Health and Care Improving Flow Plan 2026 - 2031

3. Executive Summary

Right Care. Right Place. Right Time.

Scotland's health and social care services are among our most valued public services. Every day, staff across the NHS, social care, local government, the third sector and local communities provide high-quality care and support that saves and changes lives.

However, demand for services is growing. People are living longer in ill-health, and too many continue to experience delays, difficulty navigating services and longer stays in hospital than necessary. Staff work under sustained pressure in systems that can feel fragmented and difficult to coordinate.

The current model of care is increasingly unsustainable. While hospitals remain essential for life-threatening emergencies, the most acute care and highly specialised interventions, not all your specialist care needs to be delivered in hospital settings. In many cases you can achieve better outcomes when supported at home or in your community. Specialist care is already provided in communities across Scotland. For example, you can already receive free eye tests and support for eyecare on your local high street. We want to build on this by expanding access to high quality support closer to your home wherever it is safe, effective and beneficial for you.

The Improving Flow Plan sets out how Scotland will respond. Our ambition is simple:

One connected system, simple routes to care, ensuring every person receives the most appropriate response as quickly as possible.

At its heart, this Plan is about improving how people experience care. It is about ensuring that you receive the right support, in the right place, at the right time and move safely, effectively and compassionately through health and care services from the moment you seek help through to recovery. Achieving the best possible quality of life, wellbeing and autonomy for your circumstances.

Continuity of Care

Your route to care is clear:

• Call your GP practice, or where appropriate, attend your local pharmacy or walk-in service, in hours.
• Call 999 for any life-threatening critical emergency such as a suspected heart attack, stroke or excessive bleeding.
• If you think you need A&E but it’s not immediately life-threatening, call 111, day or night.

We are committed to providing continuity of care through a local multi-disciplinary team who understands your health, circumstances and what matters most to you. Your GP Practice, supported by a multidisciplinary team, will coordinate your care and help you navigate services. Particular emphasis will be placed on strengthening continuity for people with complex needs, including those with mental health conditions, dementia, frailty or those approaching the end of life.

No one should have to navigate health and care services alone. Through a “Team Around the Person” approach, professionals will work together to provide you joined-up, person-centred care, supporting major life transitions and addressing barriers that prevent access to services.

We will improve coordination between community, hospital and urgent care services, including named consultants during hospital treatment and earlier access to senior professionals who can make decisions about your care and treatment. New Integrated Navigation Centres will bring together expertise across NHS 24, the Scottish Ambulance Service and wider system partners to provide coordinated triage, advice and access to the right service first time.

Alongside this, MyCare.scot, Scotland’s new health and care app, will be your online front door to health and care services, giving you easier access to appointments, information and support while continuing to provide telephone and face-to-face access for those who need it.

Home Care

We will ensure more care is delivered in your home whenever it is safe, clinically appropriate and aligned with your wishes.

Hospital at Home, virtual care, online and phone consultations, remote monitoring and care at home services will continue to expand, enabling you to receive high quality care in your own home. Better self-management support and digital services will help you remain independent and manage your health and wellbeing more effectively.

Community Care

A new Community First approach will strengthen local multidisciplinary services and shift more care into communities, supporting you earlier and preventing your health from getting worse.

Health, social care, wider public services and the third sector will work together more effectively through local teams, making it easier for people to access high-quality support and care when and where they need it, in person within your community or virtually, where appropriate and better for you.

We will also strengthen links with housing, welfare and other community services to provide you more joined-up support which meets your whole life needs.

Hospital Care

Hospitals will be reserved for life-threatening emergencies and highly specialised treatment.

We will improve patient flow through acute hospitals by strengthening same-day emergency care, assessment pathways, operational management and use of real-time data. Put simply, where care does not need to happen immediately, we will organise it better. This will create a more responsive and resilient system for you, our staff and our communities.

Corridor care is unacceptable and we are clear it should be eradicated. Recognising that this is a complex issue with no single solution, the broad range of actions outlined in this plan will work collectively to improve flow, reduce pressures across the system, to ensure you receive safer, more dignified care. This will also ensure our staff can deliver the high-quality care they are trained to provide.

Discharge planning will begin on day one of a hospital stay. Through the Discharge Without Delay approach, health and social care teams will work together to ensure you can return home, or move to the most appropriate setting, as soon as your treatment is complete.

Greater use of discharge-to-assess models, community rehabilitation, frailty pathways and

discharge teams will reduce delays and support you to regain independence more quickly.

What Will Be Different for You

This Plan is built around a series of transformational changes that will make care simpler, faster and more connected.

You will find it easier to get help through clearer access routes and better navigation across services. You will tell your story once, with professionals working together through coordinated teams and shared information.

More care will be provided at home and in local communities through expanded community services, Hospital at Home, virtual care and digital support. Hospitals will focus on delivering emergency and specialist care for those who need it most.

You will spend less time waiting, less time in hospital and more time recovering in your own home and community whenever it is safe to do so. Staff will benefit from better-connected services, reduced duplication and improved conditions in which to deliver high-quality care.

Accountability and Improvement

We will celebrate success and spread good practice wherever improvements are delivering better outcomes.

However, we will also be honest when performance falls short. Where we identify persistent challenges, unwarranted variation or poor performance, we will step in, working with local services and partners to understand the underlying causes, provide support and take decisive action to improve outcomes ensuring every community experiences first class services and care.

Improvement, accountability and support will go hand in hand.

Our Vision for Scotland

This Plan is more than a programme of reform.

It is a commitment to create a health and care system that is easier to access, better connected and designed around people's needs.

A Scotland where it is easier to get help.

A Scotland where more care is delivered closer to home.

A Scotland where people spend less time waiting and more time receiving care.

A Scotland where hospitals focus on those who need them most.

A Scotland where health and care services work together as one connected system.

And a Scotland where people live healthier, more independent and fulfilling lives.

This is our contract with the people of Scotland. And together, we will deliver it.