Spotlight
Advancing Same Day Emergency Care Services Across NHS Scotland
To enhance Same Day Emergency Care services across Scotland, CfSD developed a working group that carried out a comprehensive survey of all acute hospital sites in Scotland.
This provided a baseline of current service provision and identified opportunities for improvement. Based on this, the team developed draft national guidance principles. Once approved, Health Boards will be supported to implement the principles, with the aim of reducing variation and streamlining care.
This initiative focuses on ensuring patients with urgent needs receive timely assessment, treatment, and discharge within 24 hours, improving outcomes and experiences by directing them to the most appropriate services.
Emergency Department Benchmarking Across Scotland
A benchmarking exercise was carried out to explore the relationship between Emergency Department (ED) staffing, operational pressures, and performance. This involved ED sites submitting staffing data that enabled detailed analysis to correlate staffing levels with key operational metrics such as arrivals, wait times, and 4-hour compliance.
Early findings indicate a link between staffing and ED flow, and have highlighted the impact of systemic issues like exit block on crowding and staff workload. Further analysis will be ongoing over the next year. The project aims to identify shared themes across sites to inform national recommendations for ED staffing models and operational improvements, supporting better patient care and system performance.
Flow Navigation (FN)
Flow Navigation aims to improve the timeliness and safety of Unscheduled Care, through supporting the public to access the ‘Right Care, in the Right Place at the Right Time’, through earlier access to decision makers, reducing avoidable ED attendances and enabling signposting to alternatives.
Early work included discovery sessions; establishing a national group to align strategic priorities and share best practice; and introducing optimal service models, standardised coding and a reporting framework.
In addition, CfSD has supported the development a new data capture mechanism, providing analysis and feedback to Boards. In 2024, 34% of patients referred to a Flow Navigation Centre were redirected or discharged away from EDs, avoiding around 348 unscheduled attendances per day.
Flow Navigational effectiveness is closely tied to staffing models, with most impact seen from those incorporating Senior Clinical Decision Makers. Over the next year, CfSD will continue develop the role of Flow Navigation Centres as the coordinating structure for Unscheduled Care.
Heat Maps for Unscheduled Care Performance
A new ‘HeatMap’ tool was launched to provide a clear, real-time summary of 29 measures across the unscheduled care pathway. The Heat Map was originally created manually by each Health Board, but CfSD collaborated with Public Health Scotland (PHS) to develop a digital solution hosted on the PHS Discovery platform.
Developed in just 16 weeks, the prototype was refined with input from clinical and data experts from across NHS Scotland. This dynamic tool improves data accuracy and timeliness, helping stakeholders quickly identify performance trends. Ongoing user feedback will shape future enhancements, including defining minimum standards for the different measures.