NHSScotland Efficiency and Productivity: Framework for SR10
The Framework’s main purpose is to identify priority areas to improve quality and efficiency. The Framework is a companion to the Quality Strategy and provides a baseline for the changes that will need to be undertaken by the Scottish Government Health Directorates (SGHD), NHS Boards and other public sector organisations.
2 SCOPE: 2011-2015
2.1 Aims and Objectives
The key aim for the Framework is simple:
To improve the overall quality and efficiency of NHSScotland while ensuring good value for money and achieving financial balance.
Figure 1 illustrates the key area where we should focus our attention and effort by prioritising innovative redesign and improvement that improves quality and reduces costs.
Figure 1 - Quality Initiatives and Cost Reduction Programmes
The key objectives for the Framework are:
- quality is improved and not compromised
- NHSScotland to achieve financial balance over the 2010 spending review period
- NHS Boards are supported in achieving efficiency targets and improving services, and
- central coordination of support, monitoring, benefits realisation and challenge to be available to NHSScotland.
2.2 A Consistent Narrative - Quality and Efficiency
Quality, as defined by the Institute of Medicine, is maximised when care is safe, effective, equitable, person-centred, timely and efficient. It is essential that there is a consistent quality and efficiency narrative that recognises the truly transformational approach of one and the need for immediate benefits realisation of the other. As such, while there will be limited room for service developments and quality improvement that increase costs, we must also avoid efficiency savings that reduce the quality of services.
Our approach to tackling unwarranted variation is a shared endeavour between the Quality Strategy and the Framework. We intend to build on the task and finish approach (most recently applied in orthopaedics) in partnership with clinicians and managers.
2.3 Joint Working Across NHS Boards and Public Services
NHS Boards should continue to explore opportunities for achieving efficiencies through regional planning. By working across organisational boundaries, NHS Boards should continue to pursue opportunities that:
- establish a wider range of shared services with other NHS Boards
- secure sustainable and accessible services for their populations, and
- offer more integrated and efficient services by closer working with local authorities.
In addition, Regional Planning Groups should clearly evidence through their annual work plans and reports a well-defined programme for efficiency and productivity that is consistent with the ambitions of the Quality Strategy. Finally, local delivery plans should reflect, as appropriate, the connectivity of this agenda across NHS Boards.
Delivering world-leading healthcare services for people will require strong partnership working across health and care services. In recognition of the pressures on the health and social care system in a challenging fiscal climate, the Scottish Government has allocated £70m in 2011-12 to a Change Fund to enable health and social care partners to implement local plans for making better use of their combined resources for older people's services. By ensuring that older people remain independent in their own homes, the focus will be on reducing unnecessary hospital admissions and a quicker discharge after a crisis. This will result in better outcomes for older people and ease the pressure on acute hospital provision. Box 1 provides examples of the potential for joint working.
Box 1: Joint Working Across Public Sectors |
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One area where NHS Boards have identified benefits in joint service delivery is Releasing Time to Care in the Community, a service improvement approach and toolkit which provides frontline teams with the necessary skills, knowledge and evidence base to improve the organisation of local service delivery. The potential to adapt and implement this approach within integrated teams, for example within older people's services, could provide a basis for a more responsive and efficient frontline service delivery. NHS Dumfries and Galloway and NHS Grampian will be working with their partners to adapt and implement the toolkit within health and social care teams, working together to improve care. The lessons learned from the two pilot sites will be shared across NHSScotland and local authority partners, while the Scottish Government's Joint Improvement Team will provide additional support to the pilot sites. Nationally, a Scotland-wide Hub initiative is being developed as a means of improving the planning, procurement and delivery of infrastructure that supports community services. It brings local community planning partners, including Health Boards, local authorities, police, and fire and rescue services together with a development partner to:
The joint working relationships that are created through the initiative will provide increased opportunities for joint service and joint asset management planning. |
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