Health and Care Improving Flow Plan 2026 - 2031

1. Foreword

Every one of us will rely on our precious health or care services at some point in our lives.

Whether you are a parent seeking help for a sick child, needing support to remain independent in your community, experiencing a mental health crisis, or waiting to bring a loved one home from hospital, you rightly expect services that are responsive, joined up and easy to access.

Our services have been under sustained pressure since the Covid-19 pandemic and not everyone in Scotland has the same experiences of care.

You may have found services difficult to navigate, waited too long for urgent care, or spent longer than necessary in hospital because the support you need in your local community is not in place. Our staff work incredibly hard to provide the best possible care but are doing so in a system facing rising demand, increasing complexity and significant pressure.

That is why improving how you move through the system, from your first contact through to recovery, is an opportunity to improve health and care outcomes for all.

At its heart, improving hospital flow is not about targets, processes or organisational structures, it is about people. Ensuring you can access the care you need, when and where you need it. Ensuring you move through services safely, quickly and with dignity.

Our ambition is clear, one connected system, simple routes to care, ensuring every person receives the most appropriate response as quickly as possible.

This is our contract with the people of Scotland.

You will no longer be expected to navigate complex services yourself. We will take responsibility for understanding your needs as individuals and connecting you to the right care, in the right place, at the right time. Your care team will not be confined by geographical or organisational boundaries but be empowered to join your support together in one seamless, connected experience. This means improved access, a smoother journey through hospital and returning home sooner with the right support to remain independent in your community.

You will be supported by the right people to get the help you need, accessing more care at your fingertips, in your home and in your community. We will ensure there are visible hubs in your local area to provide safe, consolidated contact points for the vast majority of your care needs.

If you experience a life-threatening emergency, or require highly specialised acute care, you will be cared for in a hospital setting which prioritises your dignity, privacy and experience. We agree that corridor care and long waits in A&E are unacceptable and should be eradicated. This plan aims to tackle these issues, creating the conditions for staff to deliver the high-quality care they are trained to provide.

Put simply, we are planning for unplanned care.

In return, we ask you to use services appropriately and take an active role in maintaining your health and wellbeing wherever possible. While we are committed to providing more care closer to home, you may be asked to travel further to receive the most highly specialised care, in the most appropriate setting.

Delivering this change will require partnership at every level, transforming services nationally, regionally and locally. You, your family and your carers will remain at the heart of everything we do.

We recognise the extraordinary pressures that many of our hard-working health and social care staff face every day. Their expertise, commitment and experience will be essential to success. We will therefore work closely with our staff and their representatives to drive the improvements needed.

Across Scotland, there are already inspiring examples demonstrating what is possible: more care delivered at home, fewer unnecessary admissions to hospital, earlier discharge and better outcomes for patients and families. We are building on that progress and setting a clear national direction for the future.

You rightly expect improvement to be visible and measurable. We will be transparent about progress towards this vision, monitor the outcomes that matter most and act wherever improvement is needed. Where services are performing well, we will support learning and spread good practice. Where performance falls short, we will provide support, step in where necessary and take decisive action to improve outcomes for patients and communities.

The prize is significant: a Scotland where it is easier to get help, where more care is delivered closer to home, where you spend less time waiting and more time receiving care, and where health and social care services work together as one connected system, coordinated around your needs. A system that fits around you, rather than expecting you to fit around the system.

Together, we can build a rebalanced system that is simpler, fairer and more sustainable. A system that supports staff, strengthens communities and delivers better outcomes for everyone. Above all, a system that gives you confidence that when you need care, the right help will be there, in the right place, at the right time. Working with you, we can make this happen.

Angela Constance

Cabinet Secretary for Health and Care

Scottish Government