Healthcare science national delivery plan 2015 to 2020: final report

3. Introduction

3.1 Introduction to the Final Report

The key strategic aim of the HCS National Delivery Plan was to maximise the contribution that the Healthcare Science profession makes to NHSScotland and across Scottish Government policy priorities.

As described in section 2.0, to support the realisation of this vision, the plan included five deliverables relevant to three specialist areas of Healthcare Science – life sciences, physical sciences and physiological sciences. It was envisioned this focus had the potential to significantly enhance healthcare delivery and drive high-impact changes to support improvement in people’s health and wellbeing.

Over the past six years, much effort has gone into developing and implementing these deliverables. What has been achieved, and recommendations for building on these achievements, has been set out in this final report.

Although the coronavirus (COVID-19) pandemic impacted delivery to a degree, the pandemic has further highlighted the contribution made by the Healthcare Science workforce. For instance, the pandemic reinforced the imperative for effective actions to reduce unnecessary variation in testing. Within this context, the findings and conclusions of this final report are intended to provide a timely contribution to reflecting on progress made. They also offer learning to inform the development and implementation of any future strategy or delivery plan.

3.2 The deliverables and actions of the NDP

The NDP set out the actions that national and local leaders must take to achieve each deliverable – each of the five improvement programmes.

From the time of publication, support for implementation in NHS Boards was provided by the Scottish Government Healthcare Science Officer and the three appointed National Healthcare Science Leads, who worked collaboratively with NHS Board Healthcare Science Leads and the wider Healthcare Science Workforce.

The role of the Delivery Leads included developing and implementing agreed plans to achieve the aims of the deliverables for which they held responsibility. Delivery Leads met regularly and reported to Scottish Government on a monthly basis to review progress, share thinking and forge cross-collaborative working. Those who undertook the Delivery Lead role, and the organisations from which they were drawn, reflect the knowledge and skills that was required to achieve the intended objectives of the deliverable.

A summary of the deliverables, Leads and associated actions is referenced below. As this table indicates, some of these actions were specific, while others were more 'thematic' cross-cutting actions.

Deliverable 1

Streamlining health technology management

Actions

NHS Boards will support Healthcare Science Leads, managers and heads of service to work with the Physical Science National Lead.

National Healthcare Science Leads and NHS Board Healthcare Science Leads, managers and heads of services will work with stakeholders to deliver a high-quality, sustainable, coherent and whole systems approach to the management of health technology.

Scottish Government will work with partnership organisations, universities, public health, social care, industry and the Health Improvement Scotland (HIS) Scottish Health Technologies Group (SHTG) to encourage the development of an evidence base for the use of health technology in the community and the adaptation and spread of proven technology and good practice.

Deliverable 2

Point-of-care testing

Actions

NHS Boards will participate in the national POCT programme on the use of POCT in primary and secondary care in Scotland (as described by the Scottish Medical and Scientific Advisory Committee), implementing local plans to ensure cost-effective implementation and governance of POCT systems and sharing knowledge across Boards on how POCT technology benefits patient-pathway outcomes. Led by the HCS National Lead in Life Science.

National Healthcare Science Leads and NHS Board Healthcare Science Leads, managers and heads of services will work with medical directors and clinical teams to develop a local implementation plan that ensures clinical governance and effective roll-out of point-of-care testing.

National Healthcare Science Leads and NHS Board Healthcare Science Leads, managers and heads of services will work across disciplines to instigate whole-system improvements in the delivery of POCT in acute and secondary care settings.

Deliverable 3

Demand optimisation

Actions

NHS Boards will support Healthcare Science Leads, managers and heads of service to work with the National Healthcare Science Leads and diagnostic networks in collectively progressing this improvement work. Led by the HCS National Lead in Life Science.

National Healthcare Science Leads and NHS Board Healthcare Science Leads, managers and heads of services will work with NHS Boards and diagnostic networks to reduce unnecessary testing and measure overall impacts on patient outcomes. This will free-up capacity to address rising demand and deliver testing that positively affects the patient pathway, supports primary care preventive measures and reduces hospital referrals and admissions.

Deliverable 4

Developing sustainable services

Actions

NHS Boards will further develop and strengthen the use of extended interpretive roles and clinical reporting in laboratory medicine, with a focus on histopathology.

NHS Boards will support the recommendation of the Diagnostic Workforce Short-life Working Group that “redesign, skill mix and role extension appropriate to task should be applied across all diagnostic specialties.”

National Healthcare Science Leads and NHS Board Healthcare Science Leads, managers and heads of services will work with stakeholders to explore new and developing Healthcare Science roles that support areas of service pressure and have the potential to free-up medical capacity, with the initial focus on histopathology services.

Scottish Government will build on achievements to date to further develop excellence in extending interpretive roles and support growth in clinical reporting.

Scottish Government will develop work plans to ensure Healthcare Science workforce data are accurately reflected, providing good-quality data to support appropriate multi-disciplinary workforce planning.

Deliverable 5

A new integrated model for clinical physiology services

Actions

NHS Boards will support Healthcare Science Leads, clinical leaders and managers and heads of service to work with the Clinical Physiology Science National Lead to explore a more integrated approach to service leadership and delivery of clinical physiology services to create more sustainable and coherent quality services for the future.

National Healthcare Science Leads and NHS Board Healthcare Science Leads, managers and heads of services will work collaboratively with senior management to develop integrated models of service provision.

National Healthcare Science Leads and NHS Board Healthcare Science Leads, managers and heads of services will establish a network across the clinical physiology workforce.

National Healthcare Science Leads and NHS Board Healthcare Science Leads, managers and heads of services will support a community of practice to drive improvement.

3.3 Key roles in the oversight of delivery

The Healthcare Science Leads Group (HCS Leads), first established by the Scottish Government in August 2010, was agreed as the most appropriate group to ensure oversight and delivery of the plan. Additional membership included Healthcare Science National Leads seconded to the Scottish Government to lead on specific NDP deliverables. Monitoring of reporting was via the governance structure of the HCS Leads Group.

The terms of reference, group membership, minutes and other publications of interest are available online at the NHS Education for Scotland Knowledge Network http://www.knowledge.scot.nhs.uk/hcsleadscommunity.aspx.

Due to the expansion of the third deliverable – Demand Optimisation – has become a Scottish Government nationally commissioned programme of work. Governance was initially provided by the Scottish Government Diagnostic Steering Group (DSG), until the formation in 2019 of the Diagnostic in Scotland Strategic Group (DiSSG). The Diagnostic in Scotland Strategic Group ensures the ongoing, coherent development and delivery of high-quality services, taking into account the strategic direction set by the Health and Social Care Delivery Plan and the National Clinical Strategy. https://www.demandoptimisation.scot.nhs.uk/.

However the Scottish Government Chief Nursing Officer’s Directorate has maintained oversight via the Strategy and Policy Team in the Chief Nursing Officer’s Directorate. This team has provided policy support for the HCS NDP, as well as financial oversight of any budget proposals and spend. The Policy Team also provided the link between the Cabinet Secretary for Health and Sport and the HCS Leads.