Our winter plan, jointly published with the Convention of Scottish Local Authorities on 24 October, sets out a whole-system approach to respond to surges in demand for health and social care services and actions to relieve pressure points across the system.
The new funding measures include a £50 million boost for the Scottish Ambulance Service to assist with recruitment and up to £12 million to expand hospital at home services. That expansion will enable more people to be treated at home rather than in hospital, and it will deliver at least 380 additional beds this winter, which will relieve pressure on NHS wards.
The additional funding that is set out in the plan for hospital at home is welcome, and it will, no doubt, reduce pressure on our accident and emergency departments this winter. Can the cabinet secretary say any more about how the expansion of hospital at home will help people across Scotland, including my constituents, this winter?
The additional £12 million of investment for this winter, which will provide for the expansion of hospital at home services, will assist constituents in the member’s constituency and throughout the country by providing additional capacity for a range of services, including those for children and people with respiratory conditions. That will help to support boards that are taking forward a range of initiatives to develop hospital at home in their respective areas to expand provision over the course of the winter. The funding that we are making available to them will allow them to go ahead and develop those services this month and into the winter months, in order to provide greater capacity.
I draw members’ attention to my entry in the register of members’ interests, which states that I am a practising NHS general practitioner.
Dr Donald Macaskill of Scottish Care has said that the Scottish Government’s winter plan
“is not worth the paper that it is written on.”
He also said:
“It says nothing. It gives no hope.”—[
Health, Social Care and Sport Committee
, 31 October 2023; c 37.]
Rachel Cackett of the Coalition of Care and Support Providers in Scotland agrees with him.
Further, Reform Scotland’s recent report tells us that waiting times for hip operations are soaring, and the chair of the British Medical Association Scotland has commented that we have a system that is
“bursting at the seams, with a workforce running on empty.”
In light of all of that, how confident is the cabinet secretary that, this winter, patients are going to get the service that they need and deserve, that he can maintain social care, and that this winter will not be, as previous winters have been, the worst winter on record?
We have taken forward a range of measures with our winter plan. We started its development earlier this year, and we have taken a partnership approach to its development. That is why it takes a joint whole-system approach with COSLA to meet some of the pressures that we know exist and expect to develop in our health and social care system. We have also engaged with the social care sector in the development of the plan.
Of course, the additional investment of some £50 million in our ambulance service and the additional £12 million investment in the expansion of hospital at home are part of the package of measures that we are putting in place to help to meet the demand that we will face over the winter months.
The cabinet secretary will have seen the troubling statistics yesterday that show increased waiting times in A and E, delayed discharge rates—which are sky high—and the level of cancelled operations up again. This is only autumn. How much will his plan reduce A and E waiting times by over the winter period? Will his plan also eradicate waits of more than 12 hours?
As Jackie Baillie will be aware, the plan is to help to meet some of the challenges that we will face over the winter months. I have not hidden from the fact that A and E performance is not where we would want it to be. A big part of that is because acuity rates are greater and because we have numbers of people staying in hospital for longer periods than previously was the case, with greater hospital occupancy levels.
All of those factors will present challenges, which is why we have made very specific interventions with additional funding to help to reduce and manage some of that demand over the winter months. I cannot quantify exactly by how much the interventions will improve matters because, due to the varying nature of winter illnesses, we do not know what the demand or the pattern of demand will be over the winter months. However, I assure Jackie Baillie that we are determined to do everything that we can to support the system through what we know will be a very challenging period at the health and social care levels. That is why we have taken a whole-systems approach, in partnership with COSLA, to the plan’s development.