OUR HEALTH, OUR CARE, OUR FUTURE
Why do we need a strategic plan?
To set out a shared direction and the things we need to do:
• To maintain and raise quality standards
• To meet the needs of a changing population
• To change our relationship with patients and their carers
– putting patients at the centre
• To work more closely with other public services
• To work more efficiently.
What are the challenges we face?
• Demography, inequalities and ill health
• Multiple and chronic illnesses (Multimorbidity)
• Health service demand and rising expectations
• Tighter finances
What will success look like?
Improving the quality of care through:
• Increasing the role of primary and
community care
• Integrating health and social care
• Focus on anticipatory care, self –
management support
• Improving unscheduled and
emergency care
• Improving our approach to multiple and chronic illnesses
• Involving people in their care and in service improvements.
What will success look like?
Improving health of the population by focusing on:
• Early years
• Underlying causes of health
inequalities
• Preventative measures on
alcohol, tobacco, dental
health, physical activity
• Early detection of cancer.
What will success look like?
Better value and financial sustainability, by:
• Adapting the workforce
• Innovating to raise quality and reduce costs
• Raising efficiency and productivity
• Designing care pathways delivering what
matters to patients.
• Identifying areas for disinvestment – where
there is no contribution to the health of the
population.
What will success look like?
Previous System
Future System
Geared towards acute / single
condition
Designed around people with multiple
conditions
Hospital centred
Located in local communities and their assets
Doctor dependent
Multiprofessional and team based care
Episodic care
Continuous care and support when needed
Disjointed care
Coordinated and integrated health and care
Reactive care
Preventative and anticipatory care
Patient as passive recipient
Informed, empowered patients and clients
Self-care infrequent
Self-management/self directed support
Carers undervalued
Cares are supported as full partners
Low tech
Technology enables choice and control
What we are going to do –
the headlines
• Patient-centred, whole-system, pathways approach
• Scottish Patient Safety Programme
• Multimorbidity action plan
• Enable joint working- healthcare,
social care, 3rd sector
• Improve access to primary care &
community teams
• Reduce and eventually eliminate
delays in patients’ discharge
•
Improve the care for older people
What we are going to do –
the headlines (continued)
• Develop a new East Lothian Community Hospital
• Adapt the use of Midlothian Community Hospital
• Develop community mental health services and redevelop the Royal
Edinburgh Hospital
• Revise emergency care at the Western General Hospital
• Expand acute receiving and assessment capacity at the Royal Infirmary
of Edinburgh
• Focus major hospital care on 4 sites: RIE, WGH, St Johns & new REH
What we are going to do –
the headlines (continued)
• New configuration of acute inpatient services at RIE, WGH and SJH
• Do more on a day case basis
• Review outpatient services
•
Develop sustainable in-house
capacity for elective care
• Improve children’s services, open
new children’s hospital
• Redesign cancer pathways, build
a new Regional Cancer Centre
How are we going to do it…….?
By putting patients at the
centre of our plans.
Focus on the patients’
journey and experience,
with four names to
represent four groups of
patients.
How are we going to do it…….?
• Different working arrangements for clinical and other staff
• Work with patients, staff, GPs, social care colleagues to
design a better way of doing things
• Integrating health and social
care systems
• Organisational development
• Adapting the workforce
• Better use of information
• eHealth
• Innovation
• Managing the finances
Priority Workstreams
ACUTE
PRIMARY CARE/ COMMUNITY
• Stroke redesign
• GP practice capacity
• Unscheduled flow – all 3 sites
• Primary care capability
• Orthopaedic DCAQ
• LUCS review
• Ortho rehab ( then gen. rehab)
• Care village/ older people’s
• Ophthalmology DCAQ/ accom.
care models x4
• Out-patient redesign
• Draft integration plans x4
• Day surgery/ ambulatory care
• Year 1 H&SC priorities x4
• Gynaecology
• Maternity
• Cancer and ECC WHOLE SYSTEM PRIORITIES/ ENABLERS
• Plastic surgery
Inequalities and prevention
Workforce
• Laboratories
Information and technologies
Disinvestment/ hard choices
Patient pathways
Next Steps
•
2 April 2014 – Draft plan approved by NHS Lothian Board
•
21 April 2014 - “Our Health, Our Care, Our Future” consultation launched
•
May, June, July 2014 - meetings with staff, patients groups, third sector
organisations, carers, community groups, local authorities, Scottish
Government and other stakeholders to analyse patent pathways, consider
options and develop specific proposals;
•
8th August 2014 – Consultation closes
•
1st October 2014 – NHS Lothian Board receive definitive Strategic Plan for
approval.
How to get involved
• Discuss with your colleagues
• Respond to the consultation questions:
- Does this plan address the most important issues?
- Have we missed anything really significant? If so what?
- Is there anything else you would like to tell us before finalising the
plan?
•
•
•
Comment on the proposed criteria for making decisions
Comment on the NHS Lothian Health Inequalities Plan
Comment on the NHS Lothian Strategy for Cancer
How to get involved
• Complete the on-line questionnaire at:
www.nhslothian.scot.nhs.uk/OurOrganisation/ourHealthOurCare
OurFuture
• Respond to the consultation questions – Email us at
OurHealth.OurFuture@nhslothian.scot.nhs.uk
• Write to: Professor Alex McMahon, Director of Strategic
Planning, NHS Lothian, Waverley Gate, 2-4 Waterloo Place
Edinburgh EH1 3EG