop a national matrix of urgent care pathways for care home residents including rapid response, admission prevention, falls/frailty and end of Life Care.
Develop exemplar models of care home access to urgent care.
Flow Navigation
Ensure nationally consistent and standardised Board reporting of Flow Navigation Centre (FN) data.
Optimise existing flow navigation services and develop priority urgent care pathways.
Develop early care home support with a direct link to local Flow Navigation centres.
Spread and further develop the use of the Professional-2-Professional advice and ambulance service communication pathways.
Promote the use of Near Me for flow navigation virtual consultations.
Promote awareness of urgent care pathways to relevant staff across NHS Scotland.
Support the ongoing development of the flow navigation dashboard.
Develop flow navigation performance monitoring and patient experience reporting.
Develop Urgent care outward pathways for patients referred to flow navigation centres.
Identify opportunities to increase ability to schedule patients into planned appointments.
Hospital at home (H@H)
Establish new SDG / governance routes for Outpatient Parenteral Antibiotic Therapy (OPAT) and Respiratory.
Review OPAT and Respiratory optimal models and pathway guidance.
Implement OPAT hospital at home pathways as business as usual across NHS Scotland.
Implement Respiratory hospital at home pathways as business as usual across NHS Scotland.
Develop best practice toolkits and guidance for OPAT and Respiratory.
Retain connections with other hospital at home stakeholders to ensure alignment and synergy.
Establish cost benefit of OPAT model
Front Door Medicine
Map and assess use of enhanced triage models, Emergency Physician in Charge (EPIC) role, flow-co-ordinators and redirection or signposting for patients.
Develop a national matrix of Emergency Department (ED) pathways and processes.
Carry out scoping to identify optimal models of care for emergency department (ED) and Acute Medical Unit (AMU), with a particular focus on Acute Assessment Units, capacity and demand modelling, and frailty patients.
Develop and implement front door models aligned to local Board improvement plans and same day emergency medicine models.
Develop and implement optimal ED processes to support rapid decision making and streaming.
Optimising Flow
Coordinate the review of the National Day of Care Audits (DoCA) and other rapid tests of change based around the audit process.
Work with Boards to develop implementation plans based on audit outputs.
Support the facilitation and Board adoption of the DOCA process.
Share knowledge and best practice from DOCA and other audits.