NHS Lothian Local Delivery Plan 2014/15 Improvement and Co-Production Plan
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NHS Lothian Local Delivery Plan 2014/15 Improvement and Co-Production Plan Contents 1 Introduction Introduction from the Chief Executive p2 Executive Lead Contacts for the 12 priorities within the 2020 Route Map p3 Map of Key Local Plans p4 2 Person-centred Person-centred Care P5 Co-Production 3 Safe Safe Care P10 Complaints 4 Effective Primary Care P11 Unscheduled and Emergency Care p13 Stroke Integrated Care p17 - Integration - Innovation - Use of independent Health Care Sector for Acute Hospital Care Care for Multiple and Chronic Illnesses p23 - Strategic Clinical Framework - Multi Morbidity Action Plan - Chronic Pain Early Years p25 Health Inequalities p26 - Learning Disabilities Prevention p30 Workforce p32 1 1.1 Introduction from the Chief Executive As we look forward to 2014/15, NHS Lothian is progressing a number of priority actions to deliver the 2020 Vision. Work has commenced on many of these actions in 2013/14 and will continue in 2014/15. This work has been developed through engagement in national discussions on all the priorities set out in the Route Map, and involves co-production with staff, patients, public and partners. We are currently developing our Strategic Plan for 2014-2024 and through this our aims and ambitions are being aligned to the aspirations of the 2020 Vision. The Draft Strategic Plan is being submitted to the NHS Lothian Board on the 2nd April for approval. From there the propositions that we set out will be taken forward for consultation, engagement and further development as appropriate. The plan outlines how we will deliver health and care across the whole system, including primary and community care and acute hospital services. It considers the whole system and our proposals to transform patient pathways for those with complex needs and co-morbidities. It builds on our aspirations in respect of integration and the need to shift the balance of care to provide care at home and in the community whenever possible. We will review what activity is currently undertaken across our physical estate in order to ensure maximisation of space and our workforce. In doing so we are committed to retaining our four acute sites. These being the Royal Infirmary of Edinburgh, the Western General Hospital, St John’s Hospital and the Royal Edinburgh Hospital. In addition, we will explore options to improve the quality and safety of hospital facilities. This will include re-providing complex care beds from Corstorphine Hospital, some from Astley Ainslie Hospital in upgraded accommodation at the Royal Victoria Hospital, and the long term use of the Royal Victoria Hospital. With Edinburgh Council a priority for 2014/15 is to explore the future role of the Royal Victoria Hospital and Liberton Hospital to meet the care needs of older people. This will include the potential development of care villages. The options for both the Lauriston Building and the Princess Alexandra Eye Pavilion sites will also be reviewed. We will consider better utilisation of the Midlothian Community Hospital and the development of the new East Lothian Community Hospital for older people’s care. We have also restated our ambition to reprovide the Edinburgh Cancer Centre on the Western General site. These, along with other propositions will be set out within the final Strategic Plan which we will forward to you once the plan has been approved by the Board. Tim Davison Chief Executive 2 1.2 Executive Lead Contacts for the 12 priorities within the 2020 Route Map Melanie Johnson Person-centred Care Director of Nursing, AHPs and Unscheduled Care David Farquharson Safe Care Medical Director David Small Primary Care Director of Health & Social Care Partnership East Lothian Unscheduled and Melanie Johnson Emergency Care Director of Nursing, AHPs and Unscheduled Care Alex McMahon Integrated Care Director of Strategic Planning, Performance Reporting and Information Care for Multiple and Alex McMahon Chronic Illnesses Director of Strategic Planning, Performance Reporting and Information Alex McMahon Early Years Director of Strategic Planning, Performance Reporting and Information Alison McCallum Health Inequalities Director of Public Health and Health Policy Alison McCallum Prevention Director of Public Health and Health Policy Alan Boyter Workforce Director of Human Resources and Organisational Development Alex McMahon Director of Strategic Planning, Performance Reporting and Information Innovation Alison McCallum Director of Public Health and Health Policy Efficiency and Susan Goldsmith Productivity Director of Finance 3 1.3 Map of Key Local Plans Person-centred Care Clinical Governance & Risk Management Functions - 2013/14 Safe Care Work Plan NHS Lothian Primary Care Strategy Demand-Capacity-Access NHS Lothian Primary Care Premises Strategy Primary Care NHS Lothian Strategic Plan Appendix - Developing Primary and Community Services Unscheduled and NHS Lothian Local Unscheduled Care Action Plan Emergency Care Integration Schedules x4 (in progress) Delivering for Patients - NHS Lothian's Commitment to meet and sustain the Treatment Time Guarantee and Outpatient Integrated Care Standards Joint Older People’s Plans x 4 NHS Lothian Mental Health and Wellbeing Plan Care for Multiple and Draft NHS Lothian Strategic Plan 2014-2024 Chronic Illnesses NHS Lothian Multi-Morbidity Action Plan Improving the Health and Wellbeing of Lothian’s Children and Young People - Draft NHS Lothian strategy for children and young people 2013 – 2020 Early Years NHS Lothian Children and Young People’s Strategy 2014 – 2020 - Improving the Health and Well-being of Lothian’s Children and Young People - Draft Implementation Plan 4x Integrated Children’s’ Services Plans What’s next for people with learning disabilities in Lothian? 2009 – 2013. Health Inequalities NHS Lothian Learning Disabilities One Year Interim Plan Draft NHS Lothian Health Inequalities Strategy Lothian Sexual Health & HIV Strategy (2011- 2016) Prevention 4x Local Authority Prevention Plans (in progress) Draft Human Resources and Organisational Development Workforce Strategy 2014-2017 Innovation Draft Innovation Action Plan 2014 - 2020 NHS Lothian 2014/15 Local Re Investment Plan Draft NHS Lothian 5 Year Property and Asset Management Efficiency and Investment Programme 2014/15 - 2018/19 Productivity Draft NHS Lothian Financial Plan for the period 2014/15 – 2018/19 4 2. Person-centred Person-centred Care For a long time, and in common with much of the rest of the UK, we have planned the way we deliver health services separately in different parts of our system (primary care, acute care, NHS, local councils). We have also tended to plan around buildings, or around individual services. What is proposed here is a radical shift away from this ‘traditional’ approach to a patient-centred, whole-system approach, focussing much more explicitly on the needs of people who use NHS Lothian’s services. Our Strategic Plan is predicated on the need for redesign to deliver improvements in health and care services in Lothian. A central tenet of service redesign is to focus on the patients’ journey and experience, to help identify where service improvements are necessary and to involve a wide range of service users and providers in analysing and redesigning improved patient pathways. Using intelligence and evidence, we have identified representative patients with varying degrees of care needs. We then use these patients as examples to illustrate their pathways of care, understand their care needs, how their care needs are currently being met and agree how these can be met more effectively and efficiently in radically different ways. This is being conducted through a designed and managed process of engagement during 2014 and is expected to inform large and significant parts of the final plan. Person Centred Health & Care Programme The national Person Centred Health & Care Programme (PCHC) was launched by the Cabinet Secretary in November 2012 with the aim of developing health and care services that are centred on the people who use our services. This programme build on the work that NHS Lothian has done to date and gives us a further emphasis on how we use the experiences of patients, families and carers to improve our care and services. There are five elements that as an organisation we should consider when speaking with patients and service users What matters to you? Who matters to you? What information do you need? Personalised contact Involved in discussions and communication about your care 5 In addition to this national improvement programme, NHS Lothian will also consider other sources of patient feedback and information such as patient stories. We will use a range of approaches to ensure that the patient's voice and their experiences are used to drive improvements so that care and services are provided safely, effectively and in a person centred way. This work also builds on our organisational values of care and compassion, dignity and respect, quality, teamwork, openness, honesty and responsibility. 2.1 Co-Production The Scottish Government and CoSLA are of the view that using ‘assets-based approaches’ such as co-production are instrumental if we are to successfully shift the balance of health and social care and develop public services that are focused on prevention and independence (Governance International 2013). Co- production recognises that people have ‘assets’ such as knowledge, skills, characteristics, experience, friends, family, colleagues, and communities. These assets can be