Priority 6 - National Unscheduled Care Programme
Support Boards to improve urgent and unscheduled care provision. This includes identifying best practice, supporting innovation, and transitioning established improvements to business as usual.
Responsible Team: National Unscheduled Care Programme
Strategic Planning and Board Discovery
Following the transition from the Scottish Government to CfSD, the Programme Team identified 5 initial portfolios that cover the key priorities the Programme will focus on. These portfolios cover Community Urgent Care, Flow Navigation, Hospital at Home, Front Door Flow, and Optimising Flow. (See below for more details about the specific portfolio actions undertaken.)
As part of the initial strategic planning process, the Programme arranged a series of Board “discovery days” that were used to gain initial insights into the new portfolio areas. The Programme then arranged a series of debriefing sessions to identify and agree specific areas where Boards would benefit from support and targeted improvement.
The outputs from this work included the development of Heat Maps for the 5 portfolio areas. These Heat Maps set out the current optimal model for service delivery, including services, processes and other features observed within high-performing Boards. This work, along with the development of portfolio-specific insights matrices, and driver diagrams will inform future improvement work. This work will continue into next year.
Community Urgent Care
The Community Care team commenced a series of care home visits across Scotland to help understand and map current service delivery. In addition, the team are carrying out scoping work to develop a national matrix of urgent care pathways. This work will continue into next year.
Flow Navigation Centre
A new Flow Navigation Specialty Delivery Group (SDG) has been formed, and several meetings have been held over the year. This has included work to optimise existing FNC services and develop priority urgent care pathways. In addition, a new SDG subgroup has been formed which will act as an advisory group for the development of new national pathways.
The team have also carried out work to develop data collection processes and common definitions. This work will help create a baseline for future monitoring, reporting, improvement activity and quality assurance. This work will continue into next year. The team are also developing key performance indicators (KPIs) to help assess flow navigation system activity across each Board.
Hospital at Home
The team are currently in the process of forming an SDG to focus on Outpatient Parenteral Antibiotic Therapy (OPAT). This group will initially focus on formulating an optimal hospital-at-home model for OPAT, and will then develop the necessary guidance to support implementation of this model.
Front Door Medicine
The team are currently in the process of forming a Front Door Flow SDG to support their work and provide clinical leadership and advice. As an initial priority, the SDG will help Boards implement Front Door models aligned to local Board improvement plans and national guidance.
Development of the SDG is at an early stage, and the team are currently identifying suitable members for the group, and are drafting terms of reference. The SDG will be formally launched next year.
Optimising Flow
The team are currently in the process of developing a national Whole System Operating Framework. This will help to standardise escalation practices in Boards when they do not have enough local capacity.
In addition, the team are also modernising the existing Day of Care Audit (DOCA) process and implementing new methods to help Boards carry out this work. This includes the development of a new electronic app to support data collection.