Presentation by Heidi May
 Board Nurse Director NHS Highland
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April 1st 2012 NHS Highland integrated with the
Highland Council
The Lead Agency model was used (not Body
Corporate)
NHS Highland leading on Adult Health and Social
Care (including 17 Care Homes and Care At Home
Services); the Highland Council leading on
Community Children’s Services
Employment of Children’s Services Health Visitors,
some Learning Disability Nurses and AHPs
transferred to the Council
Social Workers, Contract Managers, Care Home
staff, Care at Home staff, OTs transferred
employment to NHS Highland
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Like most Boards NHS Highland has more
than one Council in its Boundary
Integration with Argyll and Bute Council will
take place by 1st April 2016
Body Corporate Model being used
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NHS Highland = 41%
landmass of Scotland
(size of Denmark)
24 inhabited Islands
312,000 population
24 Hospitals
Multiple Community
Teams
Two Councils
IN
Then a
miracle
occurs
“Good work ……. but I think we need
just a little more detail right here”
JW99
OUT
Corporate
Visible
approach
Coal face
to
Professional
identity &
standards
The Person
boardroom
Influencing
Visioning
Workforce
Planning
Human
factor staff
Communication
Structures
formal /
informal
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Hardest thing??
What are we trying to achieve that we aren't
currently doing
What has to change
“The Highland Partnership is committed to
achieving the best possible outcomes for our
population and service users. We believe that
services should be person centred and
enabling, should anticipate and prevent need
as well as react to it, should be evidence
based and acknowledge risk. We will improve
the quality and reduce the cost of services
through the creation of new, simpler,
organisational arrangements that are
designed to maximise outcomes and through
the streamlining of service delivery to ensure
it is faster, more efficient and more effective.”
The Highland Council & NHS Highland 16 December 2010
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Seamless care – health and social care
Quality of Experience – right every time
Opportunity to design/redesign care pathways –
what adds value to the person
Joint vision – Staff, People, Relatives, Carers,
Residents
Joint working – health, social care
Single budget – everyone agrees what priorities are
Performance management structure – what’s the
impact on the person
The will to improve!
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Single Point of Access
Co-location
Integrated Teams under one manager
Virtual Ward
Single Budget
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Fear of change/unknown
Different organisational cultures
Team Leader structures
Maintaining clinical identity
Reaching the decision makers
Connecting decisions to the patient
Who has accountability
We don’t know what we don’t know
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Stakeholder Events
Staff workshops
Issues Log
Escalation Process
Ward Forums
Communication and Engagement Plan –
Public events, newsletters, website, public
notices, newspaper articles
Elected and Board Members Briefing
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No Magic Bullet!
Marathon – not a sprint
Be visible
Meet with staff
Do visioning events with staff
Use tools to bond the multidisciplinary Team
◦ CBAS
◦ Releasing Time to Care
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Capture the stories
Address the logistical problems and concerns
◦ E.g. shared data bases
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Care Home standards (Care Inspectorate grading)
have risen across the Board
 Care Standards Steering Group
 Dedicated Care Home staff e.g. falls prevention, food fluid
and nutrition
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Reduction in length of stay in Care Homes
Increased availability of Care at Home services
Improved co-ordination, response and flexibility
of multi disciplinary teams.
Easier access to services through a single point
of access
Enhanced community care through Virtual Wards
Improved satisfaction and quality of life
Thank you
Any Questions?