• A major shift of treatment into community settings is planned
• Some services and treatments will be centralised on either a regional or national basis.
• A new Public Health Strategy will be developed and mental health services will be mainstreamed across all health services
• A new Workforce Plan will be developed in 2017
The Scottish Government have published a Health and Social Care Delivery Plan (from now on “the Delivery Plan”). This sets out the Scottish Government’s aims and proposals for health services and social care services. Amongst the things that will be different in a “transformed Health and Social Care System” people will be “Equal partners with their clinicians”, “Everyone will have online access to a summary of their Electronic Patient Record” and “People will lead more active, and as a result, healthier lifestyles.”
A greater emphasis on public health is part of the plan as is a shift away from delivering care in acute settings towards delivering more and a wider range of health care in the community. This will be accompanied by delivering some services on a more regional or even national basis. To facilitate these changes a National Health and Social Care Workforce Plan will be drawn up by Spring 2017 – this will be preceded by a National Discussion Document in early 2017.
An emphasis is placed on securing better value. This is linked to shifting the balance of where care and support is delivered from hospital to community care settings. Services are to be redesigned around communities.
The plan speaks of need for a “fundamental move away from a ‘fix and treat’ approach to one based on “anticipation, prevention and self management”. This will require a more comprehensive cross sector approach involving a range of public sector services working together systematically. Health Boards must work more collaboratively but this “doesn’t mean structural change to NHS Boards”
Health and Social Care Integration
A stress is laid on Health and Social care partnerships better anticipating care needs. A target of reducing delayed discharges by 10% by 2018 is set. This is to be achieved by improving links between secondary primary and community care under integration and taking action (unspecified) to understand better and then reduce emergency. Agreements will be made with partners as to how performance on delayed discharges is to be raised. Health and social care targets will be reviewed in 2017.
National Clinical Strategy
The Delivery Plan is part of the national clinical strategy which emphasised a shift away from hospital based care. In the Delivery Plan this is talked of as meaning building up capacity in primary and community care and supporting development of new models of care. This will involve expanding the multi-disciplinary community care team with extended roles for a range of professionals and a clearer leadership role for GPs. As part of this the role of district nurses is to be “refreshed”, an additional 500 advanced nurse practitioners are to be trained by 2021 and more training places for nurses and midwives created.
National public health priorities will be set in conjunction with Local Government. A clear set of Public Health priorities will be created and a new approach to Mental Health developed which will mainstream support and treatment across all parts of the Health Service. Computerised cognitive behavioural therapy services will be rolled out nationally. An emphasis will be placed on improving levels of physical activity.
NHS Board Reform
More “non patient facing services” will be centralised to a national level as part of a ‘Once for Scotland’ approach – potentially including HR, financial administration, procurement, transport and other services. These will be reviewed in 2017 with new national arrangements put in place in 2019. Health Boards must work more collaboratively but this “doesn’t mean structural change to NHS Boards”
National Health and Social Care Workforce Plan
An outline discussion paper for a National Health and Social Care Workforce Plan is published as an appendix to the Delivery Plan. This is intended to be the start of a process of consultation and development. A further Discussion document will be produced in early 2017 with the Workforce Plan published in Spring 2017 – the first of an annual series. One of the aims is to align workforce planning with strategic objectives using, as far as possible, existing infrastructure. The input of trade unions is described as key to creating the right working conditions. More Regional (ie cross Health Board) planning is expected. Health and Social partnerships are expected to play a significant role in the development of the plan.
Action for branches
Branches should ensure they are fully aware of any input into the Workforce Plan by employers.