The Scottish Government has said it is "committed to protecting planned care" in the NHS this winter through initiatives to "maximise" capacity.
The Health and Social Care Winter Preparedness Plan for 2024/25 includes a pledge to "maximise capacity and capability to meet demand" as one of four key priorities for the NHS over the coming months.
The report notes that in recent years health boards "sometimes have had to take the difficult decision to step down planned care in order to deliver emergency treatment".
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It adds: "Given the impact this has had on waiting lists, and on patients themselves, we are committed to protecting planned care throughout this winter.
"Long waits are regrettable, but we are determined to provide health boards with the support necessary to drive improvements and will continue to target resources to reduce waiting times, particularly for those waiting longest for treatment."
It comes after the latest waiting lists statistics for Scotland revealed there were more than 155,000 people waiting for inpatient or day case procedures by the end of June this year, including some 17,000 who had been waiting over 18 months.
Elective activity in Scotland remains around 13% lower than it was pre-Covid.
While National Treatment Centres in Fife and Highland are helping to significantly increase the number of operations carried out in those regions, construction on the majority of NTCs is currently paused due to curbs on capital spending.
In contrast, NHS England is already exceeding pre-Covid levels of activity thanks in part to its network of 108 surgical hubs - 90 set up since the pandemic - which are a mixture of standalone units, similar to the NTC model, as well as segregated and "ring-fenced" hubs based within acute hospitals but which have their own dedicated beds, staff, and theatre space.
They mostly operate six days a week.
In addition, NHS England refers more patients to the private sector for treatment.
In its winter plan, the Scottish Government said it would "maximise theatre capacity including National Treatment Centres through expanded sessions in evenings and weekends" and "protect planned care through maximising the use of day surgery units including increasing the proportion of procedures converted to day case surgery".
It added that it would "strive to protect cancer care with a focus on continuing to prioritise new urgent suspicion of cancer patients and protect theatres for cancer operating".
Addressing the Scottish Parliament as the winter plan was published, Health Secretary Neil Gray said that "prevention and early intervention" to stop people ending up in hospital would also be a priority.
The winter plan, agreed jointly by the Scottish Government and Cosla and published earlier than usual, will also see a record number of NHS 24 call handlers deployed alongside the annual winter vaccination programme, including immunisations against RSV for the first time to reduce hospitalisations and deaths from the virus among the elderly and young infants.
It also promises to improve discharge planning for patients admitted to acute or community hospitals, maintaining established care at home packages, and a Government-led delayed discharge response team to directly support health boards in need of assistance.
Mr Gray said: “As winter approaches, the NHS will see surges in demand across all health, social care and social work services.
"Our joint-plan Winter Plan with Cosla is just one part of a wider programme of work to respond to heightened demand.
“A record number of NHS 24 call handlers will be available this winter to direct people to the most appropriate care, helping reduce unnecessary A&E attendances.
"We will continue our work to reduce delayed discharge in hospitals with an increased focus on effective discharge planning and protecting care at home packages.
"We will also ensure planned care capacity is protected as much as possible in the face of winter pressure so patients are seen as quickly as possible.
“We are prioritising frontline services with over £14.2 billion investment in our boards this year - an almost 3% real terms uplift – and also investing £2 billion in social care services."
Cosla's health and social care spokesman, Councillor Paul Kelly, said local authorities and health and social care partnerships (HSCPs) are "working hard to plan and deliver the essential health and social care services our communities rely on every day" but this was becoming "increasingly challenging".
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Mr Kelly said this was why Cosla had worked with the Scottish Government to draw up this year's winter plan.
He added: "Local Government plays a key role in supporting people to experience better wellbeing and better outcomes, so it was only right that this plan reflects the whole system of integrated health and social care, from acute and primary care to social work, our care homes, community settings, and our partners across the sector."
Dr Sandesh Gulhane, a GP in Glasgow and the Scottish Conservative health spokesman, said Scotland's NHS is in "permanent crisis mode".
He added: “The plan outlined by Neil Gray today will do little to alleviate growing fears among my frontline colleagues and suffering patients that the health service faces total collapse this winter.
“This statement might be full of warm words but Neil Gray has continued in the vein as his predecessors by failing to outline a real vision to support our NHS through its toughest months.”
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