Long term service demand projections in Scotland
A Focus on unplanned admissions to acute hospitals

About this release

This release by Public Health Scotland (PHS) presents analyses carried out within the Population Health Monitoring programme to project unplanned acute inpatient hospital demand, based on historical trends and population projections over the next decade. It provides insight into future pressures on services and highlights key factors driving demand to support planning and resource allocation.

Main points

• Between 2024 and 2034, the estimated number of unplanned acute inpatient hospital admissions in Scotland is projected to increase by 11.8%, from approximately 586,000 to 656,000.
• Demographic change - particularly population ageing - appears to be the primary driver of increased demand among adults aged 65 and over, reflecting the significant shifts anticipated in this age group over the coming decade. This is important as it is the age-range when several long-term health conditions develop or have already manifested.
• Despite a declining child population, paediatric specialty admissions are projected to rise and total admissions for children (0-17 years) are expected to remain stable. This suggests that factors beyond demography, such as increased clinical need, changing health-seeking behaviour, and wider societal influences are at play.
• Five major condition groups - symptom-based, respiratory, circulatory, digestive, and injury related conditions - accounted for 61.2% of all projected unplanned acute inpatient hospital admissions in 2024. By 2034, respiratory conditions show the largest increase by around 23%. These trends suggest certain condition groups are contributing disproportionately to the overall growth in demand.
• While current projections suggest continued growth in unplanned acute inpatient hospital demand, this trajectory is not inevitable. With targeted investment, thoughtful service redesign, and meaningful action on the building blocks of health, there is a real opportunity to ease pressure on secondary care and to build a more sustainable, equitable, and preventative health and care system.

Background

The PHS Population Health Monitoring programme aims to provide a comprehensive picture into the health of the Scottish population. By monitoring overall trends, forecasting future health and service needs, and incorporating economic analysis, we endeavour to support improvements in population health, reduce health inequalities, and improve the sustainability of the healthcare system.

As part of this programme, this publication presents initial findings from work developing long-term demand scenarios for healthcare services. These scenarios aim to improve understanding of current and future pressures, and to assess the potential impact of interventions such as service redesign, targeted investment or enhanced prevention through scenario modelling.