NHSScotland Chief Executive's Annual Report 2013/14

Chapter 1 High Quality Health and Care for Scotland

The right folk in his corner - community-based care for veteran army boxer.

"I got a call button fitted in John's house so he could easily contact me or the emergency services."
Kate Beagan, Sheltered Housing Office, South Lanarkshire Council

John's Story

At 86, John still shows the quick wit and spirit that made him a successful army boxer in the 5th Scottish Parachute Battalion. John served in the peace-keeping force that headed to Palestine in 1945, and on his return to Scotland he saw action of a different kind as a bouncer - or 'chucker-out' as they were called in the 60s - at Glasgow's legendary Barrowland Ballroom.

The great-grandfather broke a hip last year, but was keen to get out of hospital as soon as possible - and back home to his flat in South Lanarkshire Council's sheltered housing complex in East Kilbride. Supporting John in his determination to remain independent is a team effort - one that he likens to "having the right folk in his corner" during his boxing days.

The award-winning Integrated Community Support Team (ICST) that supports John brings together housing staff, social workers and healthcare professionals to provide a wide-ranging package of care. Physiotherapy and occupational therapy have helped to get him mobile again, and his home has been equipped with aids for his comfort and safety. John now gets a visit every day to make sure he's well and happy.

John's day begins with a care worker calling in to make his breakfast and have a chat, making sure he's happy and comfortable. "John's a proud man who likes to look after himself", says home carer Billy. "It's our job to support his independence."

The multi-disciplinary team offers joined-up support under the national Reshaping Care for Older People programme (RCOP). The RCOP initiative is ensuring that many more older people like John can continue to enjoy the freedom and dignity of independent living for longer.

Transforming care and delivering improved outcomes

Our 2020 Vision

Our vision is that by 2020 everyone is able to live longer, healthier lives at home, or in a homely setting.

We will have a healthcare system where we have integrated health and social care, a focus on prevention, anticipation and supported self management. When hospital treatment is required, and cannot be provided in a community setting, day case treatment will be the norm. Whatever the setting, care will be provided to the highest standards of quality and safety, with the person at the centre of all decisions. There will be a focus on ensuring that people get back into their home or community environment as soon as appropriate, with minimal risk of re-admission.

Over the years ahead, the demands for health and social care and the circumstances in which they will be delivered will be radically different. John's story shows how NHSScotland and its partners across the public and voluntary sectors are collectively recognising and responding to the most immediate and significant challenges we face. These include Scotland's public health record and level of inequalities, our ageing population, the increasing expectations arising from new drugs, treatments and technologies, and the specific impact of inflation on the health service.

Our 2020 Vision for Health and Social Care is that by the year 2020, everyone is able to live longer, healthier lives at home, or in a homely setting.

During 2012/13, A Route Map to the 2020 Vision for Health and Social Care^[1] was developed and has continued to provide a focus on the priorities that will have the greatest impact on achievement of our vision. The Route Map describes priority areas for action in three domains:

• Improving the quality of the care we provide;
• Improving the health of the population; and
• Securing the value and financial sustainability of the health and care services we provide.

These domains are often referred to as the 'Triple Aim'. For each of these domains there is a small number of priority areas for action, often building on existing work and all requiring focused attention and acceleration.

Through our approach to quality healthcare improvement as described in the Healthcare Quality Strategy for Scotland^[2] we have continued to drive forward improvements in the care people receive. Our Quality Ambitions for person-centred, safe and effective care have continued to be the guiding light for the work that has been undertaken at national and local level, transforming care and delivering improved performance.

NHSScotland continues to have an important contribution to make to the Scottish Government's Purpose and Outcomes in helping people to maintain and improve their health and wellbeing, especially in disadvantaged communities. Through the 2020 Vision, the Scottish Government has reaffirmed its commitment to high-quality publicly funded health and social care services for the people of Scotland. It recognises that these services contribute directly to growth in the Scottish economy by ensuring that the people of Scotland live longer, healthier lives and, with a focus on prevention and early intervention, remain active within their communities.

Of course, NHSScotland does not deliver improved outcomes for people in isolation. Effective partnership working with people, staff and partners across the public, voluntary and independent sectors and industry have delivered real results and are hallmarks of our approach. Many of the achievements you will read about in this annual report are a direct result of this.

The NHSScotland workforce will be vital in responding to the challenges faced. Our shared 2020 Workforce Vision is that we will respond to the needs of the people we care for, adapt to new, improved ways of working, and work seamlessly with colleagues and partner organisations. We will continue to modernise the way we work and embrace technology. We will do this in a way that lives up to our core values. Everyone working in NHSScotland will be expected to live by our shared values of: care and compassion; dignity and respect; openness, honesty and responsibility; and quality and teamwork.

We will, however, need to go further. Achieving better outcomes for people from the care they receive will require NHSScotland to work more closely with its partners in local government, improving the quality and consistency of health and social care services, and ensuring that people receive the necessary service, at the right time, and in the most appropriate setting. The Public Bodies (Joint Working) Scotland Act - which received Royal Assent on 1 April 2014 - is transformational legislation that will introduce joint accountability arrangements for the planning and delivery of health and social care services, using the totality of adult health and social care budgets. New integrated authorities will be required to deliver national health and wellbeing outcomes.