OUR HEALTH, OUR CARE, OUR FUTURE

Why do we need a strategic plan?

To set out a shared direction and the things we need to do:

• To maintain and raise quality standards

• To meet the needs of a changing population

• To change our relationship with patients and their carers – putting patients at the centre

• To work more closely with other public services

• To work more efficiently.

What are the challenges we face?

• Demography, inequalities and ill health

• Multiple and chronic illnesses (Multimorbidity)

• Health service demand and rising expectations

• Tighter finances

What will success look like?

Improving the quality of care through:

• Increasing the role of primary and community care

• Integrating health and social care

• Focus on anticipatory care, self –management support

• Improving unscheduled and emergency care

• Improving our approach to multiple and chronic illnesses

• Involving people in their care and in service improvements.

What will success look like?

Improving health of the population by focusing on:• Early years

• Underlying causes of health

inequalities

• Preventative measures on

alcohol, tobacco, dental

health, physical activity

• Early detection of cancer.

What will success look like?

Better value and financial sustainability, by:

• Adapting the workforce

• Innovating to raise quality and reduce costs

• Raising efficiency and productivity

• Designing care pathways delivering what

matters to patients.

• Identifying areas for disinvestment – where

there is no contribution to the health of the

population.

What will success look like?

Previous System Future System

Geared towards acute / single condition

Designed around people with multiple conditions

Hospital centred Located in local communities and their assets

Doctor dependent Multiprofessional and team based care

Episodic care Continuous care and support when needed

Disjointed care Coordinated and integrated health and care

Reactive care Preventative and anticipatory care

Patient as passive recipient Informed, empowered patients and clients

Self-care infrequent Self-management/self directed support

Carers undervalued Cares are supported as full partners

Low tech Technology enables choice and control

What we are going to do – the headlines

• Patient-centred, whole-system, pathways approach

• Scottish Patient Safety Programme

• Improve the care for older people

• Multimorbidity action plan

• Enable joint working- healthcare, social care, 3rd sector

• Improve access to primary care & community teams

• Reduce and eventually eliminate delays in patients’ discharge

What we are going to do – the headlines (continued)

• Develop a new East Lothian Community Hospital

• Adapt the use of Midlothian Community Hospital

• Develop community mental health services and redevelop the Royal

Edinburgh Hospital

• Revise emergency care at the Western General Hospital

• Expand acute receiving and assessment capacity at the Royal Infirmary

of Edinburgh

• Focus major hospital care on 4 sites: RIE, WGH, St Johns & new REH

What we are going to do – the headlines (continued)

• New configuration of acute inpatient services at RIE, WGH and SJH

• Do more on a day case basis

• Review outpatient services

• Develop sustainable in-house

capacity for elective care

• Improve children’s services, open

new children’s hospital

• Redesign cancer pathways, build

a new Regional Cancer Centre

How are we going to do it…….?

Focus on the patients’

journey and experience,

with four names to

represent four groups of

patients.

By putting patients at the

centre of our plans.

• Different working arrangements for clinical and other staff

• Work with patients, staff, GPs, social care colleagues to design a better way of doing things

How are we going to do it…….?

• Integrating health and social care systems

• Organisational development

• Adapting the workforce

• Better use of information

• eHealth

• Innovation

• Managing the finances

Priority Workstreams

ACUTE• Stroke redesign• Unscheduled flow – all 3 sites• Orthopaedic DCAQ• Ortho rehab ( then gen. rehab)• Ophthalmology DCAQ/ accom.• Out-patient redesign• Day surgery/ ambulatory care• Gynaecology • Maternity• Cancer and ECC• Plastic surgery• Laboratories

PRIMARY CARE/ COMMUNITY• GP practice capacity• Primary care capability• LUCS review• Care village/ older people’s

care models x4• Draft integration plans x4• Year 1 H&SC priorities x4

WHOLE SYSTEM PRIORITIES/ ENABLERS

Inequalities and prevention WorkforceInformation and technologies Patient pathwaysDisinvestment/ hard choices

Next Steps

• 2 April 2014 – Draft plan approved by NHS Lothian Board

• 21 April 2014 - “Our Health, Our Care, Our Future” consultation launched

• May, June, July 2014 - meetings with staff, patients groups, third sector

organisations, carers, community groups, local authorities, Scottish

Government and other stakeholders to analyse patent pathways, consider

options and develop specific proposals;

• 8th August 2014 – Consultation closes

• 1st October 2014 – NHS Lothian Board receive definitive Strategic Plan for

approval.

How to get involved

• Discuss with your colleagues

• Respond to the consultation questions:

- Does this plan address the most important issues?

- Have we missed anything really significant? If so what?

- Is there anything else you would like to tell us before finalising the

plan?• Comment on the proposed criteria for making decisions• Comment on the NHS Lothian Health Inequalities Plan• Comment on the NHS Lothian Strategy for Cancer

How to get involved

• Complete the on-line questionnaire at:

www.nhslothian.scot.nhs.uk/OurOrganisation/ourHealthOurCare

OurFuture

• Respond to the consultation questions – Email us at

OurHealth.OurFuture@nhslothian.scot.nhs.uk

• Write to: Professor Alex McMahon, Director of Strategic

Planning, NHS Lothian, Waverley Gate, 2-4 Waterloo Place

Edinburgh EH1 3EG