2Why do we need a strategic plan? To set out a shared direction and the things we need to do:To maintain and raise quality standardsTo meet the needs of a changing populationTo change our relationship with patients and their carers – putting patients at the centreTo work more closely with other public servicesTo work more efficiently.
3What are the challenges we face? Demography, inequalities and ill healthMultiple and chronic illnesses (Multimorbidity)Health service demand and rising expectationsTighter finances
4What will success look like? Improving the quality of care through:Increasing the role of primary and community careIntegrating health and social careFocus on anticipatory care, self –management supportImproving unscheduled and emergency careImproving our approach to multiple and chronic illnessesInvolving people in their care and in service improvements.
5What will success look like? Improving health of the population by focusing on:Early yearsUnderlying causes of health inequalitiesPreventative measures on alcohol, tobacco, dental health, physical activityEarly detection of cancer.
6What will success look like? Better value and financial sustainability, by:Adapting the workforceInnovating to raise quality and reduce costsRaising efficiency and productivityDesigning care pathways delivering what matters to patients.Identifying areas for disinvestment – where there is no contribution to the health of the population.6
7What will success look like? Previous SystemFuture SystemGeared towards acute / single conditionDesigned around people with multiple conditionsHospital centredLocated in local communities and their assetsDoctor dependentMultiprofessional and team based careEpisodic careContinuous care and support when neededDisjointed careCoordinated and integrated health and careReactive carePreventative and anticipatory carePatient as passive recipientInformed, empowered patients and clientsSelf-care infrequentSelf-management/self directed supportCarers undervaluedCares are supported as full partnersLow techTechnology enables choice and control7
8What we are going to do – the headlines Patient-centred, whole-system, pathways approachScottish Patient Safety ProgrammeImprove the care for older peopleMultimorbidity action planEnable joint working- healthcare, social care, 3rd sectorImprove access to primary care & community teamsReduce and eventually eliminate delays in patients’ discharge
9What we are going to do – the headlines (continued) Develop a new East Lothian Community HospitalAdapt the use of Midlothian Community HospitalDevelop community mental health services and redevelop the Royal Edinburgh HospitalRevise emergency care at the Western General HospitalExpand acute receiving and assessment capacity at the Royal Infirmary of EdinburghFocus major hospital care on 4 sites: RIE, WGH, St Johns & new REH
10What we are going to do – the headlines (continued) New configuration of acute inpatient services at RIE, WGH and SJHDo more on a day case basisReview outpatient servicesDevelop sustainable in-house capacity for elective careImprove children’s services, open new children’s hospitalRedesign cancer pathways, build a new Regional Cancer Centre
11How are we going to do it…….? By putting patients at the centre of our plans.Focus on the patients’ journey and experience, with four names to represent four groups of patients.
12How are we going to do it…….? Different working arrangements for clinical and other staffWork with patients, staff, GPs, social care colleagues to design a better way of doing thingsIntegrating health and social care systemsOrganisational developmentAdapting the workforceBetter use of informationeHealthInnovationManaging the finances
13Priority Workstreams ACUTE PRIMARY CARE/ COMMUNITY Stroke redesign Unscheduled flow – all 3 sitesOrthopaedic DCAQOrtho rehab ( then gen. rehab)Ophthalmology DCAQ/ accom.Out-patient redesignDay surgery/ ambulatory careGynaecologyMaternityCancer and ECCPlastic surgeryLaboratoriesPRIMARY CARE/ COMMUNITYGP practice capacityPrimary care capabilityLUCS reviewCare village/ older people’s care models x4Draft integration plans x4Year 1 H&SC priorities x4WHOLE SYSTEM PRIORITIES/ ENABLERSInequalities and prevention WorkforceInformation and technologies Patient pathwaysDisinvestment/ hard choices
14Next Steps 2 April 2014 – Draft plan approved by NHS Lothian Board 21 April “Our Health, Our Care, Our Future” consultation launchedMay, June, July 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 closes1st October 2014 – NHS Lothian Board receive definitive Strategic Plan for approval.14
15How 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 decisionsComment on the NHS Lothian Health Inequalities PlanComment on the NHS Lothian Strategy for Cancer15
16How to get involvedComplete the on-line questionnaire at:Respond to the consultation questions – us atWrite to: Professor Alex McMahon, Director of Strategic Planning, NHS Lothian, Waverley Gate, 2-4 Waterloo Place Edinburgh EH1 3EG