Chamber and committees

The NCS TOM reference group last met on the 19 May 2022. The meeting was a workshop focused on review of the current system and potential options for future systems. Consideration was given at this meeting to the potential approaches for the structure of the NCS.

Health and Social Care Management Board (HSCMB) last met on‎ 24 January 2024, and it discussed strategic, tactical, and operational matters which contribute to the delivery of health and care service across Scotland.

The NCS COM reference group last met on the 19 May 2022. The meeting was a workshop focused on review of the current system and potential options for future systems. Consideration was given at this meeting to the potential approaches for the structure of the NCS.

Health and Social Care Assurance Board (HSCAB) last met on‎ 8 November 2023. At this meeting, the Co-Director of Social Care and NCS Development, provided an update on the progress of the National Care Service.

The Scottish Government keeps the eligibility criteria for free school meals under regular review to take account of any developments which may impact upon it. The eligibility criteria was last amended in April 2023. We notify local authorities whenever any changes are made to the eligibility criteria to enable them to invite fresh applications for free school meals under the new criteria.

We are currently reviewing the existing eligibility criteria for free school meals in light of the latest increases to the National Living Wage, which were announced by the UK Government on 21 November 2023.

Scottish Government officials met with NHS Scotland Board Chief Executives on 12 December where they discussed medical locum staffing as one of their priority actions. This follows detailed engagement with Boards regarding the arrangements currently in place for contracting agency staffing, the outputs of which are being used to inform targeted improvement activity in this area.

The Scottish Government has commissioned the Centre for Sustainable Delivery (CfSD) to improve Community Urgent Care (CUC) pathways as part of the wider Urgent and Unscheduled Care Programme. In addition to validated nationally collected data from Public Health Scotland, an Unscheduled Care Improvement Dashboard is in creation which will consist of ‘data for improvement’ collected manually by each Health Board Area, which supports tracking of locally held data to reflect the impact of improvement activity, creating visibility of progress.

Work is also underway through an external partner to evaluate the Redesign of Urgent Care pathway through NHS 24 111 service which launched in 2020 and provides access to local Flow Navigation Centres and virtual A&E teams.This evaluation will assess impact on a range of measures, including patient and staff experience and assess what other outcomes are impacted by the service.

• The Scottish Government has commissioned the Centre for Sustainable Delivery (CfSD) to improve Community Urgent Care (CUC) pathways as part of the wider Urgent and Unscheduled Care Programme.
• In addition to validated nationally collected data from Public Health Scotland, an Unscheduled Care Improvement Dashboard is in creation which will consist of ‘data for improvement’ collected manually by each Health Board Area, which supports tracking of locally held data to reflect the impact of improvement activity, creating visibility of progress.
• Work is also underway through an external partner to evaluate the Redesign of Urgent Care pathway through NHS 24 111 service which launched in 2020 and provides access to local Flow Navigation Centres and virtual A&E teams. This evaluation will assess impact on a range of measures, including patient and staff experience and assess what other outcomes are impacted by the service.

While Scottish Government is responsible for the strategic direction of the NHS, territorial Health Boards are responsible for delivering services in their areas, and providing appropriate community spaces for midwives and allied health professionals.

Community-based maternity services should have access to appropriate accommodation to provide face to face appointments. ‘The Best Start: a Five Year forward Plan for maternity and neonatal care’ outlines the expectation that Boards provide routine care and maternity services through Community Hubs.

We are also supporting development of primary care multi-disciplinary teams (MDT), including allied health professionals, with investment of £190 million in 2023-24 through the Primary Care Improvement Fund.

Integrated Authorities must work closely with local communities and other stakeholders to ensure that Primary Care Improvement Plans address specific local challenges and population need.

While making significant progress in these reforms, we recognise that implementation gaps remain, including around accommodation barriers.

We are now also introducing an additional ‘phased investment programme’ working with a small number of areas to demonstrate what a model MDT can look like in practice. The findings from this programme will build understanding of the national context for further implementation and inform future long-term Scottish Government investment.

A Flow Navigation Centre has been established in every mainland Health Board as part of the Redesign of Urgent Care Programme. They provide expert clinical advice, referrals to alternative services and, when necessary, schedule appointments at A&E. They play a key role in ensuring patients receive the ‘Right Care, in the Right Place’ by diverting patients to more appropriate pathways of care and reducing unplanned attendances to A&E departments.

The RUC Programme was introduced during the Covid-19 pandemic (December 2020), impacting on the comparability of statistics. However, in the 12 months to October 2023, A&E attendances where down by more than 11 percentage points compared to 2019 levels. Whilst we do not have comprehensive data available, we understand through discussions with Health Boards that the reduction in attendance is in part due to Flow Navigation Centre’s.

In order to realise the full potential of Flow Navigation Centres, the Centre for Sustainable Delivery (CfSD) have established a Flow Navigation Specialty Delivery Group to drive the development and delivery of high quality Flow Navigation services across Scotland. The group brings together key stakeholders to establish the optimal Flow Navigation Model and reduce unwarranted variation. Developing and capturing the relevant data to measure the impact of this work and to understand and evidence outcomes is part of the SDG workplan which is being taken forward over the next year.

Scottish Government officials met with NHS Scotland Board Chief Executives on 12 December where they discussed agency nurse staffing as one of their priority actions. This follows detailed engagement with Boards regarding the arrangements currently in place for contracting agency staffing, the outputs of which are being used to inform targeted improvement activity in this area.