1. CLINICAL STRATEGY REVIEW

2. Why?  Our Orkney Our Health - outdated  Redesign progress  Orkney Health & Care  Outline Business Case  New technology, new opportunities  New team  Empowered middle managers  Clinicians willing to engage  Remote and Rural recommendations  Efficiency and Productivity framework  Reduce unwarranted variation  Need to understand how we spend our money

3. Vision for Clinical Services  People of Orkney to have health and wellbeing by having access to quality services which enable them to:  participate in preventative and anticipatory care  Have access to appropriate treatment, including emergency services

4. Clinical Strategy - the priorities  National policy frameworks and direction  Financial future  Continue to deliver safe, effective and person centred care  Create sustainability  Recommendations from Remote and Rural Implementation Group  Respond to changing demography

5. Required for:-  Informing the Finance Strategy  Informing the Property Strategy  Informing the Workforce Strategy  Driving the OBC  Informing the SLAs required  Agreement on what can/can’t be provided  Agreement on how/where services delivered

6. What won’t change  Patient safety as top priority  Planning for sustainability  Community Services embedded in OH&C  Reliance on Mainland Scotland Health Boards for some services  Need for integration with our partners – OIC, SAS, NHS 24 etc

7. Rural General Hospital R&R definition  Emergency centre for the community  More advanced level of diagnostics  Level 2+ facility  First line management of emergency admissions 24/7  Provide range of outpatient, day case, inpatient and rehabilitation services

8. Primary Care Services R& R definition  Integrated - team and location  Partnership approach between agencies and multidisciplinary teams  Co-located where possible  Preventative care  Anticipatory care  Emergency response

9. Corporate Themes and Priorities  Optimise Resource Utilisation  Improve Health whilst Improving Inequalities  Delivering Service Modernisation whilst improving patient experience  Be an effective and safe organisation

10. Efficiency and Productivity 7 cost reduction workstreams  Evidence based care  Preventative and early intervention  Outpatients, community & primary care  Acute flow and capacity management  Workforce productivity  Prescribing, procurement, support/shared services  Service redesign, innovation and transformation

11. Evidence Based Care  Disinvestment  Thresholds  NHS Evidence  NICE/SIGN/QIS  Patient Safety

12. Will provide consistent and clear understanding of service delivery  Pharmacy Strategy  Primary Care Strategy, including:- -OOH (including SAS, NHS 24) - Enhanced Services - QoF -Isles Network of Care  Community Services Model (OH&C)  Secondary Care Model

13. Will give us clarity on  SLA requirements  UNPACs  IPTR