Specialist nurses in A&E and extra weekend GP cover for care homes are being used to tackle winter pressures in the Lothians.

A multi-million pound strategy has been announced for hospital and community services, aimed at managing an expected increase in demand the coming months.

The NHS Lothian plan has an emphasis on reducing hospital attendance, using community-based initiatives to avoid admissions and reducing the length of patient stays in hospital.

Figures published this month show the health board was the worst-performing A&E in Scotland, with 81.4% of patients seen within the four-hour target period in November.

Around £3.4m has been allocated to services across the acute sector and the health and social care partnerships.

The measures include boosting senior medical and other clinical staffing in areas of the highest demand, with specialist respiratory and cardiology nurses allocated to the emergency department.

Dedicated teams will help patients return home as soon as they are able, with expanded ‘discharge lounge’ facilities in hospital and transport on offer.

A policy of ‘ringfencing’ beds for both planned surgical activity and emergency surgical activity has been introduced to help make sure enough are available.

Extra GP weekend cover has also been put in place for care homes to provide better continuity of care for patients and avoid hospital admissions where possible.

Jacquie Campbell, chief officer of acute services, NHS Lothian, said: "Every day our teams perform vital, lifesaving work, but they come under increasing pressure over winter. 

“We have designed a plan that not only supports them, but also allows them to continue to provide the high quality, patient-centred care we are all so proud of.

"This diverse range of new initiatives and plans will help our frontline and community services to react in more responsive ways to the challenges that winter brings.”

She added: "We are also working with and creating more community-based services to reduce the need for patients to come to hospital and then also ensure they can return home as soon as they are fit and well enough to do so."

NHS Lothian has also launched a campaign which urges patients to think about if they need to go to A&E and consider using other services such as minor injuries units, pharmacists and GPs.