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NHS Scotland Chief Executive's Annual Report 2017/18 © Crown copyright 2018 This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/open- government-licence/version/3 or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: [email protected]. Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned. This publication is available at www.gov.scot Any enquiries regarding this publication should be sent to us at The Scottish Government St Andrew’s House Edinburgh EH1 3DG First published by The Scottish Government, November 2018 ISBN: 978-1-78781-331-1 E-book in EPUB format first published by The Scottish Government, November 2018 ISBN: 978-1-78781-381-6 (EPUB) E-book in MOBI format first published by The Scottish Government, November 2018 ISBN: 978-1-78781-382-3 (MOBI) Published by The Scottish Government, November 2018 NHS Scotland Produced for The Scottish Government by APS Group Scotland, 21 Tennant Street, Edinburgh EH6 5NA PPDAS477646 (11/18) Chief Executive’s Annual Report www.gov.scot 2017/2018 01 NHS Scotland Chief Executive’s Annual Report 2017/18 Foreword 02 Contents Chapter 1 – Transforming Care and Delivering Improved Outcomes 04 Chapter 2 – Improving Quality of Care 12 Chapter 3 – Improving the Health of the Population 44 Chapter 4 – Securing Value and Financial Sustainability 52 Chapter 5 – Making Change Happen – Our People 56 Appendix 66 02 NHS Scotland Chief Executive’s Annual Report 2017/18 Foreword 03 NHS Scotland Chief Executive’s Annual Report 2017/18 I’m pleased to present my fifth Annual Report as Last winter was particularly challenging with NHS Scotland’s Chief Executive. significant increase in demand for unscheduled care, along with the impact of severe weather. The achievements in this report are a tribute to the A&E attendances were up, along with respiratory outstanding commitment of all staff working in NHS emergency and flu emergency admissions. While Scotland and our partners to deliver the best health patients did spend more time in A&E, almost and social care outcomes for the people of Scotland. nine out of 10 spent less than four hours and Their dedication and hard work are amazing and I core sites performed well relative to the rest of greatly value and appreciate all they do. the UK. In addition, we saw increased numbers of cancelled operations due to capacity or non- On the 5th July 2018, the NHS turned 70. As we clinical reasons – but by June of this year this had entered the anniversary year, we were reminded been pulled back with some of the lowest levels of of how far the NHS has come, and of the many cancellations on record. milestones and innovations over seven decades. We were also reminded that the NHS has always In addition to the challenges faced this winter, adapted to meet the health challenges faced some NHS Boards also reported an increase in by people in Scotland. That ability to adapt and the numbers of urgent elective referrals which are change remains one of its longstanding strengths impacting on elective services. The Scottish Access – as relevant now as it has ever been - and my Collaborative was established in the autumn of annual report details many of the examples of how 2017 and is making progress in reforming elective health and social care is being reformed to meet services. And more recently, the Waiting Times the changing needs of our population. Improvement Plan launched in October 2018 sets out actions to deliver improvements in waiting times We have a good foundation on which to build. over the next 12, 24 and 30 months. People’s experience of both primary and secondary care, as reported through a range of In a year when we’re celebrating 70 years of the patient surveys, continues to be high. Recent NHS, we have the opportunity to reflect on the results from the 2018 Scottish Inpatient Experience journey still ahead. I have also been reflecting survey, for example, show that 86 per cent of for some time on my own future. Having been people rated their overall care experience positively a civil servant since 1979 and having had the and over a third said that their overall care was ‘10 immeasurable privilege of serving for five years as out of 10’. We have continued to see improvement NHS Scotland’s Chief Executive, I have taken the in a number of high-level indicators, with delayed decision to step down in February 2019 to allow discharge, emergency bed-days, emergency me to devote more time to those closest to me admissions and re-admissions to hospital within 28 and to pursue other opportunities. days all showing positive progress. So, this will be my final report as NHS Scotland Of course, for reasons that have been well- Chief Executive. I said when I came to it that it was documented, demand for services has continued the best job in the world – and it still is. The NHS to grow. Last year’s Annual Report, set out how has always been defined by the people who work we are ensuring the challenges of living longer in it and I am immensely proud of the ongoing and healthier lives are met by a health service that commitment of staff – not just in the NHS but embraces and drives the necessary change. The across health and social care - whose compassion, Health and Social Care Delivery Plan, published in hard work and innovation continue to deliver the December 2016, set out our framework for reform. best of care to the people of Scotland. Action under the Delivery Plan is progressing across the whole of the public sector. Paul Gray Chief Executive, NHS Scotland and Director-General Health and Social Care 04 NHS Scotland Chief Executive’s Annual Report 2017/18 Chapter 1 Transforming Care and Delivering Improved Outcomes 05 NHS Scotland Chief Executive’s Annual Report 2017/18 The challenges of driving greater improvements and addressing the numerous challenges of developing a health and social care system that is fit for 21st century Scotland are well- rehearsed. People are living longer and increasingly need services that can support multiple health ‘The key … is transforming conditions. At the same time, parts of Scotland continue to experience health inequalities. While all the care people receive from public services are affected by financial challenges, the NHS and other public these are being particularly felt in health and services, working together to social care due to the increasing demand for deliver improved outcomes.’ services. The key to meeting these challenges is transforming the care people receive from the NHS and other public services, working together to deliver improved outcomes. The Health and Social Care Delivery Plan1, published in December 2016, set out our framework for reform. Action to transform care and improve outcomes under the Delivery Plan is progressing across the whole of the public sector. This chapter focuses on four areas where the pace of change and ambition is growing, and where partnership across the public sector and a shared commitment to act is driving forward change: public health; health and social care integration; Realistic Medicine; and digital health. This chapter also provides information on the measures of health and social care in 2017/18. Public Health In 2015, the Public Health Review2 made a number of key recommendations to strengthen the public health function in Scotland. Given the significant and rising costs associated with ill-health and resulting demand on services, this renewed focus on prevention will have both health and economic benefits; the shift to focus on prevention, integration and closer collaboration, as set out in the Health and Social Care Delivery Plan, will improve health outcomes for people, whilst also contributing to Scotland’s long-term sustainable economic growth. Visit www.nhsscotannualreport.scot for the online version of the Annual Report, including peoples’ stories and key facts and figures. 1 Health and Social Care Delivery Plan, The Scottish Government, December 2016. Access at: https://beta.gov.scot/publications/ health-social-care-delivery-plan 2 Further information on the Public Health Review can be found at: https://www.gov.scot/Topics/Health/Healthy-Living/Public- Health-Review 06 NHS Scotland Chief Executive’s Annual Report 2017/18 This underpins the public health reform programme are embedded, with a strong focus on the role with its vision of ‘a Scotland where everybody of Community Planning Partners in involving and thrives’, and its ambition for Scotland to be a world- empowering communities. It is intended that this leader in improving the public’s health. The reform shared responsibility for developing the various programme is being led in a partnership between commissions will lead to a shared ambition for the the Scottish Government and the Convention of programme, together with greater commitment Scottish Local Authorities (COSLA). It is recognised, and improved collaborative working. however, that this ambition cannot be achieved by any one body or organisation alone. It requires the combined efforts of partners from across the public, Health and Social Care Integration private and third sectors and, importantly, from Health and social care integration is helping to within local communities as well. improve people’s lives. Increasingly, the shared goal across the public sector is for truly integrated Our Shared Priorities services focused on the needs of citizens – Agreeing Scotland’s public health priorities is an individuals, carers and families – and on the health important first step in the public health reform and wellbeing of local communities.
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