1. Emerging Themes from the North of Scotland Clinical Strategy Dr. Michael Bisset Regional Medical Director

2. North 1.3 million (25%) 61% of area West 2.6 million (50%) 29% of area North of Scotland East 1.3 million (25%) 10% of area

3. National Clinical Strategies Regional Health Board

4. Clinical Stakeholder Event Are you ready to think about health services across the North of Scotland in a different way? Work across health board areas to continuously improve the quality of care Build on our communities strengths to re-design care and promote self-management. Consolidate and expand access to specialist services for our population Promote the health and wellbeing of those that live and work in remote and rural areas

5. An Open Mind Requirement for Taking Part

6. Vox PoP: Bringing the voices of our patients and our staff into the room What you told us (themes) Communications Time for care Joined up patient journey Empowerment Team Working

7. What you told us (themes) Improve communication and breakdown silos Be proactive as a region to challenge our thinking locally, regionally and nationally Recruitment and sustainability means moving from specialist services to a robust generalist model

8. What you told us (themes) Equity of outcome is what is most important Evidence of outcomes should frame the enquiry into consolidating and redesigning specialist services Change is uncomfortable – how do we manage the transition and support all staff

9. Why do we need to work collaboratively ? Plan services on a population basis Safer Effective Critical mass to sustain services Allow more flexible use of workforce Sustain ‘vulnerable’ services

10. Vulnerable Services The 3 island Health Boards All services 4 Health Boards Radiology 3 Health Boards Ophthalmology, Orthopaedics 2 Health Boards Oncology, Rheumatology, Echocardiograpy, General Surgery, Upper GI surgery, Hepatobilary cancer, Paediatric, Obstetric, Gynaecology, General Practice

11. Planning for a North of Scotland Population of 1.3 million North of Scotland Public Health Network Creating a world class NHS Evidence Search and Synthesis National Services Scotland

12. ‘Quality is not just about outcome’

13. Drivers for Change Barriers to change

15. ‘I do not know how to think differently’

16. How to Make the Complex More Simple 1. Always think of the bigger picture 2. The whole is greater than the sum of each individual part 3. Commit yourself to finding a solution 4. Agree on a common vision