1. Portfolio/Number/Name:H/C5Preventing inappropriate hospital
admissions |
2. Programme/Activity: Please
include a short description By improving the management of patient
care in the community setting, including
improved management of chronic disease
treatment and care, and supporting
self-care models, this will result in a
reduction in inappropriate hospital
admissions. This will: release bed capacity
in acute hospitals, there will potentially
be a decrease in the number of delayed
discharges, and waiting times for elective
procedures will improve. In order to ensure
and monitor a reduction in inappropriate
hospital admissions: The SEHD will: - ensure systems are in place to
monitor multiple admissions data
- ensure performance management
arrangements are in place
- establish a national working group
to advise on best practice
- undertake a review of community
nursing and advise on the development
of new roles, and
NHS Boards, working with partners,
will: - inform the SEHD of the service
improvements they are putting in place
to support the care of people in the
community environment
- absorb the cost of those service
improvements in the primary care
setting through the savings they are
making by reducing inappropriate
admissions in the acute environment,
the Arbuthnott formula will be applied
to identify the savings for each Health
Board area
- produce action plans to document
the intended actions and to enable
monitoring of the reduction in the
number of inappropriate
admissions.
|
3. Planned Savings | | 2005-06 | 2006-07 | 2007-08 |
Cash (m) | 5 | 15 | 25 |
Time Releasing (m) | 0 | 0 | 0 |
4. Accountable Officer for
delivery | Kevin Woods |
5. Project Manager | Paul Martin |
6. EGDG account manager | Gillian Woolman |
7. Quality Impact | Describe any impact on the quality
of service delivery. Be specific and
explain if the expectation is positive,
negative or neutral. It is expected that the level of
patient care in the community setting will
be at least as good as would be provided in
an acute hospital setting, but the
intention is that it should be considerably
better, given that it is more appropriate
care. |
8. Dependencies | Explain if your savings are
dependant on legislation or other
structural changes being achieved. Effective implementation of all of
these initiatives is dependent on
partnership planning and working between
the NHS and local authorities within the
Community Health Planning (CHP) structure.
A culture of maintaining people at home is
now the preferred option for all those
caring for patients. Other dependencies
include the voluntary sector and carers
support organisations and their ability to
respond to an increase in demand for
services. |
9. Description of efficiency and
actions to be taken | 9.1 How will the saving be made? Be
specific about number/size of contracts, staff,
posts dates etc. The savings will be made by releasing
bed capacity, reducing delayed discharges
and improving waiting times for elective
procedures. |
9.2 What action is critically needed to
secure delivery of this saving? Be specific,
and name the key action managers if they are
outwith your immediate management chain (e.g.
in an NDPB.) This action will have the continued
support and drive from NHS Chief
Executives. In order to monitor the
effectiveness of the initiative there will
be the commitment and involvement of NHS
performance managers and/or finance
personnel to monitor and report. |
10. Impact on Staffing to achieve the efficiency
gain | If there are to be any changes in
staff numbers (at activity level) to
achieve the efficiency gain, please
indicate how many full time equivalents and
how far you expect savings to be achieved
by natural wastage (show additions as + and
reductions as -). |
| 2005- 06 | 2006- 07 | 2007- 08 |
+ | | | |
- | | | |
Net | | | |
Explanation | Change will be in the working practice and
programmes of care, and the focusing of staff
on otherpriorities |
11. Benefits | In general, the benefits of the
Scottish Executive Efficiency Plan are the
enhanced outputs from the resources
Ministers have been able to allocate in
SR04. But if there is a direct connection
between this efficiency saving and the
enhancement of a particular service please
describe it here. The 25m savings identified here have
not been re-allocated to any other area of
expenditure in SR04; NHS Boards are
expected to circulate (internally) the
savings made from inappropriate hospital
admissions to the primary and community
care initiatives which are reducing
inappropriate hospital admissions. |
12. Gross/Net Cash Savings | 12.1 Please set out the gross recurring
saving and any offsetting recurring
expenditure. 5m/15m/25m is the planned aggregate
saving across all NHS Boards over the three
years |
12.2 Against what budget does this
expenditure and saving fall? It falls against the Revenue Resource
Limit (RRL) allocation to NHS Boards. |
12.3 Has this saving been built
into your budget? Yes |
12.4 If so, what is the maximum
allowable expenditure against the published
budget data, in each year, for that saving
to be delivered? It falls against the Revenue Resource
Limit (RRL) allocation to NHS Boards. |
12.5 If not, how do you propose to
invest the additional cash back into public
services?N/A |
12.6 What plans do you have to exceed the
required saving? Explain by how much in each
year. There are no plans to exceed the
required saving. |
13. Time - release savings | 13.1 Please explain any time-releasing
savings indicated at question 3
.N/A |
13.2 Please describe the method you
plan to use to calculate the cash equivalent of
those time release savings.N/A |
14. Measurement and
Monitoring | 14.1 How are you proposing to measure the
expected efficiency benefits (e.g. in terms of
costs, level of output or quality of
service)? As with any new service development there
is a requirement to have built in evaluation
systems and demonstrate public/user
involvement. Health Board areas will also be
required to demonstrate any resource
shift. |
14.2 What monitoring & reporting
procedures will be put in place to measure the
efficiency savings (How often will progress
towards the target be monitored? Who will have
lead responsibility for reporting progress and
what procedures will be in place?) NHS Boards will, within their Local
Health Plans, monitor the number of
hospital admissions and demonstrate how
they will achieve the target. This
indicator will be monitored through the
performance management framework. |
14.3 Monitoring Data: Sources, validation
and risks - What data will be used to
measure progress? Is all the required
information quantifiable and readily
available? If not what action will be
taken to rectify this?
- What measures will be in place
to validate the accuracy of the data?
Who will take responsibility for this?
- Are there any issues or risks
relating to how you plan to use the
data? (e.g. accuracy, difficulties in
collection)
Multiple admissions to hospital
will be monitored by ISD using SMR01
discharge forms. The data collection
process will be validated using the ISD
quality assure systems. Need to ensure
ISD has sufficient resources to carry
the data collection/analysis.
|