1. Care Across Boundaries – From Canterbury, New Zealand to the North of Scotland – and Beyond
Malcolm Wright, Sharon Hopkins and Jillian Evans

2. Malcolm Wright CEO NHS Grampian, Tayside & North of Scotland Regional Implementation Lead

6. Promising
VITAL SIGNS

7. Slowed demand curve for acute care
Reduced acute bed days

8. 553 fewer fractured NoF 32,000 fewer bed days
211 fewer deaths at 180 days
Over 4 years

9. 140 fewer acute readmissions
470 reduced admissions
7,300 fewer bed days
140 fewer acute readmissions
Over 1 year

10. ONE SYSTEM, ONE BUDGET

15. Data Sharing & ANALYTICS Vision
LEADERSHIP SKILLS
Vision
REDESIGN
&
INNOVATION
Alliance
Contracting

16. “Clinically led, management enabled”
“We discuss, we decide”
“Identify with system, not the organisation”
“It’s about relationships”
“System reorientation - start with the patient at home”

17. Sharon Hopkins Deputy CEO & Director of Public Health and Transformation, Cardiff & Vale University Health Board, Wales

18. Cardiff and Vale University Health Board A little bit about us
Serve a population of 480,000 people
Growing rapidly ;diverse, large inequalities
Large city and rural populations
Cover population health , primary , community, secondary and tertiary care
Education, training and research important
More and more integration with two Local Authorities
14,500 staff
Budget £1.2 billion

19. Cardiff and Vale Our learning from Canterbury
Vision – consistent and compelling vision
Clinical engagement and empowerment
Culture – permissive and accountable
Patient centred – system wide
Some consistent supporting ‘tools’/approaches
“It should be seamless for the person...they have no sense of having been passed from one organisational structure to another...the services are just organised around them”.

20. Learning from Canterbury Culture – we see this as fundamental
Best for patient, best for system
One health system, one budget
High trust, low bureaucracy
Skills and leadership development:
Reinforce vision
Enable change
Servant leadership
Permissive and accountable

21. Data – live and accessible
Some Tools – we are adopting and adapting
Clinically led ‘problem solving’
Person/patient at centre
Bring professional experience and expertise
Solution is accepted
Alliancing
Pathways constructed by teams of clinicians and other partners
Multiple multidisciplinary teams
Span primary , community and secondary care
Build trust and shared purpose
Same goal – best for person/patient – best for system
Inside web based framework
Health pathways
Data for information to clinicians
Easily understood
‘Live’ – 15 minute updates
Interactive
Meaningful feedback
Trusted
Data – live and accessible

22. Lots more learning adoption and adaption
So far for us:
Lots more learning adoption and adaption
improvement
innovation
Management discipline
the basics
Continuous service improvement
transformation
The vision and strategy…...
The people
Culture
The partners
our communities and patients
tools
Outcomes that matter
and measures
approaches

24. Caring for People, Keeping People Well
What do we want to achieve?
Caring for People, Keeping People Well
A person’s chance of leading a healthy life is the same wherever they live and whoever they are
Our strategy is to achieve joined up care based on ‘home first’, avoiding harm, waste and variation, empowering people and delivering outcomes that matter to them

25. Jillian Evans Head of Health Intelligence NHS Grampian

26. Learning Health System
Assemble
Analyse
Interpret
Feedback
Change
Aligning science,
informatics, incentives
and culture for continuous
improvement & innovation
North of Scotland

27. BIG DATA
ANALYSIS
INSIGHTS

28. Clinical & predictive informatics for improvement
Research & innovation
Clinical & predictive informatics for improvement
Modern public health surveillance

29. Environment
Informatics
Research
People
Engagement

30. 01 Grow public sector capacity locally and regionally to meet scale of ambition
02 Build on existing collaborations by forming regional alliance and local management teams
03 Enhance national systems by operating as north pipeline with remote & rural lens

31. Learn large
Innovate
Improve

32. What does this mean for us?

33. Establish formal health system alliances
Entrust clinicians & patients in designing pathways
Establish formal health system alliances
Invest in building blocks for working differently
Find ways to incentivise change
Make visible commitment to using local assets

34. Professional development & education General Practice & Pharmacy
Academic collaborations & links
Whole country coherence
We are well down this road

35. THANK YOU
Malcolm Wright, Sharon Hopkins and Jillian Evans