Realising Realistic Medicine: Chief Medical Officer for Scotland annual report 2015-2016 appendix

NHS Borders

Initial thoughts

Realistic Medicine is at the forefront of clinical leaders' minds in NHS Borders. Patient and public engagement will be key in achieving the aims of Realistic Medicine

What have we done so far?

Sessions have been undertaken with ISD and Discovery looking at helping the Health Board deal with variation.

Realistic Medicine was featured in the NHS Borders Annual Review and discussed in a forum which was well-received. It was also taken to the Borders Carers Voice, which is an overarching body for the third sector. Information was shared and this will continue.

The Clinical Leads group set up three collaborative sessions involving clinical leaders to discuss quality and efficiency in the context of Realistic Medicine. Leads all discussed what they were going to look at around variation in individual departments.

There are now monthly meetings chaired by the Medical Director where a template report to the Director explicitly includes Realistic Medicine and so it has become part of the usual order of business.

The Quality Improvement programme has also become more closely linked with Realistic Medicine, linking Human Resources and Finance staff with QI opportunities in order to use different skills and ideas. Realistic Medicine is a 'hook' which can help build relationships in the system and provide a structure with which to look at variation.

What next?

An 'empowering poster' has been developed and will be displayed. It includes questions for patients to be encouraged to ask their doctor. It will be displayed in waiting areas and used to encourage dialogue from the patient perspective. This will be aligned with themes from Realistic Medicine and Choosing Wisely and further literature will also be aimed at junior doctors and students, empowering them to approach seniors and ask about tests, management, etc.

Final thoughts

A trusting and supportive Health Board is essential to allow clinicians to not only practice Realistic Medicine, but produce innovations related to it and undertake novel improvement projects.

NHS Borders Template report for monthly meetings with Medical Director.

Realistic Medicine poster for display in waiting areas in NHS Borders.