The Scottish Government has unveiled an ambitious new plan to transform how healthcare is delivered across Scotland, with a greater emphasis on community services and care delivered in patients' homes.
The new Health and Care Improving Flow Plan sets out a programme of immediate, medium and long-term reforms designed to improve access to care, reduce pressures on hospitals and help people live healthier, more independent lives.
Under the proposals, hospitals will increasingly focus on emergency, specialist and life-threatening care, while more routine treatment, assessments and preventative support will be provided within local communities.
A central goal of the plan is ensuring patients can access the right care at the right time, reducing unnecessary hospital admissions and improving patient experiences across the health and care system.
Key commitments include:
- Introducing an enhanced urgent care triage system supported by new Integrated Navigation Centres delivered jointly by NHS 24, the Scottish Ambulance Service and Health Boards.
- Expanding same-day care services, enabling more patients to receive diagnostic tests and specialist assessments without requiring an overnight hospital stay.
- Providing patients with a planned discharge date on their first day in hospital, with most expected to leave within three days where clinically appropriate.
- Removing barriers to weekend discharges to improve patient flow.
- Intensifying efforts to eliminate corridor care, which ministers say is unacceptable.
- Expanding Hospital at Home services to support more than 10,000 patients during the coming winter period.
- Building on existing GP walk-in services, healthy heart and lung checks, and mental health hubs to create integrated community health and care hubs.
- Implementing the Discharge Without Delay approach across all health boards this winter, including expanded use of Acute Frailty Units.
The strategy reflects a wider shift towards preventative and community-based healthcare, providing patients with more opportunities to access treatment and support without attending hospital.
Services such as pharmacies, community diagnostic checks and local healthcare hubs are expected to play a significantly larger role in meeting healthcare demand.
However, ministers acknowledge that some patients may need to travel further to access highly specialised services where concentrating expertise can deliver better outcomes.
Scottish Health Secretary Angela Constance said:
“At its heart, improving hospital flow is not about targets, processes or organisational structures. It is about people and ensuring they can access the care they need, when and where they need it.
“Our plan will help people access more care at their fingertips, in their homes and in their communities and these reforms are designed to support them to live healthier, more independent lives.
“While more care will be offered closer to home, via pharmacies, community-based hubs such as GP walk-in services and healthy heart and lung checks, some people may need to travel further to receive the most highly specialised care.
“Where people are experiencing a life-threatening emergency or requiring acute care, they will continue to be cared for in a hospital setting that prioritises dignity, privacy and experience.
“We are asking people to take an active role in maintaining their health and wellbeing and to use services appropriately, only calling 999 in emergency situations where they feel they have to go to A&E and dialling 111 for non-emergencies.
“We will continue to evaluate how this Plan is being implemented. Where services are performing well, we’ll support learning by spreading good practice. Where it falls short, we will provide support and, if necessary, take decisive action to improve outcomes for patients and communities.”
The reforms represent one of the most significant shifts in Scotland's healthcare delivery model in recent years. By moving more care into communities and patients' homes, the Scottish Government hopes to improve outcomes, reduce delayed discharges, ease pressure on acute hospitals and create a more sustainable health and care system for the future.
As implementation begins, healthcare leaders will be closely monitoring whether the changes can improve patient flow while maintaining quality, safety and access across Scotland's NHS services.
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