£9 million commitment to emergency care

Health boards across Scotland are sharing an additional £9 million this year for emergency departments, hospitals and primary and social care teams to get ready for winter.

The funding supports dedicated multi-disciplinary teams to improve patient flow in A&E, across the hospital and in the community.

By enhancing staffing cover over winter, providing the same level of discharging at weekends as midweek or providing treatment in the community, patients will get the best care in the most appropriate place, preventing unnecessary hospital admissions and freeing up beds and resources for those who need them most.

First Minister Nicola Sturgeon highlighted the funding during a visit to the Chronic Obstructive Pulmonary Disease (COPD) unit at the Royal Infirmary of Edinburgh (RIE). Respiratory illness is a key diagnosis in three of the top five A&E cases, accounting for 45,000 emergency bed days every year. Since 2013, the COPD unit at RIE has worked collaboratively to reduce the level of admissions and free up nearly 3,000 bed days.

A recently published review of last winter shows that, despite increased admissions across Scotland, A&E waiting times improved significantly and the number of people delayed from leaving hospital was reduced.

Nicola Sturgeon said:

“A&E attendances last winter increased, yet emergency departments consistently improved their performance. This is testament to the immensely hard work and dedication of our NHS staff and follows a three year, £50 million unscheduled care fund which supported boards to make changes.

“The additional £9 million for this year will ensure patients get the best treatment in the most appropriate place, easing pressure on our A&E departments and maximising patient flows within hospitals which face additional admission demands in winter.

“The approach taken here at the RIE to target respiratory illness - which is the most common factor in A&E presentations in winter - has freed up 3,000 emergency bed days and demonstrates the value of successful working across the health and social care system.

“With more and more people now living with long term conditions, and a growing number of older people with multiple and complex conditions, it is also vital that the NHS has robust preventative care plans. Winter guidance was issued to boards in August and health boards are now well advanced in their unscheduled care planning - putting them on the front foot to build on last year’s good performance and deal with additional pressures throughout the coming winter.”

Dr Gourab Choudhury, Consultant Respiratory Physician and COPD Clinical Lead at the Royal Infirmary of Edinburgh said:

“Chronic Obstructive Pulmonary Disease (COPD) is projected to be the third most common cause of death worldwide by 2050. People with COPD have breathing difficulties which can affect their day to day lives, and these can be far worse in winter when they are more at risk from colds and the flu.

“At least 30 per cent of patients with COPD could be cared for in their home surroundings, rather than requiring hospital admission, and in Edinburgh we have been working to improve the support available within communities through the development of a community based multidisciplinary COPD hub.

“The community team works closely with the team here at the hospital to assess patients, to encourage self-management and to quickly identify the right treatment when required. We have seen a real success in reducing the need for patients to be admitted to hospital, and are now looking at how we can extend this model of care across Lothian and Scotland.”

Vice President Royal College of Emergency Medicine Scotland, Martin McKechnie said:

“We have seen a sustainable difference in terms of unscheduled care performance over the last year, with last winter seeing some of the best performance we have seen in a number of years. The Scottish Government has demonstrated a strong commitment to working with partners such as the Royal College of Emergency Medicine and the Academy of Royal Colleges to ensure that patients who need to attend A&E and Assessment Units receive the best experience they deserve. It is also not by accident that Scotland has been performing better than anywhere else in the UK for over a year.

“The launch of the unscheduled care six essential actions in May 2015, and the early winter planning guidance issued in August, has supported the achievements we have seen. I also welcome the recognition and efforts by Government to focus on enhancing the community based support, which will see patients being treated in the most appropriate environment, avoiding inappropriate hospital admissions and easing unnecessary pressures on A&E and Assessment Units as we head into winter.”