Health and Care Improving Flow Plan 2026 - 2031

7. Immediate Priorities

While this Plan sets out a five-year vision for transforming health and social care, people should begin to see improvements much sooner.

Over the next 12 months we will focus on practical changes that make it easier for you to access support, reduce delays, tackle corridor care and help you receive more care closer to home. These include:

• Launching a national campaign, in Autumn 2026, to help people access the right care, in the right place, at the right time.
• Expanding access to senior clinical advice through NHS 24 and Navigation Centres and improve triage in Emergency Departments.
• We will strengthen direct referral pathways from our navigation centres into alternative services.
• Increasing Hospital at Home capacity so more people can receive treatment and monitoring at home.
• Reducing conveyance to hospital through enhanced community pathways
• Expanding mental health crisis support.
• Introducing earlier discharge planning and increasing use of Home First and Discharge to Assess approaches to reduce the time people need to spend in hospital.
• Expanding access to Same Day Emergency Care services, increasing the number of people who can receive timely assessment and treatment without requiring admission.
• Supporting younger people who are admitted to hospital with multiple comorbidity and multiple disadvantage through multidisciplinary care and continuity between community and hospital settings.
• Improve the care of the older person living with frailty through properly tailored care in line with best practice identified by Healthcare Improvement Scotland and the Discharge without Delay principles.
• Ensure robust escalation procedures that anticipate pressures and optimise capacity across the whole system, recognising that A&E performance is not solely an Emergency Department issue but reflects the effectiveness of flow across the entire health and care pathway.
• We will deliver earlier identification of frailty, improve uptake of anticipatory care planning, and promote coordinated multidisciplinary support for people living with frailty and dementia.
• Remove barriers to weekend discharge by implementing effective seven-day working models, ensuring patients do not remain in hospital longer than necessary due to service availability.

7.1.1 Preparing for Winter Surge

In the coming months, urgent action is required to prepare for the period of surge over winter. Systems are already experiencing significant pressure, and we cannot wait for longer-term reforms to take effect before delivering improvements.

Improving delayed discharge is one of the most effective actions available to increase capacity, reduce overcrowding, improve patient experience and prepare services for winter demand. Ahead of this winter, we are asking all Health Boards to make improving discharge and reducing delays in acute hospitals an immediate priority. By winter 2026/27, every Board is expected to have implemented the core principles of a Discharge Without Delay approach and established improvement trajectories for discharge performance and average length of stay. This will include ensuring discharge planning begins at the point of admission, identifying likely discharge needs as early as possible, supporting clinical decision-making within the first 72 hours of a hospital stay, reducing avoidable delays within hospitals, and increasing the use of criteria-led discharge where appropriate. Ministers will have direct oversight of this improvement activity through our Collaborative Response and Assurance Group.

To ensure improvements are sustainable, we will strengthen collaboration between hospital, community, primary care, social care and third-sector services to support timely discharge and recovery at home, including expanding discharge-to-assess, step-down and community-based support pathways. Together, these actions will help ensure you spend only as long in hospital as is clinically necessary and can return home sooner, where it is safe to do so.

Vaccination also remains a key part of our approach to winter preparedness. Alongside the delivery of new and expanded vaccination programmes, we are working with Health Boards and partners to strengthen this year's winter vaccination programme and maximise uptake among eligible groups. A national public information campaign will support this effort, encouraging people to come forward for vaccination when invited, helping to reduce serious illness, protect vulnerable people and ease pressure on health and care services during the winter period.

7.1.2 Next Steps

This Plan sets out a clear direction for the future of health and care in Scotland. By improving flow across the whole system, strengthening community and home-based care, enhancing continuity of care, and ensuring hospitals focus on those who need them most, we will create a more sustainable, connected and personalised system of care. Delivering this vision will require collaboration, commitment and a relentless focus on improvement, but the prize is significant: better outcomes, better experiences and a health and care system that works seamlessly around your needs. Together, we will build one connected system, with simple routes to care, ensuring you receive the most appropriate response as quickly as possible.

Following the publication of this plan, our NHS Sub-National Planning and Delivery Committees will develop detailed delivery plans working with a wide range of partners, to deliver practical improvements at pace. This will align with the ambitions outlined in our Programme for Government; our existing reform activity outlined in the Service Renewal Framework and Population Health Framework; and the new Community First approach, to deliver a stronger, more accessible and more integrated service. We will monitor progress against this plan, reporting annually, working with Audit Scotland, and in line with our other reform publications.