Making the Books Balance – Understanding the Financial Context and Efficiency Savings
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NHSScotland has an excellent track record in delivering and exceeding efficiency savings targets. In 2011‐12 we will continue to eliminate waste and drive modernisation programmes to achieve productivity and efficiency gains without compromising quality. This session will provide an overview of the challenges that lie ahead for NHSScotland but also the opportunity to ensure we make the best use of the resources that we have.
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How diagnostics can drive efficiency within the NHS
How diagnostics can drive efficiency within the NHS
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Plenary 3.2 From Idea to Delivery - A Journey of Discovery
This document discusses the history of hearing healthcare in Denmark and a plan to redesign community services. It begins by describing pioneering Danish legislation from the 1950s that made hearing examinations and aids free for all citizens and established regional hearing centers. The document then outlines themes from community engagement including giving back, caring for others, and recognizing resilience. It proposes a new service model delivered locally but also at scale through collaboration between community organizations, healthcare services, and technology.
Parallel Session 1.5 The Process of Innovation
The document outlines an experiential challenge where teams must create an innovative solution to safely launch a fresh egg without breaking it. Teams are given materials and brief instructions. The goal is to design, build, cost and brand a product to launch an egg into the target zone. Teams have 25 minutes to build their solution and the first intact egg to land in the target zone wins a prize. The document also includes an overview of the innovation process and how it relates to the challenge.
Parallel Session 3.9 The Quality Improvement Hub: Supporting You to Develop S...
This document summarizes resources from the Quality Improvement Hub in Scotland. It describes the hub's website as a one-stop shop for free quality improvement resources. It outlines support available for implementation, education, networks, and measurement. It also summarizes programs for a Quality Improvement Education Program, Knowledge into Action initiative, SPSP Fellowship, and building a network of networks to spread best practices in healthcare quality improvement across Scotland.
Parallel Session 3.8 A Digital 2020 Vision
The document discusses NHS Lanarkshire's plans to develop a clinical portal that will pull together a patient's clinical information from various systems into a single view, addressing issues around fragmented records and information sharing between services. It aims to provide clinicians with a complete patient record regardless of where data was created or stored. The portal is intended to improve care coordination and reduce risks around late intervention or lack of awareness of a patient's full clinical history.
Plenary 3 Ministerial Address
The document discusses options and opportunities for health science innovation in Scotland. It outlines current challenges posed by chronic diseases and emphasizes the need for quality healthcare and research. It presents information science as a catalyst for change and the role of academic health science networks. Case studies are provided on initiatives like the Scottish Diabetes System that have improved clinical outcomes through coordinated efforts and data sharing.
Plenary 2 Leaders and Leadership - The Good, The Bad and The Ugly
Leaders and leadership - the Good, the Bad and the Ugly by Irwin Turbitt discusses different types of leadership. It notes that leadership requires change, which leads to loss and distress, but that distress can be productive. Adaptive leadership maintains people within their productive zone of distress and focuses on relationships rather than authority alone. Creating public value through both goods/services and obligations is important for public sector leadership. Overall it emphasizes that leadership is about facing complex problems through trial and error while keeping people focused.
Plenary 1 Driving Quality Through Innovation
This document discusses values and culture within the NHS in Scotland. It outlines "The Lothian Way", a set of values developed within NHS Lothian including being person-centered, having partnerships, integrity, accountability, and innovation. It also discusses some underlying cultural assumptions like suppressing bad news. The document advocates for continuing to improve safety and quality of care, making the right choices, learning together, and renewing a commitment to ethics and values. It aims to deliver the highest quality healthcare and for Scotland to be a world leader in healthcare quality.
Parallel Session 4.9 Talking and Really Listening - Taking an Innovative Appr...
This document discusses using dialogue techniques to achieve large-scale change in complex situations. It outlines three fundamental dialogue concepts: monologue vs generative conversation, dialogue actions and intentions, and fields of conversation. Examples of using dialogue in NHS Fife are provided. The document recommends dialogue methodologies when issues are complex with no obvious solution, multiple interconnected roles must be aligned, and authority is unclear. Dialogue allows all voices and perspectives to be heard to increase understanding before commitment.
Parallel Session 4.8 Creative and Innovative Approaches to Empower and Suppor...
The document discusses creative and innovative approaches to empowering people through self-management and greater control over their health outcomes and risks. It focuses on person-centered care, identifying assets and building support networks to facilitate self-management of long-term conditions. The importance of risk enablement is emphasized to promote choice and control for individuals through self-directed support options.
Parallel Session 4.7 Understanding Potential and Evaluating Actual Impacts of...
The document discusses initiatives by three health care providers - Perth and Kinross CHP, North Lanarkshire CHP, and Midlothian CHP - to improve outcomes for people with dementia while reducing costs. It provides an overview of the Dementia Demonstrators program, which aims to demonstrate better outcomes for more people using the same or fewer resources. The sites hope to achieve this by addressing unnecessary resource use through interventions people don't need or want, or providing interventions too late.
Parallel Session 4.6 Developing Your Team’s Safety Culture and Safety Practic...
The document discusses improving safety culture and practices in primary care through implementing a patient safety program. It outlines why safety is important in primary care given the high volume of patients and risk of harm from errors. The program aims to help primary care teams identify and reduce harm through tools like reliable care bundles, trigger tools to detect harm, and surveys to measure safety climate and culture.
Parallel Session 4.5 Stronger Communities... Better Lives?
The document discusses initiatives in Perth and Kinross, Scotland that aim to engage communities and improve health and social well-being through co-production with local people and organizations. It describes programs like the Healthy Communities Collaborative and Time Banking that bring community members, volunteers, and agencies together to address issues, develop skills, and exchange services to enhance resilience. Evaluation of the programs show increases in social connections, activity levels, and community participation as well as benefits to health.
Parallel Session 4.4.2 My Pathway, My Choice
This document discusses self-management of health and increasing health literacy. It finds that successful self-managers experience a 66.7% reduction in hospitalization, 77.9% reduction in hospital length of stay, and 41.7% reduction in doctor visits. The document advocates for changing the relationship between patients and healthcare providers (HCPs) by empowering patients and lessening paternalism. It suggests promoting patient empowerment through shared medical records, community support, and teach-back methods. The goal is for patients to see themselves as leading partners in their own health management.
Parallel Session 4.4 My Pathway, My Choice
This document discusses implementing a national telephone triage service for cancer patients in Scotland. It aims to provide consistent triage using the UKONS tool and refer patients to secondary care if needed. The service would involve NHS 24 call handlers triaging patients who call a dedicated number with concerns after cancer treatment. Patients referred for further assessment would be seen by an acute oncology team within each region. The benefits cited include safe and reliable triage, timely access to care, and audit capabilities to support quality. Next steps include developing training programs and further planning electronic health integration between NHS 24 and secondary care services.
Parallel Session 4.3 The Right Medicine?
This document summarizes guidance on improving polypharmacy and mindful prescribing through multidisciplinary collaboration. Key points include:
1) Rates of multimorbidity and polypharmacy are projected to rise significantly in Scotland, increasing costs and risks.
2) A multidisciplinary model is proposed involving health boards, clinicians, pharmacists, patients, and decision support tools to conduct regular medication reviews targeting high-risk patients.
3) The goal is to improve understanding of medications, discontinue those no longer valid or causing harm, and sustain safe, effective, and person-centered care associated with medicines through a multi-professional approach.
Parallel Session 4.2 ‘It’s What Matters to me that Counts’ – Keeping the Pers...
This document summarizes Thistle Foundation's journey towards implementing a person-centered approach over the past 15 years. It discusses how Thistle redesigned services, invested in training staff in person-centered concepts, and now uses the Talking Points framework to focus on identifying and realizing personal outcomes for those supported. The framework emphasizes building strong relationships, focusing on strengths and what matters most to each person, and involving natural supports. While progress has been made, fully translating positive changes to quality of life remains a work in progress.
Parallel Session 3.7 Applying Best Practice to Develop Innovative and Effecti...
This document summarizes presentations on improving communication practices in NHS Scotland. It discusses a new morning huddle format implemented in Edinburgh that improved information sharing, priority setting, and outcomes. It also describes tests of changing handover practices in Ayrshire to reliably identify deteriorating patients, including establishing multidisciplinary handovers and an escalation process. Measures like attendance, standardized tools, and staff education were used to monitor the changes. Next steps involved expanding participation and ensuring sustainability of the improved practices.
Parallel Session 3.6 Reshaping Care - Shifting the Focus and Shifting the Power?
This document summarizes presentations from a conference on shifting the focus and power of healthcare to communities.
The first presentation discussed community engagement, resilience and health service development initiatives in Scotland's Annandale and Eskdale regions to better support older adults, those with long-term conditions, caregivers and people with dementia.
The second presentation described a project in Clackmannanshire, Scotland that employs community development workers and an older adult support worker to map resources, gather community input, identify hidden caregivers and co-produce new support services.
The third presentation was about a lifestyle management program for long-term conditions run by the Thistle Foundation. It is staff-led but co-facilitated
Parallel Session 3.5 Crossing Boundaries to Improve Outcomes
This document discusses human factors in healthcare. It provides definitions of human factors and outlines some key aspects including work environment, teamwork, safety culture and individual factors. It notes that errors are inevitable due to human fallibility and that around 80% of critical incidents relate to human factors issues. The need for defenses in depth is discussed including integrating human factors into education and having a just culture of reporting and learning from incidents. Examples from other industries like aviation are provided that demonstrate how human factors can be successfully incorporated. The document advocates for a systems approach and taking human factors as a core skill in healthcare.
Parallel Session 3.4 RIP+MIX: Unlocking Creativity to Enable Staff, Patients ...
This document provides an introduction to a session on RIP+MIX, a design tool to encourage creativity and innovation in transforming outpatient service delivery. The session aims to introduce RIP+MIX, which was developed by Deutsche Telekom and the University of Dundee to include stakeholders in innovation processes. It has been used as a first step to transform demand for outpatient services. The session outcomes are to provide an overview of RIP+MIX, help participants think creatively about their own services using RIP+MIX tools, and have fun.
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Plenary 3.2 From Idea to Delivery - A Journey of Discovery
Plenary 3.2 From Idea to Delivery - A Journey of Discovery
Parallel Session 3.9 The Quality Improvement Hub: Supporting You to Develop S...
Parallel Session 3.9 The Quality Improvement Hub: Supporting You to Develop S...
Plenary 2 Leaders and Leadership - The Good, The Bad and The Ugly
Plenary 2 Leaders and Leadership - The Good, The Bad and The Ugly
Parallel Session 4.9 Talking and Really Listening - Taking an Innovative Appr...
Parallel Session 4.9 Talking and Really Listening - Taking an Innovative Appr...
Parallel Session 4.8 Creative and Innovative Approaches to Empower and Suppor...
Parallel Session 4.8 Creative and Innovative Approaches to Empower and Suppor...
Parallel Session 4.7 Understanding Potential and Evaluating Actual Impacts of...
Parallel Session 4.7 Understanding Potential and Evaluating Actual Impacts of...
Parallel Session 4.6 Developing Your Team’s Safety Culture and Safety Practic...
Parallel Session 4.6 Developing Your Team’s Safety Culture and Safety Practic...
Parallel Session 4.5 Stronger Communities... Better Lives?
Parallel Session 4.5 Stronger Communities... Better Lives?
Parallel Session 4.2 ‘It’s What Matters to me that Counts’ – Keeping the Pers...
Parallel Session 4.2 ‘It’s What Matters to me that Counts’ – Keeping the Pers...
Parallel Session 3.7 Applying Best Practice to Develop Innovative and Effecti...
Parallel Session 3.7 Applying Best Practice to Develop Innovative and Effecti...
Parallel Session 3.6 Reshaping Care - Shifting the Focus and Shifting the Power?
Parallel Session 3.6 Reshaping Care - Shifting the Focus and Shifting the Power?
Parallel Session 3.5 Crossing Boundaries to Improve Outcomes
Parallel Session 3.5 Crossing Boundaries to Improve Outcomes
Parallel Session 3.4 RIP+MIX: Unlocking Creativity to Enable Staff, Patients ...
Parallel Session 3.4 RIP+MIX: Unlocking Creativity to Enable Staff, Patients ...
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Combination Therapies
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Making the Books Balance – Understanding the Financial Context and Efficiency Savings
- 2. NHSScotland Event 1 2 3 Economic Overview Quality and Efficiency Current Perspective Horizon Scan SCENE
- 4. Total Managed Expenditure vs Current Receipts
- 5. Public Sector net borrowing
- 6. Two-Speed Recovery Two-Speed Recovery
- 7. International GDP Growth - Update
- 8. ‘ On the road from the City of Skepticism, I had to pass through the Valley of Ambiguity’ Adam Smith SCENE
- 10. Estimated Scottish Government DEL Expenditure – June 2010 Budget Results (2010/11 Prices) £39
- 11. UK Comprehensive Spending Review 2010 Scottish Government DEL Settlement 2011-12 to 2014-15 Change 2010-11 2011-12 2012-13 2013-14 2014-15 2010-11to 2014-15 £bn £bn £bn £bn £bn £bn % Cash terms Resource 25.9 25.4 25.8 26.0 26.1 0.2 0.8% Capital 3.3 2.5 2.5 2.2 2.3 -1.0 -30.3% Total DEL 29.2 27.9 28.3 28.2 28.4 -0.8 -2.7%
- 14. Quality & Efficiency – Two sides of the coin “ To improve the overall quality and efficiency of NHSScotland while ensuring good value for money and achieving financial targets.”
- 20. Scottish Patient Safety Programme 72% reduction in critical care c.diff 14% increase in ward hand hygiene 58% decrease in ward c.diff 23% increase in surgical briefings 15% increase in on-time antibiotics` 1 2 3 4
- 36. “ We look to Scotland for all our ideas of civilisation” Voltaire (1694-1778) SCENE
Editor's Notes
- According to the latest Government figures, Total Managed Expenditure (TME) is likely to rise to 48% of GDP in the current year, 2009/10, a level last seen in the 1970s. At the same time receipts from tax proceeds are expected to fall to levels last seen in the recession of the early 1990s. Since 1948-49 till now Expenditure and Receipts tend to follow a similar pattern. The previous exception was during the mid 1990s and the gap was then closed within 4 years. The current gap of 10% is the largest to date and the period over which it will be closed is still not certain.