Health and social care - surge and winter preparedness: national planning priorities and principles

National Planning Priorities and Principles

Heath and social care systems already undertake surge and winter planning and preparedness, and collaborative whole system planning is the most effective way to ensure that operational surge plans are designed around local needs. However, it is important that there is consistency between the principles that underpin these plans across Scotland.

These five national planning priorities reflect the Scottish Government’s and Local Government’s shared commitments to delivering a more resilient, person-centred, and integrated health and social care system. They are aligned with the strategic direction set out in the SRF, PHF and OIP. Local systems are expected to embed these priorities in their surge and winter planning, supported by national oversight mechanisms such as the Collaborative Response and Assurance Group.

Scottish Government and COSLA are committed to supporting the health and social care system to continuously improve, including in planning for surge pressures, to ensure people are able to access the right care, in the right place, at the right time. We recognise that expectations around transformation and change may shift during periods of exceptional surge demand. Scottish Government and COSLA are working in partnership to progress whole system improvement across health and social care so that services are person-led and sustainable in the longer term.

This approach recognises that local plans should consider the interdependency of services, recognising that pressures in one system area can have a knock-on effect on another.

Local systems should also consider the three overarching principles in their surge and winter planning, to ensure the focus is retained on the individual regardless of pressures on services. These are:

• Person centred and person led care as embodied through the Getting it Right for Everyone (GIRFE) Principles, to support a personalised way to access care and ensure that people are at the centre of decisions that affect them.
• Strong leadership and partnership working across the whole Health and Social Care system.
• Implement local and national actions that we know work, to improve outcomes for individuals, such as the Discharge Without Delay principles.

Supporting these national principles are five priorities which the actions set out in local surge plans should ensure address.

• Prioritise care for all people in our communities who need it the most, enabling people who are most at risk to live well with the support they require and ensuring safe, person-centred care through integrated, placed-based planning
• Utilise effective prevention to keep people well, avoiding them needing hospital care through supporting primary and community care to manage demand and reduce avoidable admissions, delivering vaccination programmes and promoting public awareness through national messaging campaigns
• Ensure people receive the right care, in the right place at the right time, prioritising care at home, or as close to home as possible, where clinically appropriate
• Maximise system capacity and capability by improving patient flow and access, reducing delayed discharges and long waits, minimising unmet need, and using data and intelligence to support real-time decisions. Strengthen urgent and unscheduled care pathways, including hospital at home and virtual capacity, and protect access to planned care and established services
• Support the mental health and wellbeing of the health and social care workforce, improve capacity, retention, and support unpaid carers