OUR HEALTH, OUR CARE, OUR FUTURE Your Chance to Help Shape Healthcare in Lothian
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OUR HEALTH, OUR CARE, OUR FUTURE Your chance to help shape healthcare in Lothian NHS LOTHIAN’S DRAFT STRATEGIC PLAN FOR 2014-2024 SUMMARY CONSULTATION Our Health, Our Care, Our Future 1 We want to hear as many views as possible on how NHS Lothian should evolve. INTRODUCTION NHS Lothian works experience patients have to help people live of our services. This will WE NEED A STRATEGIC healthier, longer lives – take planning and change. PLAN TO: no matter who they are Our 10-year strategic • Provide high quality or where in the region plan gives us guidance care at all times they live. Much progress to ensure that services • Adapt to a growing and has been made, but are developed in the best ageing population significant challenges and way for patients, and that opportunities lie ahead. the approach we take is • Make patients and carers efficient and cost-effective. our partners Healthcare is advancing • Work more closely with at great speed. At the We will work with patients, our other partners, including same time, our population carers and everyone local authorities and is growing and ageing, else with an interest in voluntary organisations and we are caring for Lothian’s health service • Be more efficient many more people with to get our direction and complex needs. The tough priorities right. economic climate also means we have to make This summary outlines our savings of £40 million a aims and issues and shows year, savings that we will what success could look reinvest into providing like. It is also an invitation new and expanded to get involved – we want services for patients. to hear as many views as possible to help shape our By preparing for the plans to deliver our health, challenges, and embracing our care and our future. the opportunities, NHS Lothian can bring tremendous improvements Tim Davison in care, and in the Chief Executive 2 Our Health, Our Care, Our Future We want everyone to enjoy longer and healthier lives at home, or somewhere homely. OUR VISION We want everyone to enjoy longer and healthier lives at home, or somewhere homely. For this to happen, health and social care services must be fully joined up and work smoothly for patients. Care must be of the highest quality and patients have to be involved in decisions that affect them. Patients and carers must be our partners in care. We need to do more, together, to prevent illness, anticipating patients’ changing needs and helping them to manage their own conditions. Most care should be delivered at home, or as close to home as possible. When someone needs hospital treatment this will normally be for a day. Where a longer spell in hospital is needed, we will get patients home, or somewhere homely, as soon as they are ready. NHS Lothian also needs the right technology, buildings, equipment and skilled staff. Our systems must be reliable, sustainable and efficient, supporting patients on a care pathway that is timely, safe, evidence-based and ensures they have the most positive experience possible. Our Health, Our Care, Our Future 3 CHALLENGES Our NHS has to adapt to early on. Cancer and LOTHIAN’S POPULATION the needs of a population dementia are on the rise, that is larger, older as are serious health 2010 and has more complex problems like type 2 conditions than ever. diabetes. We must tackle 836,711 the causes of ill health The older we get the more like obesity, poor diet long-term conditions we and limited physical 2025 tend to have. For over 65s activity, smoking and 965,007 the average is two, and over excessive alcohol. INCREASE 75s it’s three plus. Older people also tend to be Money is also a great 15% admitted to hospital more challenge. Right now we often and for longer. We have to find £40 million need to do more to prevent in savings a year to AGED OVER 65 avoidable admissions and to reinvest in our services, rehabilitate patients quickly. then find more money 2010 for some of the more 124,313 People who are poor or expensive investments disadvantaged often have proposed in our plan. This poorer health. Tackling will mean we have to stop 2025 health inequalities is a doing some things, and 175,631 fundamental challenge. do other things differently We need to find ways to make sure we use our INCREASE to reduce ill health and resources where they provide effective help deliver greatest benefit. 30% EFFICIENCY SAVINGS – HELPING TO BALANCE THE BUDGET 65-74 74-84 85+ 9.2% 6.2% 2.8% SPENDING Prevention UPLIFT INCOME UPLIFT Pay costs £16.7m Medicines £17.7m Budget uplift £31.6M Increased capacity £17.6m Efficiency savings Developments £9.4m £37.3M Other £7.5m TOTAL £68.9M TOTAL £68.9M Obesity, poor diet and limited physical activity, smoking and excessive alcohol NHS Lothian base budget £1,141m 4 Our Health, Our Care, Our Future Our strategy needs to be based on a clear vision and everything needs to be measurable. This is what we think success should look like: OPPORTUNITIES More GP and community-based care We have tremendous opportunities to improve health and reduce costs by preventing illness and providing care at an Integrated health early stage and in the community. Services can and social care be redesigned, putting the patient first. This will be part of wider change that sees NHS professionals, local authorities, the voluntary Greater safety in all healthcare environments sector, patients and carers as partners in care. Different groups within the NHS often work in an isolated way – much can be achieved by getting Better emergency care everyone with a role in a patient’s care working much more closely together. The way staff work, and the skills they have, is of huge importance. Improved approach to There are opportunities to make sure services multiple and chronic illness are available more flexibly to meet needs. Some services that are currently only available in Involving people in their hospital can also be provided in the community care to improve services or at home. Some buildings are old and no longer fit for Adapting purpose. This gives us the chance to create the workforce new, purpose-built specialist centres on some sites and to dispose of others. IT and web-based Innovating to raise quality technologies can speed up services, making them and spend money where more accessible and cutting administration. it can deliver the greatest benefit to patients NHS Lothian will encourage its values of quality, Higher efficiency dignity and respect, care and compassion, and productivity openness, honesty, responsibility and teamwork in all it does. We will also encourage staff to be Care pathways (a patient’s innovators and believe there are opportunities care journey through the to improve leadership, ensuring that staff at all NHS) that deliver what levels are clear about their responsibilities to matters to patients patients and colleagues. Our Health, Our Care, Our Future 5 People in Lothian’s wealthiest areas can expect to live 21 years longer than those in the most deprived communities. LIFELONG CARE The NHS is here to provide care at all stages of life. Our draft plan outlines how we will do this. Children and young people: Services for children and young people are to be improved. More health visitors and school nurses will be recruited and we will implement the Children’s Bill so there is a named person responsible for every child aged 0-5. Preventing illness: We aim to help prevent or delay the onset of illness by tackling the underlying causes, such as smoking, obesity and overuse of alcohol. This will be done by strengthening healthy lifestyle initiatives and working with the most vulnerable. Health inequality: Your chances of becoming ill are closely linked to factors such as levels of deprivation, race, disability and gender. We will work with local authorities and other partners to reduce poverty, improve education and employment, and improve health and wellbeing. We will target and tailor clinical services to those most in need. 6 Our Health, Our Care, Our Future Frail older people: Continuing care for older people needs to change so they can move smoothly between home, residential home and, when necessary, hospital. We propose a wider range of community services so fewer older people will need to go into our acute hospitals. This can be offered in residential homes, community hospitals or with support at home. End of life care: When people near the end of their lives we want them to be in the place they wish to be cared for and, when practical, to die where they choose. Part of this involves making sure CARE CLOSE TO HOME that the care is available to avoid unnecessary emergency Some of our most far- Right care, right time: hospital admissions and we are reaching ideas involve Patients need to be sure developing plans to provide increasing the role and of a timely consultation better community-based capacity of GP and with an appropriate health palliative care. community services – care professional. They moving care away from should wait no more than hospitals and closer 48 hours for a non-urgent to home. appointment with a GP or practice nurse. Patients and More care at home: carers must also be involved By strengthening GP and in decision-making. community teams and involving patients more GP services: in the management of A review is needed of GP their own health, we can and practice staff numbers deal with problems earlier and whether their premises and reduce the need are suitable and located for hospital admissions.