A Route Map to the 2020 Vision for Health and Social Care
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
A Route Map to the 2020 Vision for Health and Social Care
02 A Route Map to the 2020 Vision for Health and Social Care
Introduction
This paper sets out a new and ■■ maintains the commitment to
accelerated focus on a number of priority pursuing the 2020 Vision for Health
areas for action in the form of a ‘Route and Social Care through a focus on
Map’ to the 2020 Vision for Health and improving quality at scale across
Social Care in Scotland. It summarises Scotland (building on success, e.g.
some of the excellent achievements Family Nurse Partnerships, Scottish
that have been secured in recent years Patient Safety Programme etc.);
through a focus on improving quality in
■■ pursues opportunities to work with
our health and care services through the
other public sector and business
implementation of the Quality Strategy,
partners to drive transformational
and reflects that these achievements
innovation, providing growth in the
are at least partially responsible for the
Scottish economy;
high regard with which Scotland is held
internationally. It is therefore important ■■ identifies particular areas for
to emphasise our continued commitment accelerated improvement and
to pursuing the three Quality Ambitions enhanced roles in unscheduled and
of safe, effective and person-centred emergency care, in primary care, and
care, as set out in the Quality Strategy. in services for people living with
multimorbidities providing a whole
However, over the next few years the system response to improve the
demands for health and social care and patient pathway in order to reduce
the circumstances in which they will be pressure on A&E departments;
delivered will be radically different. It is
■■ supports our commitment to shift
our job to ensure that we can continue to
the balance of power to, and builds
provide the high quality health and care
up and on the assets of, individuals
services the people of Scotland expect
and communities through a focus
and deserve into the future, securing
on achieving social change (more
the best possible outcomes for people
people able to care, volunteer etc.),
from the care and support they receive.
support for the self-management of
We must therefore collectively recognise
long-term conditions and personal
and respond to the most immediate and
action (drinking, exercise, diet and
significant challenges we face. These
engagement) through working in
include Scotland’s public health record
partnership in Community Planning
and level of inequalities, our ageing
Partnerships (CPPs) and the new
population, the increasing expectations
Integrated Health and Social Care
arising from new drugs, treatments and
Partnerships; and
technologies and the specific impact of
inflation on the health service. ■■ develops our strategy for engaging
and empowering our workforce,
The Route Map has been designed to providing our response in Scotland to
retain our focus on improving quality addressing many of the issues raised
and to make measureable progress to the by the Mid-Staffordshire/Francis
2020 Vision, with specific deliverables Inquiry, and equipping them to work
in 2013/14. The key features are that it: in an integrated way which reflects
the different needs of different people
■■ recognises the importance of the
and different places across Scotland.
public service reform agenda as a
framework for delivering the 2020
Vision for Health and Social Care;A Route Map to the 2020 Vision for Health and Social Care 03
The 2020 Vision for Health and Care in Scotland
We must be bold enough to agree and
'Our vision is that by 2020 everyone pursue the key actions that will allow
is able to live longer healthier lives us to turn this 2020 Vision into a
at home, or in a homely setting. reality. It is only by doing this that we
We will have a healthcare system will secure the health and social care
where we have integrated health and services in Scotland that will best meet
social care, a focus on prevention, the needs of future generations, and
anticipation and supported self- demonstrate our ability to deliver a
management. When hospital world-leading high quality health and
treatment is required, and cannot care service to the people of Scotland.
be provided in a community setting,
day case treatment will be the norm.
Whatever the setting, care will be
provided to the highest standards of
quality and safety, with the person at
the centre of all decisions. There will
be a focus on ensuring that people get
back into their home or community
environment as soon as appropriate,
with minimal risk of re-admission.'04 A Route Map to the 2020 Vision for Health and Social Care
Our record of excellence
In Scotland we have considerable We have achieved these successes
experience and success in delivering through working in partnership across
and improving high quality and the Scottish Government, the wider
sustainable healthcare services which public sector and with staff. Looking
are already recognised internationally ahead, our model remains one of
as world-leading. In particular our integration, collaboration, outcomes
record of successes include: focus, values trust and innovation. We
continue to categorically rule out the
■■ legislation to ban smoking in public
disruptive type of reforms and upheaval
places;
being put in place in NHS England and
■■ significantly reducing premature are committed to continuing to provide
mortality from cancer, heart disease high quality health and social care to
and stroke through a number of the people of Scotland. Our recognition
initiatives including most recently of the importance of local ownership of
the high profile detect cancer early decision making and service delivery
programme; complements our unified system for
governance and accountability in
■■ delivering enhanced patient safety
NHSScotland.
with major reductions in levels of
Healthcare Associated Infections (HAI);
During the current spending review we
■■ massively reducing waiting times and have committed to protecting health
delayed discharge from hospital; and spending by giving a real terms resource
increase recognising the very specific
■■ effective management of a £12 billion
inflationary and service pressures
budget.
facing the delivery of health and care
services. Efficiency savings identified
These, and other successes, are
by territorial NHS Boards amounting
recognised internationally as innovative
to over £1 billion in the last four years
and aspirational both for what they
have been retained by them and used to
have delivered to date and for their
further enhance local services.
future scope and potential for improving
health and social care in Scotland.A Route Map to the 2020 Vision for Health and Social Care 05
The Challenges
Over the next 10 years, the proportion There will be a continuing shift in the
of over 75s in Scotland’s population – pattern of disease towards long-term
who are the highest users of health conditions, particularly with growing
and care services – will increase by numbers of older people with multiple
over 25 per cent. By 2033 the number conditions and complex needs such as
of people over 75 is likely to have dementia. Estimates suggest that the
increased by almost 60 per cent. Over number of people with dementia is set
the next 20 years demography alone to rise from 71,000 to 127,000 within
could increase expenditure on health the next 20 years. If we do not dedicate
and social care by over 70 per cent. resource to dementia there will be
These challenges will augment the tremendous financial costs to the NHS
specific impact of inflation on health and social services as well as the health
and care services. and cost impact on carers. Compared
with non-caregivers, carers of people
Despite efforts to address the challenge with dementia are more likely to take
of health inequalities in Scotland over prescribed medication, visit their GP
recent years, we have made very and to report higher levels of stress
little progress. This remains a key and physical symptoms.
priority area.06 A Route Map to the 2020 Vision for Health and Social Care
The 2020 Vision Route Map
The accelerated pursuit of the 2020 prevention as a priority area of activity
Vision through the Route Map set out around population health, but it is also
on the opposite page, building and fundamental to the approaches we will
developing on our model for integrated develop to improve care for people
health and social care delivery, will with multi-morbidities, and in support
demonstrate competency through our of older people through an integrated
recognition as a world-leader in high system. Finally, we will be driving
quality health and care services. improvement across the range of
priority areas using the Framework for
Public Service Reform Improvement which has measurement
It is also important to confirm that the and performance as one of its key
approach makes a vital contribution features.
to our commitment to the four pillars
of public service reform set out in We continue to support the focus
our response to the Christie Report – on performance across NHSScotland
reflecting our commitment to achieving through the annual process of agreeing
outcomes which matter to the people of NHS Board Local Delivery Plans with
Scotland while ensuring the financially improved monitoring and assessment
sustainability of our public services. of outcomes. Ensuring that HEAT targets
evolve to reflect the key priorities
Working in partnership is fundamental set out in the 2020 Vision Route Map
to achieving progress in each of the will make an important contribution,
priority areas – partnership across the alongside a focus on supporting
NHS in Scotland, with local government, NHS Boards to strengthen their
with the third sector, with industry, governance roles, and the commitment
with central government and with to work through Community Planning
people. This partnership approach is Partnerships (CPPs) and Integrated
particularly vital for one of our three Health and Social Care Partnerships.
Quality Ambitions: that all the services This will ensure that Single Outcome
we develop and deliver are person- Agreements properly reflect health
centred. The focus in the Route Map and social care priorities and that local
on developing the workforce and NHS Boards will be held to account for
leadership capacity also makes an their effectiveness in the delivery of
important contribution to the people these priorities and for ensuring the
pillar. The Route Map clearly identifies effectiveness of CPPs generally.A Route Map to the 2020 Vision for Health and Social Care 07
The Route Map describes 12 priority priority areas for action, often building
areas for action for pursuing our 2020 on existing work and all requiring
Vision for high quality sustainable focused attention and acceleration.
health and social care services in In addition to these 12 priority areas
Scotland in three domains: for improvement action, it is vitally
important to emphasise the need for a
1. Quality of care
continued focus on ensuring that the
2. Health of the population underpinning foundation of high quality
health and care services are maintained
3. Value and financial sustainability.
as business as usual. These include:
performance (e.g. HEAT), governance,
These domains are often referred to
planning (services, workforce, finances
as the ‘Triple Aim’. For each of these
and estate), IT and measurement.
domains there will be a small number of
2020 Vision/Quality Ambitions
2020 Vision Safe, effective and person-centred care which supports people
to live as long as possible at home or in a homely setting
Value and
Health of the
Triple Aim Quality of Care Financial
Population
Sustainability
Independent
living
Services
Quality are safe Effective
Healthier living
outcomes Engaged resource use
workforce
Positive
experiences
12 Priority Areas for Action (as detailed on page 12)08 A Route Map to the 2020 Vision for Health and Social Care
Route Map to The 2020 VisioN
TRIPLE AIM Key deliverables for 2013/14:
−− Bill introduced to Parliament and
gaining Royal Assent
1. Further improving the
−− Preparatory work with NHS
quality of the care Boards, local authorities, third and
we provide with a independent sector partners and
particular focus on: including development and delivery
against new Single Outcome
■■ Increasing the role of primary care – Agreements and the building of
There is now a strong consensus on effective Integrated Health and
the urgent need for an expanded role Social Care Partnerships.
for primary care and general practice
in particular. This is at the heart of ■■ Accelerating our programme to
our 2020 Vision, specifically focused improve safety in all healthcare
on keeping people healthy in the environments – Building on the
community for as long as possible world-leading and recognised
and represents a critical prerequisite success of the Scottish Patient
to tackling health inequalities and the Safety Programme, we will continue
challenges facing unscheduled care. the ground-breaking extension of
this programme into primary care,
Key deliverables for 2013/14: maternity services, paediatrics and
−− Implementation of the new GP mental health, and will embark on
contract with benefits fully the development of a new Scottish
explored and realised Patient Safety Index to accelerate
−− 2020 Vision for expanded primary our progress in driving down harm in
care developed acute care settings.
−− New models of ‘placed-based’ Key deliverables for 2013/14:
primary care developed including −− Further increase safety in Scottish
a model for remote primary care hospitals as measured by HSMR
implemented and evaluated and HAI
−− New broader measure of safety
■■ Integrating health and social care –
developed to increase impact of
Integration of adult health and social
improvement (SPSI)
care is a key part of the Scottish
Government’s commitment to public −− Maternity, mental health and
service reform in Scotland. We will primary care components of the
continue to drive forward the widely Scottish Patient Safety Programme
endorsed commitment to integrating implemented with measureable
health and social care services improvements
in Scotland.A Route Map to the 2020 Vision for Health and Social Care 09
■■ Improving the way we deliver Key deliverables for 2013/14:
unscheduled and emergency care – −− Person-centred Health and Care
A new Expert Group has been Collaborative being implemented
established to identify and agree with measureable improvements
high impact actions to transform locally in experience for patients,
the way that unscheduled care is their carers and for staff
delivered with a focus on reducing −− Support and clear accessible
the number of people who present at information will be available to
A&E departments through action in enable people and their carers to
the community, in primary care and manage confidently at home and
to improve the flow of patients out during times of transition
of A&E. Specific work will be done
to improve services at weekends ■■ Improving our approach to
and out-of-hours in both urban and supporting and treating people who
remote and rural areas. have multiple and chronic illnesses –
Key deliverables for 2013/14: Will deliver improved outcomes
−− Develop out of hospital care as part for people living with multiple
of the National Unscheduled Care morbidities, including mental health
Action Plan conditions. We will consider the
whole pathway of care with a focus
−− Achieve a sustainable performance
on people aged under 65 in areas
on 4-hour A&E waits by the end of
of deprivation and high levels of
December 2013
health inequalities. This work will
−− Improve patient care in hospitals link closely with the work to expand
by increasing flow through the the role of primary care, to improve
system unscheduled care, to put people at
the centre and to integrate health and
■■ People-powered health and care care services. Much of this work will
services – Through the Patient Rights require strong partnership working,
Act and ground-breaking work to and will be supported by health
develop more person-centred health and social care providers playing
and care services we will give the a full role in Community Planning
public a voice on their experiences Partnerships and the development
to drive up the quality of care, of Single Outcome Agreements, and
promote personal responsibility for through the new Integrated Health
health and wellbeing, and support and Social Care Partnerships.
self-management so that people are
better able to maintain their health Key deliverables for 2013/14:
and to manage periods of ill-health. −− Key pressure points in the
This will include a focus on improving entire patient pathway for most
resources and support to people to commonly occurring combinations
help them navigate and understand of chronic-term illnesses will be
the system, so that they become identified and actions for how we
more involved and engaged in address these will be agreed
their healthcare. −− Through more detailed analysis
of existing data, people will
be identified as ‘at risk’ and
anticipatory plans will be agreed10 A Route Map to the 2020 Vision for Health and Social Care
2. Improving the health of ■■ Preventative measures on alcohol,
tobacco, dental health, physical
the population with a activity and early detection of cancer
particular focus on: – Despite significant improvement
in health outcomes in recent years,
■■ Early years – We will drive forward Scotland continues to have a poor
the Early Years Collaborative, record of healthy life expectancy.
breaking new ground in improvement Alongside the commitment to
methodology across the full range of refocus energy on targeting health
public partners involved in a child’s inequalities, we will continue to
early years, building on successes pursue a preventative agenda in
such as Family Nurse Partnerships partnership across the public sector,
and working on the ambition to make concentrating on tackling Scotland’s
Scotland the best place for children relationship with alcohol, smoking
to grow up. and increasing levels of physical
Key deliverables for 2013/14: activity. We will also continue to
−− The world’s first national multi- invest in the hugely important
agency quality improvement programme of work to increase
programme will be implemented the early detection of cancer. Once
across partner organisations to give again, much of this work will require
our children the best start in life strong partnership working, and will
be supported by health and social
■■ Reducing health inequalities – care providers playing a full role in
We will refocus our efforts on health Community Planning Partnerships and
inequalities particularly in the context the development of Single Outcome
of benefits cuts which will impact Agreements, and through the new
those most at risk of ill-health. We Integrated Health and Social Care
will do this by targeting improvement Partnerships.
resources into primary care in the Key deliverables for 2013/14:
most deprived areas of Scotland −− There will be a measureable
including staff and equipment such increase in early detection of
as tele-health facilities, learning from cancer across Scotland, and
and rolling out successful initiatives particularly in deprived areas
such as the ‘Deep-end’ GP practices resulting in better outcomes
in Glasgow.
−− Implementation of new restrictions
Key deliverables for 2013/14: on tobacco advertising will result
−− There will be a new focus on in a reduced rate of smoking
targeting resources to the most amongst teenagers
deprived areas
−− The successful approach developed
in the ‘Deep-end’ GP practices will
be rolled out more widely across
relevant areas of Scotland reducing
the risk of admission to hospital
and improving outcomes for
people in Scotland’s most deprived
communitiesA Route Map to the 2020 Vision for Health and Social Care 11
3. Securing the value and is an ambitious one and aims to
target high value fundraising through
financial sustainability philanthropy, European funding, and
of the health and care assessing other models of fundraising.
services we provide: Key deliverables for 2013/14:
−− A new fund to provide pump-
■■ Establish a vision for the health and
priming for innovative approaches in
social care workforce for 2020, and
healthcare will result in more small/
setting out a clear plan of actions
medium Scottish companies working
which will have an immediate effect –
with NHSScotland to develop and
We will take forward a major
test solutions which improve the
programme to work in partnership
quality of care and contribute to
with staff, professional bodies, and
Scottish economic growth
unions to establish and agree a vision
for the health and care workforce −− A new procurement portal will be
required to realise the 2020 Vision. established to encourage small/
We will develop a detailed action plan medium enterprises and other
with key deliverables which start to partners, including third sector,
have a significant positive impact for to work with NHSScotland
staff and patients in 2013/14 and
each year thereafter. One of the early ■■ Increase efficiency and productivity
actions will be a focus on workforce through more effective use of unified
planning to ensure that we have the approaches coupled with local
right people, in the right numbers in solutions and decision making where
the right jobs. appropriate – We will fully implement
the Efficiency and Productivity
Key deliverables for 2013/14: Portfolio of action at scale, including
−− 2020 Vision for NHSScotland a specific focus on implementing
workforce published in June 2013 shared services where possible
following extensive consultation and appropriate, reducing drug
−− Implementation plan to deliver costs through a single programme
2020 Workforce Vision through management focus on prescribing
modernisation, leadership and savings, which better co-ordinates
management by November 2013 both the national and local work in
this area and optimises the use of
■■ Increase our investment in new management information to highlight
innovations which both increase areas for improvement.
quality of care, and reduce costs
Key deliverables for 2013/14:
and simultaneously provide growth
−− A review of national services to
in the Scottish economy – The new
NHSScotland will be carried out
Innovation Partnership Board which
with recommendations to increase
has been established to take forward
shared services and to achieve
the joint Statement of Intent between
further contributions to the
government, NHS and industry will
shift required of resources from
additionally be asked to oversee
management to front-line services,
a new Innovation Fund which will
where this does not negatively
be tested through two initial pilots
impact on the quality of care.
before role out to scale. The approach12 A Route Map to the 2020 Vision for Health and Social Care
ROUTE MAP TO THE 2020 VISION FOR HEALTH AND
SOCIAL CARE
12 Priority
Quality
Triple Aim Areas for 25 Key Deliverables for 2013/14
Ambitions
Improvement
Person-centred Health and Care Collaborative
1
Person- Person-centred implemented
centred Care Information and support to enable people at
2
home and during times of transition
3 Further increase in safety in Scottish hospitals
4 New broader measure of safety developed (SPSI)
Safe Safe Care Maternity, mental health and primary care
components of the Scottish Patient Safety
5
Programme implemented with measureable
improvements
6 Implementation of new GP contract
Primary Care 7 2020 Vision for expanded primary care
8 New models of ‘place-based’ primary care
Quality of
Care Unscheduled 9 Out of hospital care action plan
and Emergency 10 Sustainable performance on 4-hour A&E waits
Care 11 Increase flow through the system
12 New Bill
Preparatory work with NHS Boards, local
Integrated Care authorities, third and independent sector and
13
the building of effective Integrated Health and
Social Care Partnerships
Key pressure points in the entire patient
Care for 14 pathway for most common multiple illnesses
Multiple will be identified and actions agreed
and Chronic Through more detailed analysis of existing
Illnesses 15 data, people will be identified as ‘at risk’ and
anticipatory plans will be agreed
Effective The world’s first national multi-agency quality
Early Years 16 improvement programme will be implemented
across partner organisations
Health of the 17 New focus on most deprived areas
Health
Population Inequalities ‘Deep-end’ GP practices approach rolled out
18
more widely across relevant areas
19 Early detection of cancer
Prevention
20 New restrictions on tobacco advertising
21 2020 Vision for NHSScotland workforce
Workforce Detailed action plan agreed to deliver 2020
22
Workforce Vision
A new fund to provide pump-priming for
23
Value and innovative approaches in healthcare
Sustainability Innovation A new procurement portal will be
24 established to encourage working with
SMEs and third sector
Efficiency and
25 Recommendations to increase shared services
ProductivityYou can also read
