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14 CHAPTER FOURTEEN
CONCLUSION
01 Changes in what patients need in the
future from the
NHS will require a shift in the balance
of care. The ageing of the population, the growth of long
term conditions and the continuing pressures on emergency
beds can and must be dealt with by an integrated, whole
system response. This will move the
NHS in Scotland from an organisation
reacting to illness - too often by doctors in hospitals -
to an organisation working in partnership with patients to
anticipate ill health and deal with it in a continuous
manner through the efforts of the whole health care
team.
02 The
NHS in Scotland can meet that
challenge by;
- Building a new relationship of partnership and
trust with the public aligned around the direction set
in this report.
- Equipping frontline staff to design service change
and to develop new roles and skills.
- Ensuring all staff are working to a shared vision
with a sense of pride in what they are doing.
- Providing modern information technology to improve
access, quality and effectiveness.
- Maximising services in the community: delivering
care that is as local as possible and as specialised as
necessary.
03 This report sets out a range of actions
at national, regional and local levels. There is a clear
need to ensure that at each level, the recommendations in
this Report (as approved by the Minister for Health) are
delivered.
04 At a national level, we envisage a
continuation of the National Planning Team set up to
support the Advisory Group in the preparation of the
report. The recognition of national planning as a
continuous process, rather than a one-off event, will be
important as the role of the Team shifts from analysis to
implementation. In addition to taking forward
implementation of the key recommendations around highly
specialised care (including neurosurgery and children's
tertiary services), the Scottish Executive will have a role
in co-ordinating and evaluating progress on the delivery of
the other recommended actions.
05 At a regional level, we have identified
a need to further raise the profile and impact of Regional
Planning. That will mean that
NHS Boards will have to deliver a much
greater level of support for the Regional Planning Groups.
This report sets a challenging agenda for regional
planning, not least around the re-configuration of planned
care and the requirement to integrate thinking on this
issue with a new model of unscheduled care.
06 At a local level, we need to actively
pursue the shift in the balance of care that underpins this
Report. The delivery of community based, co-ordinated,
anticipatory care with the patient as a partner in
providing care is at the heart of our proposals.
NHS Boards and their Community Health
Partnerships have a crucial role to play in ensuring that
we take an effective and systematic approach to caring for
people (particularly older people) with long term
conditions. That care should be delivered at home or close
to home where possible, freeing up the service to deal with
hospitalisation where it is necessary.
07 What we require is whole system
improvement, based on a clear understanding of what it is
we are trying to achieve and an integrated, collaborative
and co-ordinated response from the whole service working
across the traditional boundaries and across Scotland.
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