Future Vision for Health and Social Care

We know that we need to change and improve how we deliver care if we are to have an NHS and social care sector able to support the health needs of this generation – and generations to come.

It is vital that our health and care services evolve as the population of Scotland evolves and that we continue to meet the needs of the people of Scotland.

This is why Health Secretary Shona Robison recently launched the National Clinical Strategy which will serve as the blueprint for health and social care over the next 15 years.

Developed by senior clinicians, the strategy outlines plans to deliver a range of improvements and reforms to modernise the way care is provided.

It reflects some of the initial findings from the Healthier Scotland conversation, including having a greater focus on person-centred, joined up care and easier access to local services and has been shaped by the views of patients and clinicians who have contributed to the conversation.

Similar to Healthier Scotland conversations, this long-term plan takes into account Scotland’s ageing population, the shift to more teams working across all types and disciplines of care and rapid advances in research and technology.

The National Clinical Strategy outlines:

  • The need to provide more care where people need it, with as much care as possible delivered locally
  • The transformational change taking place within primary care, which will be delivered by multi-disciplinary teams with strong links with local authority social services
  • That to give patients the best possible outcomes, complex treatments may be delivered in specialist centres, with follow up treatment available locally
  • The importance of supporting patients to fully understand and manage their health needs, with a focus on rehabilitation and independence

The foundation of this strategy is to provide care as locally as possible, with a whole-team, community-based care approach. This will mean that people continue to be treated close to home, or even in their home, in the majority of cases.

When it comes to needing hospital care, we want the best results for patients. Evidence shows that people who need specialist treatment often get better outcomes by receiving it from teams doing complex operations more frequently.

The strategy also outlines proposals to support smaller and rural hospitals to deliver for their communities, this includes having clinicians working across more than one hospital to allow specialist input to be delivered to remote and rural locations. There are good examples of this happening already and we need to build on these successes to ensure equity of access to expert care for all patients.

Our health and social care system is going through a period of change and this strategy will guide how services advance to meet the needs of an ageing population and provide care which is responsive to the needs of the people of Scotland.

The task now is to work with all stakeholders, local clinicians and decision makers – and most importantly of all, patients and the public – to deliver the improvements we all want to see.

You can find the full strategy here: A National Clinical Strategy for Scotland (.PDF, 1.10 MB)

The Scottish Health Awards 2015 – Quality Champion of the Year Award Winner

Gavin Hookway – NHS Highland


Source:  Daily Record Scottish Health Awards 2015 Supplement

A PDF copy of the Supplement can be found here: Scottish Health Awards 2015 Supplement – Page 4

Winners Story:

Gavin is the Senior Quality Improvement Lead within NHS Highland.  Gavin has taken the lead in developing the Highland Quality Approach which aims to ensure that everyone who experiences health and social care in Highland get the right care in the right place at the right time and that waste, harm and variation from other systems is eradicated.

He has worked to increase the knowledge and awareness of skills of frontline staff. managers and leaders to adopt a whole systems quality approach based on the Toyota Production System and adapted by Virginia Mason in USA.  He has endeavoured to bridge the gap between frontline clinical staff, service managers and planners and remains focussed on improving the care experience for those who use the services.

Gavin has trained and coached several cohorts of Lean Leaders across NHS Highland providing them with the required mentorship and support as they lead improvement projects across a range of services.  He has been patient and understanding, supportive in his approach translating the methodology to frontline staff in a way that reflects the local context and is meaningful.

In addition to these, he has embedded the Highland Quality Approach across NHS Highland, has achieved significant increase in the Board’s infrastructure to lead improvements across all services and has secured commitment and motivation across the Board to eliminate waste, harm and variation.

The Bigger Picture:

Gavin has demonstrated an ability to work with staff across all levels of the organisation, to influence thinking and change from Chief Executive to hospital porter and across professional groups.  He has led and supported a huge range of process improvement work across all parts of NHS Highland from the Isle of Bute to Caithness and everywhere in between.  His focus has included community mental health, Child and Adolescent Mental Health Services (CAMHS), endoscopy, chronic obstructive pulmonary disease (COPD), cardiac, community care assessment, and musculoskeletal services among many others.

His approach to quality improvement has stamped a level of organisation and formality that makes NHS Highland a very impressive and forward thinking Board in Scotland.

Gavin’s approach illustrates the inspiring work to achieve our Scottish Government focus on the delivery of improved quality and safer patient care whilst ensuring that the service is sustainable and delivers value for the public purse. 

The impact that Gavin’s work has had has been to achieve significant benefits for patients and staff.  These include:

  • Reduction in waiting times for community health services in Lochgilphead
  • Reduction in waiting times for CAMHS in Inverness
  • Reduction in waiting times for community care assessment in Isle of Bute
  • Reduction in length of stay in hospital for people with COPD
  • Improved access and quality of experience of endoscopy services.

Scottish Health Awards 2015 – Services to Women and Children Award Winners

Dr Joyce Davidson and the Paediatric Rheumatology Team – NHS Greater Glasgow & Clyde

woman & children

Source:  Daily Record Scottish Health Awards 2015 Supplement

A PDF copy of the Supplement can be found here: Scottish Health Awards 2015 Supplement – Page 3

Winners story:

Dr Joyce Davidson and the Paediatric Rheumatology Team were nominated for their Services to Women and Children by Laura Young, founder of the Teapot Trust in memory of her daughter Verity who died aged 8 of systemic lupus erythematosus (SLE Lupus) and cancer.

In her nomination, Laura commented that the amenities available at outpatient departments when attending appointments for the two medical conditions her daughter had were markedly different.  She described the facilities available on children’s cancer appointments to be first class.  However, there was little to distract the children attending the Rheumatology Outpatients Department and noted that play therapists were either not funded or only worked part-time which did not necessarily tie in with every patient’s appointment.  The result was that children were anxious and stressed whilst waiting on their outpatient treatment.

The Paediatric Rheumatology team recognised that there were fewer charities associated with Lupus, Juvenile Idiopathic Arthritis (JIA) and other related conditions in children and went about driving forward improvements to change that position.

Through the Rheumatology Team’s advice, the Teapot Trust has been able to set up a robust and comprehensive art therapy programme for patients at six different hospitals around Scotland.   Using the creative process of art making to improve and enhance the physical, mental and emotional well-being of individuals of all ages.  Art therapy also helps to reduce anxiety in children whilst they are waiting for their appointment.

Dr Joyce Davidson and her team have continued to work with and advise charities to support patients with such conditions in order to improve the experiences of children accessing rheumatology services across the whole of Scotland.  The team have been instrumental in improving the waiting room experience for children and the provision of support out with the hospital environment for patients and their families.

Dr Davidson is a Patron of the Scottish Network for Arthritis in Children (SNAC) which provides a national support network for children with arthritis and their families through the provision of factual, practical and emotional support. SNAC aims to pull together the wider community of affected children in Scotland as well as raise public awareness of childhood arthritis.

The Bigger Picture:

Laura’s nomination highlighted that, as a result of the efforts of Dr Davidson and the team, the Outpatients Department experience is unrecognisable from what it was previously.  The  presence of the Teapot Trust and the opportunity for the family of each newly diagnosed patient to benefit from time at a SNAC away weekend has transformed patient and carer experience.

The work of the team illustrates a clear and practical demonstration of our Quality Ambition for Person-centred care which states:

There will be mutually beneficial partnerships between patients, their families and those delivering healthcare services which respect individual needs and values and which demonstrate compassion, continuity, clear communication and shared decision-making.

As well as the clear focus on the provision of patient-centred care, this nomination provides an excellent example of the Everyone Matters: 2020 Workforce Vision which states:

“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.”


Scottish Health Awards 2015 – Care for Long-Term Illness Award Winners

COPD (chronic obstructive pulmonary disease) Integrated Services Project – NHS Lothian

Long term care

Source:  Daily Record Scottish Health Awards 2015 Supplement

A PDF copy of the supplement can be found here: Scottish Health Awards 2015 Supplement – Page 3

Winners Story:

The Chronic Obstructive Pulmonary Disease (COPD) Integrated Services Project has brought together acute, community, emergency and Out of Hours services to create a Community Based Respiratory Hub.  The Hub ensures patients have access to the right service for them, at the right time and in the right place with a strapline of “wherever and whenever, the patient should have the best service”.

The aims of this project were to integrate existing services of patients with COPD, creating more streamlined pathways, improve patient care, increase self-management skills and reduce unnecessary hospital admissions.  The Hub provides supported self-management through the use of telehealth and became one of the first teams in NHS Lothian to use FLORENCE messaging service to increase adherence to treatment plans.

For GPs and other healthcare professionals dealing with patients who have COPD, the Hub aims to make options for care simple – refer the patient to the Hub via the Community Respiratory Team, and the patient will be considered for all appropriate care both in the community and acute sectors.  This has been supported through communications with all Edinburgh GP practices and referrals into the Hub have increased considerably since the beginning.

The Hub has a holistic approach, with Specialist Respiratory Physiotherapists, Advanced Nurse Practitioners, Respiratory Consultant and Nurses and Pharmacists helping the patient manage their physical illness; while a Clinical Psychologist and Specialist Occupational Therapist support patients to adjust to living with COPD and manage the high prevalence rates of anxiety, panic and low mood.  The Hub also includes Grapevine Disability Information Service, providing financial and social support and signposting to housebound patients with COPD.

The Bigger Picture:

The changes that the Community based Respiratory Hub has made to care and support for patients with COPD have had hugely positive effects for patients, carers and healthcare professionals.  The balance of care has been shifted into the community; patients are activated to self-manage their COPD, supported during acute exacerbations, and given the opportunity to receive psychological and social support.  The integrated approach ensures holistic care and creates an environment for continual professional learning.  This model works and has great learning opportunities for other long term conditions.

This project exemplifies our 2020 Vision for Health and Social Care which states that:

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.

The impact that the Hub has had (since June 2013) is as follows:

  • Saved 1549 respiratory days
  • Case managed 214 frequently attending patients multi-disciplinary team meetings
  • Assessed 242 frequently attending patients by psychology
  • Completed 159 full pharmacy reviews for frequently attending patients
  • Prevented 16 admissions through the new Bed Bureau Pathway
  • Prevented 251 admissions at the Front Door of hospital through Respiratory Nurse Specialists
  • Prevented 18 admissions through the new CRT-SAS Pathway
  • Received 6 referrals from Lothian Unscheduled Care Service (LUCS) Out of Hours
  • Supported 146 extra patients to self-manage using Lite Touch telehealth

Scottish Health Awards 2015 – Innovation Award Winners

Edinburgh Alcohol Related Brain Damage Team – NHS Lothian


Source:  Daily Records Scottish Health Awards 2015 Supplement

A PDF copy of the supplement can be found here: Scottish Health Awards 2015 Supplement – Page 2

Winners Story:

This team designed and created a service for individuals with Alcohol Related Brain Damage (ARBD). Those in need of this service have very often hit rock bottom and have lost much of their dignity, self-worth and the ability to function independently.  Many have lost contact with family members and support networks.

Previously people suffering from ARBD were admitted to acute hospital beds within NHS Lothian for acute problems such as alcohol withdrawal.

A group was assembled to look at whether a designated unit could be provided for the re-enablement of these individuals. The aim was to try to offer as many as possible the ability to live independently.

This culminated in the establishment of a designated unit at  Milestone House – a 10 bedded unit in Oxgangs where individuals can stay for up to 12 weeks managed by the third sector organisation, Penumbra. During the 12 week programme, individuals work with designated key workers such as professionals in physiotherapy occupational therapy, psychiatry and psychology (as required).  Work focusses on reintroducing normal activities of daily living as well as cognitive recovery, coping strategies, physical ability and abstinence techniques.

Milestone House offers this very vulnerable group with a safe and home-like environment whilst providing activities to stimulate cognitive recovery and reinstate a sense of self.

The Bigger Picture:

The work of this team and the compassion, empathy and care they have shown to those who have stayed at Milestone House has had a significant impact on the lives of the residents and their families.  Relatives of residents have said that their work is changing lives and is bringing families together again.  Residents themselves have given very positive feedback to indicate that they felt “happy and safe” during their stay.

This is a clear demonstration of a direct contribution to our Quality Ambition for Effective Care which has a focus on identifying those improvements where there is clear and agreed evidence of clinical and cost-effectiveness, and to support the spread of these practices where appropriate to ensure that unexplained and potentially wasteful or harmful variation is reduced.

The service is estimated to have released over 1200 acute bed days (not including the avoidance of readmissions) with an estimated saving of £5000 per patient admitted to Milestone with far improved outcomes.

Cognitive assessment is carried out using Addenbrooks Cognitive Assessment III (ACEIII) and shows an average improvement of 10% in the 12 weeks in the unit.  It is anticipated that cognitive recovery will continue with persistent abstinence and data is being collected to look at these longer terms outcomes.

The Scottish Health Awards 2015

The prestigious Scottish Health Awards took place recently. These Awards are delivered by the Daily Record in partnership with the Scottish Government to recognise the outstanding achievements of people who work in or with the NHS in Scotland.

Shona Robison, Cabinet Secretary for Health, Wellbeing and Sport presented the winners’ trophies at the Awards Ceremony held on 4 November 2015 to the winners  who come from all corners of Scotland  showing that pioneering work is not confined to the big cities.

Over the next few weeks we will be showcasing some of the winner’s stories to showcase just some of the amazing work that already takes place throughout Scotland.

ShonaShona Robison – Cabinet Secretary for Health, Wellbeing and Sport gave the following editorial to the Daily Record.

Dedication is extraordinary:

Each year, the Scottish Health Awards provide us with an important opportunity to recognise individuals and teams who are dedicated to the delivery of high-quality health and care services to the people of Scotland. As the Cabinet Secretary for Health, Wellbeing and Sport, I often see first-hand the energy, commitment and compassion shown by ordinary people doing an extraordinary job working in our NHS and across our partner organisations.

The awards not only celebrate and recognise the contribution of those staff working in front-line health and social care positions but also those who work behind the scenes in support roles, which are crucial to the success of NHS SCOTLAND and its partners in the social care and third sectors. Of the 296 nominations received across the 16 award categories, many were from patients and the public. The quality of the nominations received demonstrates the affection that the people of Scotland have for those who deliver their health and care services.

All of the nominations contain examples of how individuals, teams and local NHS and care systems are working together with patients, families and carers in Scotland to provide compassionate and responsive health and care services. I heartily congratulate the winners in each of the award categories for their dedication and the significant contribution they have made to improve the health and care services delivered to the people of Scotland.


Source: Daily Record – Scottish Health Awards 2015 Supplement

A PDF copy of the Supplement can be found below:



Still time to apply for the Healthier Scotland Engagement Fund

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As part of the national conversation about the future of health and care services in Scotland (Creating a Healthier Scotland – What matters to you?) VAF is delighted to announce the launch of the Scottish Government’s new Healthier Scotland Engagement Fund.

From August 2015 to Spring 2016 the Scottish Government is holding a national conversation on improving the health of the Scottish population and the future of health and social care services in Scotland.

With £26,000 to give out in grants the Healthier Scotland Engagement Fund is part of this conversation.  It aims to help small voluntary organisations and community groups in Scotland run an event or engagement activity to gather views of people who would not normally participate in a consultation of this nature.

Grants of up to £500 (or exceptionally up to £1,000) are available to support an event or engagement activity with a group of five or more people.

We are particularly keen to fund events or engagement activities that will involve seldom heard or hard to reach groups or communities. Applications that will gather the views of these groups will be considered a priority as will applications from groups with an income under £100,000.

Applications should be received by VAF by 5pm on Friday 11 December 2015. Applicants will hear the outcome of their application by Thursday 7 January 2016. A short report on the event or activity should be returned to Voluntary Action Fund by Thursday 18 February 2016.

Further information, including the guidance and application form, is available on the VAF website at www.voluntaryactionfund.org.uk or click on this link: http://www.voluntaryactionfund.org.uk/funding-and-support/healthier-scotland-engagement-fund/

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