« Previous | Contents | Next »
Listen
Executive Summary
This report sets out a programme of action for the NHS, as we seek to shift the balance of care. We need to reduce our reliance on episodic, acute care in hospitals for treating illness, increasingly through emergency admissions. Instead, we need to move towards a system which emphasises a wider effort on improving health and well-being, through preventive medicine, through support for self care, and through greater targeting of resources on those at greatest risk, with a more proactive approach in the form of anticipatory care services.
Our aim is to improve the health of the people of Scotland, and to close the gap in life expectancy. We are working to encourage people to take greater control over their own health. We want the NHS and new Community Health Partnerships to tackle this challenge at local level, with local authorities and the community planning machinery contributing wholeheartedly.
The National Framework for Service Change assessed the changing needs for health care in Scotland. It highlighted the combination of an ageing population and the growth in long term conditions; the trend of rising emergency admissions to hospital among older people; the growing divergence in life expectancy, despite the general improvement for Scotland as a whole. It reinforces the clear evidence of public interest in the future of the NHS.
We want to respond to the wishes of the people of Scotland to have more local health care, a more responsive NHS, and a greater say in the way their NHS is run. And as we do so, we must address the unacceptable inequalities in healthy life expectancy across Scotland.
The National Framework for Service Change concludes that there needs to be a shift towards preventive medicine, towards more continuous care in the community, with targeting of resources and anticipatory care to reach out to those at greatest risk. By strengthening local services; with more support for self-care; more intensive case management for individuals with serious long term conditions; and with more capacity for local diagnosis and treatment, it is possible to reduce the rising trend of unscheduled hospital admissions. It also showed that much can be done to manage hospital admissions and discharges better.
The challenge of improving health care services in Scotland requires a national action plan with clearly defined commitments, clear responsibilities, effective mechanisms to hold the service to account, and objective measures of performance. It requires a culture that promotes innovation and redesign, but always with an ultimate focus on the delivery of better care for patients.
Delivering for Health describes the main actions we will take within current spending plans to implement the recommendations of the National Framework for Service Change, which have been widely welcomed. The pace of implementation will depend on the amount of resources that can be allocated for these purposes, from both the savings achieved through the Efficient Government programme and future public spending plans.
Box ES.1 shows the kind of changes patients and their families in Scotland should expect to see as we implement the actions contained within this paper.
We will deliver our plans through the continuing development of the NHS as an integrated service, so that patients experience a smooth and quick 'journey of care' wherever and however they may access services. The emphasis on integrating care will require multi-disciplinary team working. It will require collaboration and co-ordination between professionals and across organisational boundaries - in fact, a partnership approach at all levels to achieve continual improvements in quality and value for money. It requires the NHS to deliver public health improvements by engaging with other public authorities for services such as transport, housing, education and leisure.
It is the job of our NHS to improve health and improve the quality of health care. But it also has a responsibility to improve efficiency and increase productivity, because by doing that we can offer more care with the resources available. By 2008, annual funding for the NHS will reach £10bn - that is double what it was in 1999, and well in line with health spending in Western European countries. Alongside that major investment and commitment the heath service must use the money more effectively for the benefit of patients.
Organisational change is taking place within the Scottish Executive Health Department ( SEHD) to ensure a sharp focus on the delivery of key priorities and targets, including the commitments in this plan. A new Delivery Group will draw together and strengthen the performance management function by agreeing annual Local Delivery Plans with each NHS Board, providing systematic monitoring of performance, and playing a more assertive role in supporting or intervening. A new Group for Primary and Community Care will help to prioritise the development of health care services in community settings and partnerships with social care services.
"Our aim is to improve the health of the people of Scotland . . . with a shift towards preventive medicine and more continuous care in the community. Our strategies, policies and actions are intended to support that key objective."
Record levels of investment in NHSScotland over the last six years have yielded demonstrable improvements in the service we provide to the people of Scotland.
That investment has produced a sustained increase in staff numbers and modernisation of buildings and equipment. Improvements for patients include better survival rates for the killer diseases, shorter waiting times, the introduction of new treatments, and effective action to improve public health.
We must go further. Our collective aim should be to implement the proposals in this plan by engaging with, and winning the support of the people we serve.
The first section of this report describes this progress more fully. Section 2 addresses the big strategic challenges that face NHSScotland. Section 3 focuses on other implications of our ambition for an integrated approach to health care services.
Box ES.1 The changes patients will see More of their health care will be provided locally in GP practices, in community pharmacies or, increasingly, in Community Health Centres, with greater use of day case treatment. If they stay in a less well-off area, their local primary care team will have dedicated resources to reach out and help people with higher risks of ill-health. If they have a long-term condition, help and support will be available so they can play an increasing role in managing the condition themselves. If they are older, frail or liable to frequent hospital admission, they will get co-ordinated care provided locally. Carers will be treated as partners in the provision of care. Patients will have access to their own Electronic Health Record and so will all the clinical staff who treat them. If they need specialist treatment in hospital they will get access to a good, safe service provided by the right person, even if that means they have to travel. If they need to go to hospital, they will have quicker access; more tests will be done locally, and their length of stay will be planned and shorter. If patients require care urgently, they will be able to see the right person, with the right skills, at the right time. Patients will experience fewer cancelled appointments or procedures because of an emergency or because tests are not available. If they stay in remote and rural areas, the NHS will provide them with a core set of services in Rural General Hospitals. |
« Previous | Contents | Next »