Out-of-Hospital Cardiac Arrest: A Strategy for Scotland

DRIVING AND SUSTAINING IMPROVEMENT

Leadership and Governance

The ambition to make Scotland an 'International Leader for OHCA Outcomes' demands clear and effective leadership at all levels to ensure that the complex range of aims and actions are designed and delivered by a wide range of stakeholders across the whole country. This will require a shared understanding and commitment to the overarching strategic aims of the strategy and its components. Effective delivery will require contributions from the public sector, academia, third and voluntary sectors and crucially from communities themselves.

In order to provide governance and co-ordination of the OHCA Strategy, the Scottish Government will continue to host a Reference Group to bring together the leaders of the main stakeholder groups. This group, chaired by the Director-General for Health and Social Care, will meet to maintain an overview of progress and help to ensure a continuing national focus on OHCA. The Reference Group will be supported by an OHCA Strategic Delivery Group which will further develop the themes and proposals set out in this strategy and be responsible for co-ordination, information sharing and reporting.

However, central to the success of our aim to change the system and improve outcomes of OHCA will be the commitment and drive of the national and local groups and organisations - and the people within them - who have a role in responding to OHCA.

Measures and Monitoring

The monitoring, effective use and also the public reporting of performance and outcome data will be a key driver of the implementation of the strategy. The OHCA Registry and an appropriate mechanism to ensure that the data within it is effectively captured, quality assured, analysed and used is central to this. Work to develop the Scottish OHCA Registry is already in hand and it is hoped that it will be fully operational during 2016.

A subset of measurable objectives will be developed to demonstrate progress towards the strategic aim. These objectives will be locally applicable but will also be matched against internationally agreed comparators in order to objectively evidence our international position.

Costs and Benefits

There are of course costs as well as benefits to seeking to improve Scotland's response to OHCA. However, little has been published on the cost effectiveness of addressing OHCA and the health economics case around OHCA is rather limited. It is also difficult in the context of a complex, multi-organisational system, to easily calculate the net additional costs of improving OHCA given that it is not clear at this stage what proportion of the proposed improvements might be absorbed through different and more effective use of existing resources. Or what efficiencies might be achieved through better co-ordination amongst stakeholders.

Having agreed to the principle that Scotland can and should improve our OHCA outcomes, stakeholders individually and in collaboration need to continue to develop their improvement programmes to determine how best to take forward the necessary actions.

Quite rightly, the focus must be on the benefits to patients and their families. Our aim that by 2020 some 300 more lives will be saved every year (compared to now) is ambitious, important and achievable.