Improving health and social care service resilience over public holidays: report

Chairman’s Foreword

This Public Holiday Review Report has been prepared in response to the request to review the resilience of health and social care services over public holidays and in particular, the Christmas and Easter Festive periods. We took account of a number of recent Scottish Government policy documents and reviews including: the Primary Care Out of Hours Review, ^[1] the Health and Social Care Delivery Plan ^[2] and National Workforce Planning developments. ^[3] We offer Key Messages in Section 1 and describe our remit and review process in Section 2. As part of our open review process, we have already shared our emerging findings with the service. These findings have been incorporated into winter planning arrangements for 2017-18. ^[4]

There is ample evidence to confirm that there are significant additional pressures on health and social care services over public holiday periods, which is illustrated in Section 3. This includes both in-hours and out of hours ( OOH) services, Accident & Emergency (A&E) services, acute and community hospitals, primary and social care services, NHS 24 and the Scottish Ambulance Service ( SAS). These pressures are particularly pressing during prolonged public holiday periods – during the Christmas and Easter festivals. They include: reduced or lack of availability of some services, resulting in additional challenges and pressures, ultimately impacting on overall patient and staff experience.

The introduction of health and social care integration provides the obligation and opportunity to transform health and social care services, taking justifiable local variation into account.

Resilience planning must be transformed across the whole spectrum of health and social care service provision in Scotland, both in and out of hours. This is a pressing matter that needs to be dealt with sustainably and coordinated effectively. To optimise ‘joined up’ care services, we looked at current care models and processes, in order to promulgate best practice, to improve pathways of care and to promote care innovation.

Services must be mapped onto the specific needs of individual communities and localities. Going forward, the leadership role of Integration Authorities is of pivotal importance, in concert with Health Boards and other partners, including professional organisations, the Third Sector and Scottish Government.

Acknowledgments: The Public Holiday Review process has brought together a large group of health and social care professionals, representatives of the third and independent sectors and the public. Members of the Review are listed in Appendix 1, including organisations represented. Colleagues contributed with commitment and enthusiasm throughout and have consulted widely with their peer groups, developing a range of shared and specific recommendations, listed in Section 7 and Appendix 2. I am indebted to all who participated in the Public Holiday Review, and I am particularly grateful to the programme support team for their sterling work throughout.

In conclusion, the Review Group believes that the recommendations offered - implemented well and monitored effectively - will enhance resilience over public holiday periods, but also will contribute to 24/7, 365 days a year service sustainability.

During public holidays, those who provide health and social care services, forego the company of family and friends in order to help others. Getting urgent and emergency care right is of paramount importance for the people of Scotland and for those who provide care for them. Significant progress is already underway – however, further rapid and cohesive whole system action is essential. We will need to do this with resolve, to do this well, and to do this together.

Lewis D Ritchie

Chairman, Public Holiday Review