Publication - Research and analysis

NHS Scotland redesign of urgent care - first national staging review report: 1 December 2020 – 31 March 2021

Published: 15 Jul 2021
Health Performance and Delivery Directorate
Part of:
Health and social care

The redesign of urgent care (RUC) programme by definition includes the entire patient pathway from the time of patient or carer need to the conclusion of that episode of care. This evaluation has therefore attempted to explore the whole patient journey in terms of data and feedback from stakeholder groups.

NHS Scotland redesign of urgent care - first national staging review report: 1 December 2020 – 31 March 2021
Annex C: Conceptual Framework and Phase 1 principles

Annex C: Conceptual Framework and Phase 1 principles

Image showing Urgent Care: Right Care, Right Place, Right Time optimising self-care at all times. Boxes and lines indicate service to be augmented and/or developed


Right Care, at the right place, at the right time.


Collaborate across the whole health and social care system to design and implement a safe, sustainable, patient and outcomes focused system of urgent care access, pathways and treatment in Scotland that delivers better health, care and life outcomes for our patients, staff, their families and the wider community in which we all live, grow, learn, work and play.


  • Minimising the risks of moving patients around the system
  • Establishing an emergency care system that benefits everyone
  • Delivering a new model of care that is national, simple, effective and safe for all
  • Making the best use of scarce resources
  • Aligning closely with wider winter planning work
  • Addressing inequalities
  • Patient and staff safety is out priority across the whole system
  • Supporting staff training and organisational development
  • Keeping the access route as simple and as clearly defined as possible

Strategy #1 Scheduling Attendances

  • Delivering care as close to home as possible by minimising unnecessary face-to-face contact and maximising access to a senior decision maker
  • Effective management and scheduling of the flow of self-presenters to Emergency Departments and local Board services
  • Taking a multi-agency, multi-professional approach to scheduling, directing patients to the most appropriate professional and place and for their needs
  • Patients receive the care they require closer to home by optimising existing pre-hospital patient care and developing new systems based on COVID-19 learning

Strategy #2 National Messaging

  • Delivering strong public messaging to support any changes to care to allow the public to use the system responsibility and ensuring that it is linked to self-care and management and healthier life choices
  • Focused public messaging linked to responsive health care systems
  • Planning and delivery will take a while-systems approach and will not be 'owned' by one part of the system

Strategy #3 Access, Triage & Flow Centres

  • Ensuing patients are seen in the most appropriate clinical environment by the most appropriate clinician to minimise the risk of harm and ensure safety
  • Reduction in self-presenters to Accident and Emergency when care can be delivered more appropriately in another setting by another professional
  • Reducing numbers of patients attending Emergency Departments by providing alternative care pathways
  • Establishing a single national access route which delivers simple clear access to patients
  • Developing an approach that appropriately and sensitively responds to mental health issues
  • Increased use of the role of General Practitioner in urgent care

Strategy #4 Virtual Technology

  • Maximising and building upon digital solutions
  • Enhancing the use of digital health through NHS Inform NHS24 / 111
  • Increasing the use of virtual consultations by NHS 24, SAS and new Local Flow Centres
  • Adopting a digital first approach that defaults in the first instance from face to face triage and consultation to digital
  • Focusing on improving outcomes for those most in needs, including disadvantaged groups who use Accident and Emergency due to difficulty accessing other parts of the Health and Social Care system