Scotland’s Improving Flow Plan: what it means for independent providers

The recently published Scottish Government’s Health and Care Improving Flow Plan 2026–2031 aims to make it easier for people to move through health and care services. Its central ambition is to provide more care at home and in communities, while allowing hospitals to focus on emergencies and specialist treatment.

Several commitments are relevant to independent providers. The plan envisages expanding community diagnostics and screening, making more specialist outpatient care available locally, and increasing Hospital at Home, virtual care and remote monitoring. It also prioritises faster discharge through rehabilitation, step-down services and Discharge to Assess, with health boards expected to improve discharge performance ahead of winter.

The plan calls for better use of capacity across the whole system and more connected patient pathways, supported by MyCare.scot and an integrated health and care record.

There is, however, no explicit commitment to increase the use of independent healthcare providers. The next test will be whether the detailed delivery plans developed by NHS Scotland’s sub-national planning and delivery committees make practical use of the capacity and expertise already available across the sector.

In her recent speech following the publication of the plan, Cabinet Secretary for Health and Care, Angela Constance also referenced prevention and the need to shift from reacting to illness to preventing it. This is also an area where the independent sector could play its part.

The Scottish government have committed to a National Orthopaedic Plan where ‘simple structures will increase access to elective procedures and eradicate long waits.’ We will be watching closely to better understand what this means for elective care.

Separately, the Scottish Government’s Programme for Government 2026–2031 proposes replacing the current 14 territorial health boards with two strategic health boards. Details of how responsibilities, local delivery and commissioning would work under this model have yet to be set out. IHPN will follow both the Flow Plan’s delivery arrangements and the board reforms closely and make the case for independent providers to be involved early rather than treated as a last-resort source of capacity.