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

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

Prevention is key to mitigating the impact on surges in demand and ensuring that periods of surge are limited where possible. Whilst the nature of such prevention will to an extent depend on the trigger for the surge in demand, surge planning should encompass some key preventative measures which can be stepped up as necessary during periods of surges. The Scottish Government and COSLA’s Population Health Framework sets out an ambitious national plan for improving public and population health through primary prevention – stopping people from becoming unwell in the first place. Surge planning requires a greater focus on secondary and tertiary prevention: early detection of a problem to reduce the level of harm (secondary), and minimising harm through careful management (tertiary).

Vaccination programmes and delivery should aim to protect those most at risk of severe illness, reduce transmission of infection and support the resilience of the health and care system, particularly during the winter. In addition, vaccination and infection prevention, as well as social connections, exercise and meaningful activity are all vital for the wellbeing and quality of life of everyone, but in particular those living in a care home. Appropriate specialist advice should be sought via the Scottish Vaccination & Immunisation Programme (SVIP) and local Health Board immunisation teams as necessary regarding the most effective vaccination programmes.

Another key preventive measure to be embedded in surge planning and preparedness is to ensure effective communications, public messaging, and up to date information and advice on services. This will ensure that that people know how and where to access appropriate care services when they need it most, and whether there are any changes in place as a result of surges in demand. By increasing the awareness of other key sources of information, it will support people with their care needs and decrease emergency department admissions for treatment that can be provided more appropriately elsewhere in the system. Where it is determined that a national approach to communication is required, the Scottish Government and COSLA will work with system leaders to facilitate clear, national messaging.

Surge planning should encompass collaborative working across health boards, local authorities, primary care contractors, third and independent sector providers, carer centres and voluntary sector partnerships to consistently redirect and signpost people to the appropriate services for their needs, whether through national, regional or local communications. This includes whether that information is delivered in person by social workers, care home and care at home providers, community pharmacists or local GPs, via the telephone by NHS 24 / 111 call handlers, or digitally via NHS Inform, the NHS 24 online app, Care Information Scotland or local authority websites.