Winter preparedness plan for Scotland 2023/24
Scottish Government and COSLA published a joint Health and social care winter preparedness plan for 2023-2024
The purpose of a Winter Plan is to outline the priorities for health boards and local authorities across Scotland over the winter months when pressures on health and social care will increase significantly.
In response to the Winter Plan, CoEL spoke with East Lothian Health and Social Care Partnership about how they are taking some of the priorities from the plan forward. You can see details of the discussion below:
1)With a surge in demand for health and social care services likely and a priority on people receiving care at home where clinically appropriate, how are East Lothian ensuring that health social care professionals are engaging with carers and families in hospital discharge discussions to ensure their needs and wants are central to decision making?
As set out in ELHSCP strategic plan 2022-’25, care at home or as close to home as possible is already a strategic direction for ELHSCP. Staff have a duty under section 28 of the Carers Act to involve carers in planning around hospital discharge, a programme of education is under way aiming to take in all staff within our community hospital. A pilot project of a Carer Support Worker to support carers of people in hospital is in development and aims to embed this duty more fully.
NHS Lothian has updated their discharge framework shared with all staff which highlights where responsibilities lie and makes it clear that when the person is ready for discharge the responsibility for arranging support and making discharge happen falls to the HSCP.
2)The Governments winter readiness plan acknowledges that unpaid carers play a vital role in supporting people to live well at home. How are East Lothian ensuring that unpaid carers have the capacity to care safely? What considerations have been made in relation to the knowledge and skills that unpaid carers need to care safely, the impact on their own mental health and their financial wellbeing (particularly in light of a continuing cost of living crisis?)
ELHSCP have increased support available to carers at a local level over the last five years, all carers can access advice, information and support through our local carers centre, Carers of East Lothian. All carers have a right to an ACSP which should identify the impact of the caring role on different aspects of their life. If Carers meet local eligibility criteria funding is available to meet identified needs which include mental health and financial well being.
The partnership continue to aim to highlight the role of unpaid carers and the support available through campaigns around Carers week and carers rights day, there is a dedicated resource on our website which we will continue to develop.
ELC have produced a Cost of Living guide which includes information for unpaid carers, the digital version is available now on the council website and has been promoted through social media. It will be advertised through the courier, printed supplies for distribution including by the foodbanks, in council libraries and offices, in mailings to customers and a planned school bag drop. Copies have been provided to Carers of East Lothian.
ELC have a dedicated Financial Support Team to offer support to people struggling with the cost of living.
3)How will any local communications incorporating public messaging about care, that signposts people to the right services be disseminated to unpaid carers in East Lothian and how can CoEL and ELHSCP collaborate to deliver consistent messaging to unpaid carers that ensures the right care, in the right place, at the right time?
There will be public briefings on access to pharmacy, care at home, vaccinations and access to GP’s across the winter period.
ELHSCP is running a Primary care campaign into the new year on “Right care, right place” There will be social media about right care, right place and this information is available through the partnerships health pages here: https://www.eastlothian.gov.uk/elhscp/health-services A booklet containing this information has just been published and will be available in all GP surgeries as well as copies being provided to Carers of East Lothian.
It is hoped that there will be a household drop of this booklet making it available to every household in East Lothian.
4)What are East Lothian’s contingency plans to cover NHS staff disruption and are they robust enough to ensure disruption will not cause a crisis in unpaid care? Can any contingency plans be made transparent to unpaid carers as well as to paid staff?
ELHSCP is already experiencing staff shortages and are managing services to the best of their ability, the partnership cannot predict levels of staff disruption over the winter period but have plans in place to prioritise services if necessary. ELHSCP will work to the best of their ability to maintain public services and will communicate any adjustments to these.
The partnership will be asking through our public communications that where family are able to assist they do so to help in any way they can.
Recruitment of paid care staff is a huge area of work in East Lothian, among the work there is an ongoing campaign to recruit more paid carers with the aim of expanding services and providing more care at home, this will include a radio campaign on Forth 1.
5)How are the HSCP working with the third sector at a time where they are likely to see a surge in referrals from unpaid carers?
ELHSCP have significantly increased investment over the last five years in third sector services that offer support to unpaid carers at a local level. We have worked to increase partnership working between providers and therefore ensure carers are offered the right support at the right time. Partners like Carers of East Lothian have good links with the partnership where they can highlight areas of concern and support future planning.
Our Third sector Interface, Volunteer Centre East Lothian have been involved in winter preparedness planning.
6)What outreach work is happening in EL to promote uptake of winter vaccines amongst unpaid carers, with a particular focus on under-served communities and where uptake continues to be lowest, including Polish, Gypsy/ Traveller, African and Black/ Caribbean ethnic groups and people in areas of highest SIMD.
The plan for winter vaccinations can be seen here:
Current vaccination programme | Primary Care Services in East Lothian | East Lothian Council
ELHSCP have good links with organisations offering support to carers from under-served communities and use these links to promote uptake, for example Feniks work directly with Polish carers, MECOPP with minority ethnic carers including gypsy/traveller communities, Milan with older people from South East Asia.
The vaccination programme in East Lothian has had a strong uptake for both seasonal influenza and COVID vaccination this winter – we are nearing the end of these programmes and we achieved some of the highest levels of uptake in Scotland. Currently we have vaccinated 34,700 East Lothian resident for seasonal influenza and 41,400 residents for the COVID19 vaccination. The COVID19 vaccination uptake is at 64% (the highest in Lothian).
We have also increased the number of sites we provide vaccinations from in East Lothian and are now also using the Belhaven Hospital in Dunbar to increase access in that area
We have an inclusivity programme for vaccinations and have worked closely with the NHS Lothian Public Health team. Actions we have taken in this programme are:
- Attendance at the MECOPP Working towards Cultural Competence workshop which took place on 18thOctober to support and helped guide our programme.
- Engaged with Health in Mind as they were organising an International Picnic for Black and Minority Ethnic Communities (through Peer Connecting) on 24thOctober and 21st November at the Inveresk Lodge Garden in Inveresk, Musselburgh. This was with a view to finding out whether or not they felt their service users would welcome the opportunity to speak to a vaccinator to ask questions etc. The event on the 24th October is their first one in East Lothian and they are going to have a chat with the group to see how they feel and will contact us if they think this would be beneficial.
- We have also had the vaccination bus out and about in East Lothian. This is supporting outreach both in areas with highest SMID, areas with lower uptake and also remote and rural areas.
- The HSCP LD team offer bespoke outreach to their clients when they are unable to access vaccination clinics.
- We are due to attend a Pop up clinic at Esk Centre to support those with substance misuse access vaccination.
- We are working with our ELC colleagues to support outreach for those experiencing homelessness and are also looking to arrange pop ups/bus visits near food banks.
- Email communication is going out to NHS, social care young and unpaid carer groups to ensure they are aware of how to access vaccination and support will be given where this is identified.
- We currently do not have static traveller sites we can access but out local colleagues are aware of us and know to engage if temporary encampments are known about and if there is a need for us to attend to vaccinate.