The Gathering

Derek Feeley

Chief Executive NHS Scotland

Partnership working

6 Key Challenges

• Political

• Economic

• Demographic

• Epidemiological

• Population Health

• Changing Expectations

And so…..

Questions;

Is the answer to this range of challenges likely to be one dimensional?

Is the optimal response likely to lie in just doing more of the same or just changing everything?

How should we deploy our combined efforts to thrive in this new environment?

It’s complicated….

Too bad all the people who know how to run the country are busy driving cabs and cutting hair.

-- George Burns

Triple Aim

Health of the

Population

Experience of Care

Best Value for Money

The Triple Aim

Integration

Quality, Quality and more Quality

• Mutually beneficial partnerships between patients, their families and those delivering healthcare services. Partnerships which respect individual needs and values and which demonstrate compassion, continuity, clear communication and shared decision-making.

• No avoidable injury or harm from the healthcare they receive, and that they are cared for in an appropriate, clean and safe environment at all times.

• The most appropriate treatments, interventions, support and services will be provided at the right time to everyone who will benefit, with no wasteful or harmful variation.

Our ‘2020 Vision’

EVERYONE IS ABLE TO LIVE LONGER HEALTHIER LIVES, AT HOME, OR IN A HOMELEY 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 future – Gathering all 3 curves

Time

Perform

ance

Performance

Improvement

Co-production& assets

“The 3rd Curve”

• Given the challenges – hard to see sustainable route without this – can’t treat our way through this.

• Untapped potential of public activation• Patients and families tell us that healthy living is

a key outcome for them• Shifting the balance of care and shiftin gthe

balance of power

Assets and Co Production: In Plain English

• Made here by us• Nothing about us, without us, is for us• Building the boat not just steering it• Working with us, not doing things to or for us• On tap not on top• Lighting 1000 fires all over the community• I have a problem I want help to fix it• What can I do?

Assets vs Deficits

Assets thinking•Strengths based•How can we create community spirit?•What can I do?•We’re all in this together•We’re getting there•Work with engaged people•People have the answers•People control their lives

Deficit thinking•Problem orientated•How to fix this problem?•Someone needs to sort this•Us versus them•Problems are embedded•Do things to people •People are a problem•People can’t be trusted to decide/be in control

Some foundations?

Use the tools (and strengths) we have

• Engagement Matrix

• Change Fund Programme

• Gaun yersel’

• All together now

• Co-production guide

Making change happen

• Promote shift to assets thinking & behaviours• Develop a shared understanding, clear &

consistent message across policies & initiatives• Empower & skill workforce and

people/communities• Support better links, hubs, joining up • Support learning and sharing of what works• Improve intelligence on whether we are

delivering outcomes people & communities want

Theory 1

• The leaders of the future need to be experts in performance, quality and co-production. They will be comfortable with complexity and conflict and generous with power.

Theory 2

• Reliability of values, ethics and behaviours is likely to be just as important as reliable professional practice.

Keep it Real

• Don’t get lost in theory and jargon

• This is about people and communities

• There are examples of assets rich communities and fiery spirits everywhere

• We know how to do this

• We want to do it

• Just do it

Just start!!!