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Building a Better Scotland
HEALTH AND COMMUNITY CARE
To improve the health and the quality of life of the people of Scotland and to deliver integrated health and community care services making sure there is support and protection for those members of society who are in greatest need.
Objective 1 | | Working across Scottish Executive Departments and with other delivery partners to improve the health of everyone in Scotland and reduce the health gap between people living in the most affluent and most deprived communities. |
Target | 1 | Reduce the mortality rates for those aged under 75, between 1995 and 2010 by health improvement action to tackle diet, physical activity, smoking and alcohol consumption and by action to ensure early detection and improved access to treatment and care: cancer - 20%; coronary heart disease - 60%; stroke - 50%. |
Target | 2 | Reduce health inequalities by increasing the rate of improvement across a range of indicators for the most deprived communities by 15%, by 2008. (The range of indicators has been selected from the 23 recommended indicators of health inequality. For adults - coronary heart disease, cancer, adults smoking, smoking during pregnancy, and for young people - teenage pregnancy and suicides in young people.) |
Objective 2 | | To seek and take into account the views and experiences of patients, carers and communities in designing, planning and improving healthcare services. |
Target | 3 | All NHS Boards will achieve year on year improvements in the involvement of the public in the planning and delivery of NHS services to 2008 and in the involvement of patients in decisions about their own health care and the development of services, as reflected in reports by the Scottish Health Council. |
Objective 3 | | To improve the quality of NHS services to better meet the needs of patients, with particular priority to cancer, coronary heart disease, stroke and mental health. |
Target | 4 | All NHS Boards will demonstrate regular and sustained improvement, as reflected in the reports by NHS Quality Improvement Scotland (QIS) in performance against the Healthcare Governance standards set by NHS QIS. |
Objective 4 | | Ensure patients receive healthcare at the right time, in the right place and in the right way. |
Target | 5 | By December 2007, we will have delivered a further reduction to the current guaranteed maximum waiting time of 6 months for inpatient treatment and 6 months for a first outpatient consultation; and improved diagnostic services through further investment and significantly shortened waiting times, against targets to be set in spring 2005. |
Target | 6 | We will reduce the number of people waiting to be discharged from hospital into a more appropriate care setting by 20% per annum between 2005 and the end of 2008, cutting to a minimum the number of people waiting more than 6 weeks to be discharged. |
Target | 7 | By 2008, increase the number of older people receiving intensive home care to 30% of all older people receiving long term care. |
Target | 8 | To work with NHS Quality Improvement Scotland, patients and clinicians to set new maximum condition specific waiting time guarantees by spring 2005. |
Target | 9 | By 2008-09 we will reduce the proportion of older people (aged 65+) who are admitted as an emergency inpatient two or more times in a single year by 20% compared with 2004-05, to release capacity in hospitals. |
What we will do
The Health portfolio's aim to improve the health and wellbeing of the people of Scotland is accompanied by an overarching commitment to contribute to the Executive's aims to encourage economic growth, to promote equality and to close the health gap between most and least affluent. We also will ensure that our activities are sustainable and delivered in partnership.
Scotland's health is improving, but remains poor when compared to other European countries. In addition there is a substantial, growing gap in life expectancy between the most and least affluent men and women. The challenge of improving health outcomes in Scotland is one which faces the Scottish Executive as a whole. We set out in Health Improvement: The Challenge a strategic approach, drawing together actions and resources across a wide range of the Executive's responsibilities. The focus of the framework is on improving the health of children and young people, of our working age people, and of our communities, delivering health improvement actions which improve life expectancy and close the health gap for the most disadvantaged. Over the period 2005-08 we will support partnership delivery between the NHS, local authorities, private and the voluntary sectors. In doing so we will sustain a national programme of actions to improve life expectancy levels, including healthy life expectancy, and narrow the gap.
We are committed to raising the quality of care and promoting patient safety. We look to NHS Quality Improvement Scotland to provide guidelines and advice to the Service, to set standards and to report on performance. We also aim to strengthen the voice of patients and carers in the development of healthcare services and in promoting higher standards of care. We have established the Scottish Health Council to help ensure that happens.
The Scottish Executive continues to increase investment in healthcare services, and to seek major improvements in performance through investment in capacity and through a sustained programme of reform and service redesign. The NHS in Scotland is based on 15 unified, area NHS Boards, with Community Health Partnerships now emerging to strengthen the voice of healthcare at a local level, promoting better integration of primary care services with the specialist services in hospitals and with the social care services of local authorities.
We continue to invest to increase the capacity of the NHS, with Partnership Agreement targets to increase the number of doctors, nurses and other health professionals; with the largest programme spending on hospitals and community health centres; and with a strategy to improve the use of information technology and telemedicine techniques. We are funding major reforms to modernise the pay and conditions of Health Service staff in support of the required redesign of services, providing a platform for new ways of working, delivery of higher quality care, and the development of new roles for staff. Although the independent healthcare sector in Scotland is small, we will make increasing use of such independent providers on a basis which is fair and which offers a real increase in capacity.
This investment in the NHS needs to be matched by a sustained commitment to redesign the way services are delivered, so as to shorten the patient's pathway of care and provide the right care in the right place. Such redesign will mean major changes in the way healthcare is delivered in future: for example, more support for people with chronic conditions through GPs and local health centres, and less reliance on hospital care; more services to raise health standards delivered through local communities and voluntary bodies; more nurse-led clinics and day-care services; and more investment in local diagnostic facilities.
With the pressures of an ageing population, we will continue to invest in social care services, through local authorities and the voluntary sector, with the aim of delivering a wider variety of services to help more people to live longer in their own homes or in sheltered housing, and to reduce inappropriate admissions and inappropriate length of stay in hospitals.
Our immediate priority, however, remains to improve access to healthcare for all, by measures to reduce waiting times at all stages of the patient's journey of care. With this objective in mind, we will:
- deliver a further reduction on the current maximum waiting time targets of 6 months for a first outpatient appointment and 6 months for in-patient and day-case treatment by December 2007;
- expand diagnostic capacity and throughput and shorten waiting times against targets to be set in spring 2005;
- continue investment by the Centre for Change and Innovation to support service redesign activity and continue to work with NHS Boards to spread locally developed good practice;
- invest in the Golden Jubilee Hospital, Glasgow to expand its capacity for elective surgery in orthopaedics and cardio-thoracic services;
- improve dental services through incentives to help to recruit and retain dentists in the NHS and by increasing the number of dental students and increasing outreach training. We will also improve overall access to NHS Services, both routine and in an emergency situation;
- speed up existing plans for action on infection control and implement new initiatives on hospital cleaning and hand hygiene;
- undertake 7 new major hospital developments and invest in medical equipment and information technology; and
- sustain an increase in the budget of NHS Boards in real terms in the period 2005-08, maintaining spending at levels which compare with other European countries.
The NHS in Scotland will contribute fully to the Efficient Government Initiative, through the following measures:
- plans are well advanced for NHS Boards to share financial, human resource and payroll services and to improve logistic arrangements;
- a review to rationalise NHS estates and facilities management is in hand;
- a national benchmarking exercise to compare performance with equivalent organisations elsewhere in the UK and in Europe is being undertaken; and
- we will explore further options to improve drug prescribing practices.
Food Standards Agency Scotland The Food Standards Agency aims to protect consumers by improving the safety of food and by giving honest, clear information. Over the Spending Review period we will focus on three key activity areas; Food Safety, Eating for Health and Choice. We will continue to deliver a measurable increase in public confidence in the way food safety and standards are managed in Scotland. We will continue to reduce food borne illness in Scotland and reduce the risks to consumers from chemical contamination of food. We are committed to improving the effectiveness and recognition of food law enforcement, which plays a crucial role in protecting the public. We will make it easier for consumers to choose a healthy diet by providing consumers with clear and accurate information to help them make informed choices. We will continue to focus on working with organisations across Scotland to make healthy eating more accessible, whether eating out or preparing food at home. |
Table 7.01 Spending plans 2004-08 (level 2)
m | 2004-05 Plans | 2005-06 Plans | 2006-07 Plans | 2007-08 Plans |
National Health Service | 7,903.89 | 8,623.81 | 9,348.45 | 10,093.61 |
Health improvement | 65.90 | 78.37 | 81.27 | 84.17 |
Other health services | 55.95 | 65.19 | 71.45 | 71.83 |
Community Care | 21.94 | 21.63 | 21.83 | 21.89 |
Total | 8,047.68 | 8,789.00 | 9,523.00 | 10,271.50 |
Mental Health Specific Grant | 14.00 | 14.00 | 14.00 | 14.00 |
Food Standards Agency Scotland | 9.60 | 10.10 | 10.60 | 11.10 |
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