'Frailty teams' to redirect elderly away from busy Scottish emergency departments

First Minister John Swinney said the move would allow older people with complex needs to instead receive care elsewhere in the hospital or back at home. It came as he pledged renewed action to tackle “the crises facing too many parts of our National Health Service”.

Scotland has struggled with high waiting times in recent years, exacerbated by the pandemic. This includes in A&E, outpatient procedures and other hospital treatments, with hundreds of thousands languishing on waiting lists.

Mr Swinney said patients in Scotland were not getting “the right care in the right place at the right time”.

Delivering a speech at the National Robotarium at Herriot Watt University in Edinburgh on Monday, the First Minister announced plans to provide 150,000 more appointments and procedures, as well as providing a £10.5 million increase in funding for GPs.

Mr Swinney said: “The first and most important thing on many people’s minds is how long it can take to access services: delays in access with waiting times too long, and delays in discharge because appropriate at-home or in-community care is not available.”

As part of the plans to reduce waiting lists, Mr Swinney suggested turning some facilities, including Stracathro Hospital in Brechin, Gartnavel Hospital in Glasgow and the Queen Margaret Hospital in Dunfermline, into “centres of excellence” in certain procedures such as cataracts or orthopaedics, providing transport support to patients to access the facilities if necessary.

With the waiting list for procedures or tests sitting at more than 600,000 as of September 30, the First Minister told reporters after the speech he believed the backlog could be eliminated.

“It will be cleared,” he said. “We will get the health service into a state of sustainability.”

The Scottish Government has pledged to reduce waiting times to less than 12 months for every Scot by 2026. An app will also be created for the NHS in Scotland under the new plans, which Mr Swinney described as the “digital front door” to the health service.

“Over time, it will become an ever more central, ever more important access and managing point for care in Scotland,” he said.

The service will be trialled in NHS Lanarkshire from the end of this year before a full rollout. Mr Swinney said more care would be shifted into communities and homes to help “strengthen and renew our NHS”.

He said: “As much as possible, people who do not need to be in hospital will not go to hospital, protecting those acute services for those who absolutely need them.

“This new approach will mean changing the way we deliver acute services. By this summer, we will have specialised staff in frailty teams, at the front door of every A&E department in Scotland.

“This will mean that frail patients, often older patients with complex needs, will bypass our busy A&Es, in order to receive the specialist care and support they need, whether in hospital or back at home. It will mean better care for these most vulnerable patients while reducing the pressure on our A&Es.”

Last week, the Scottish Government abandoned plans to set up an NHS-style National Care Service after opposition politicians, local authorities and trade unions pulled their support.

Dr Iain Kennedy, chair of the doctors’ union BMA Scotland, said there was “an urgent need for a plan to deliver the kind of reforms that are required to make the Scottish NHS sustainable for generations to come”.

He said: “At this stage, we still lack the detail and comprehensive vision needed to make any plan a reality.

“Our survey just before Christmas emphasised just how desperate the position is for doctors, the teams they are part of and patients relying on care. It is clear that we must, as the First Minister said, shift the balance of care and find more funding directly for GPs. But that must be done on the basis of a full plan that does not simply remove funding from and risk destabilising hospital care, which is facing massive challenges.

“Previous pledges to increase capacity have not come to fruition, not least because such plans need the staff in place to deliver them. Yet at the moment, doctors are struggling to cope with simply keeping up with demand.

“It shows yet again that no plan for the NHS will work without a proper long-term workforce plan to ensure we have the staff needed to deliver it. So we urgently need to see details and a timescale for the outline of plans set out today, and we look forward to the Scottish Government bringing them forward.”

Scottish Conservative health spokesman Sandesh Gulhane said: “Scotland’s NHS is in permanent crisis mode on John Swinney’s watch and nothing in his speech will change that.

“He has been at the heart of an SNP Government for the last 18 years who have grossly mismanaged the health service, yet now he expects suffering patients and overwhelmed staff to believe he has all the answers to fix this crisis.

“That simply won’t wash with them. The failures by John Swinney and successive health secretaries mean that patients’ lives are being put at risk every single day, hundreds of thousands of Scots are stuck on waiting lists and SNP promises in relation to the NHS have been broken time and time again.”

Jackie Baillie, Scottish Labour's health spokeswoman, said the SNP has had “nearly 18 years to improve conditions in our GP surgeries and hospitals”.

She said: "Indeed, this speech only shows how clearly the 2021 SNP recovery plan has failed. That plan was supposed to boost capacity, yet instead the national treatment centre programme was paused.

"It promised an additional 1,000 community health workers – not a single one has been recruited.

"While the announcement of an NHS app is welcome, the real question is why we don't have one already. NHS England had an app before the pandemic.

"These recycled announcements also made little mention of workforce planning, yet the NHS is spending millions on agency staff while GP and nurse numbers are stagnating.”

Scottish Liberal Democrat leader Alex Cole-Hamilton said: “In some ways this is a strange speech. The health secretary has been sidelined and John Swinney is going through the motions.

“With significant extra funding, it would be more astonishing if the Government didn’t announce extra appointments and procedures.

“The challenge will now be delivery. We have had endless SNP proclamations over the last 18 years and yet waits for cancer treatment and A&E departments have got worse and worse.

“No wonder 98 per cent of doctors say they have no or little confidence in the Scottish Government to put the NHS on a sustainable footing. To deliver a sustained, long-term plan for the NHS and social care is going to require a change of government.”