NHS Scotland Chief Executive's Annual Report 2017/18

Foreword

I’m pleased to present my fifth Annual Report as NHS Scotland’s Chief Executive.

The achievements in this report are a tribute to the outstanding commitment of all staff working in NHS Scotland and our partners to deliver the best health and social care outcomes for the people of Scotland. Their dedication and hard work are amazing and I greatly value and appreciate all they do.

On the 5th July 2018, the NHS turned 70. As we entered the anniversary year, we were reminded of how far the NHS has come, and of the many milestones and innovations over seven decades. We were also reminded that the NHS has always adapted to meet the health challenges faced by people in Scotland. That ability to adapt and change remains one of its longstanding strengths – as relevant now as it has ever been - and my annual report details many of the examples of how health and social care is being reformed to meet the changing needs of our population.

We have a good foundation on which to build. People’s experience of both primary and secondary care, as reported through a range of patient surveys, continues to be high. Recent results from the 2018 Scottish Inpatient Experience survey, for example, show that 86 per cent of people rated their overall care experience positively and over a third said that their overall care was ‘10 out of 10’. We have continued to see improvement in a number of high-level indicators, with delayed discharge, emergency bed-days, emergency admissions and re-admissions to hospital within 28 days all showing positive progress.

Of course, for reasons that have been well-documented, demand for services has continued to grow. Last year’s Annual Report, set out how we are ensuring the challenges of living longer and healthier lives are met by a health service that embraces and drives the necessary change. The Health and Social Care Delivery Plan, published in December 2016, set out our framework for reform. Action under the Delivery Plan is progressing across the whole of the public sector.

Last winter was particularly challenging with significant increase in demand for unscheduled care, along with the impact of severe weather. A&E attendances were up, along with respiratory emergency and flu emergency admissions. While patients did spend more time in A&E, almost nine out of 10 spent less than four hours and core sites performed well relative to the rest of the UK. In addition, we saw increased numbers of cancelled operations due to capacity or non-clinical reasons – but by June of this year this had been pulled back with some of the lowest levels of cancellations on record.

In addition to the challenges faced this winter, some NHS Boards also reported an increase in the numbers of urgent elective referrals which are impacting on elective services. The Scottish Access Collaborative was established in the autumn of 2017 and is making progress in reforming elective services. And more recently, the Waiting Times Improvement Plan launched in October 2018 sets out actions to deliver improvements in waiting times over the next 12, 24 and 30 months.

In a year when we’re celebrating 70 years of the NHS, we have the opportunity to reflect on the journey still ahead. I have also been reflecting for some time on my own future. Having been a civil servant since 1979 and having had the immeasurable privilege of serving for five years as NHS Scotland’s Chief Executive, I have taken the decision to step down in February 2019 to allow me to devote more time to those closest to me and to pursue other opportunities.

So, this will be my final report as NHS Scotland Chief Executive. I said when I came to it that it was the best job in the world – and it still is. The NHS has always been defined by the people who work in it and I am immensely proud of the ongoing commitment of staff – not just in the NHS but across health and social care - whose compassion, hard work and innovation continue to deliver the best of care to the people of Scotland.

Paul Gray
Chief Executive, NHS Scotland
and Director-General Health and Social Care