OUR HEALTH, OUR CARE, OUR FUTURE

1. OUR HEALTH, OUR CARE, OUR FUTURE

2. Why do we need a strategic plan? • To set out a shared direction and the things we need to do: • To maintain and raise quality standards • To meet the needs of a changing population • To change our relationship with patients and their carers – putting patients at the centre • To work more closely with other public services • To work more efficiently.

3. What are the challenges we face? Demography, inequalities and ill health Multiple and chronic illnesses (Multimorbidity) Health service demand and rising expectations Tighter finances

4. What will success look like? Improving the quality of care through: • Increasing the role of primary and community care • Integrating health and social care • Focus on anticipatory care, self –management support • Improving unscheduled and emergency care • Improving our approach to multiple and chronic illnesses • Involving people in their care and in service improvements.

5. What will success look like? Improving health of the population by focusing on: • Early years • Underlying causes of health inequalities • Preventative measures on alcohol, tobacco, dental health, physical activity • Early detection of cancer.

6. What will success look like? Bettervalue and financial sustainability, by: Adapting the workforce Innovating to raise quality and reduce costs Raising efficiency and productivity Designing care pathways delivering what matters to patients. Identifying areas for disinvestment – where there is no contribution to the health of the population.

7. What will success look like?

8. What we are going to do – the headlines • Patient-centred, whole-system, pathways approach • Scottish Patient Safety Programme • Improve the care for older people • Multimorbidity action plan • Enable joint working- healthcare, social care, 3rd sector • Improve access to primary care & community teams • Reduce and eventually eliminate delays in patients’ discharge

9. What we are going to do – the headlines (continued) • Develop a new East Lothian Community Hospital • Adapt the use of Midlothian Community Hospital • Develop community mental health services and redevelop the Royal Edinburgh Hospital • Revise emergency care at the Western General Hospital • Expand acute receiving and assessment capacity at the Royal Infirmary of Edinburgh • Focus major hospital care on 4 sites: RIE, WGH, St Johns & new REH

10. What we are going to do – the headlines (continued) • New configuration of acute inpatient services at RIE, WGH and SJH • Do more on a day case basis • Review outpatient services • Develop sustainable in-house capacity for elective care • Improve children’s services, open new children’s hospital • Redesign cancer pathways, build a new Regional Cancer Centre

11. How are we going to do it…….? By putting patients at the centre of our plans. Focus on the patients’ journey and experience, with four names to represent four groups of patients.

12. How are we going to do it…….? • Different working arrangements for clinical and other staff • Work with patients, staff, GPs, social care colleagues to design a better way of doing things • Integrating health and social care systems • Organisational development • Adapting the workforce • Better use of information • eHealth • Innovation • Managing the finances

13. ACUTE Stroke redesign Unscheduled flow – all 3 sites Orthopaedic DCAQ Ortho rehab ( then gen. rehab) Ophthalmology DCAQ/ accom. Out-patient redesign Day surgery/ ambulatory care Gynaecology Maternity Cancer and ECC Plastic surgery Laboratories PRIMARY CARE/ COMMUNITY GP practice capacity Primary care capability LUCS review Care village/ older people’s care models x4 Draft integration plans x4 Year 1 H&SC priorities x4 Priority Workstreams WHOLE SYSTEM PRIORITIES/ ENABLERS Inequalities and prevention Workforce Information and technologies Patient pathways Disinvestment/ hard choices

14. Next Steps 2 April 2014 – Draft plan approved by NHS Lothian Board 21 April 2014 - “Our Health, Our Care, Our Future” consultation launched May, June, July 2014 - meetings with staff, patients groups, third sector organisations, carers, community groups, local authorities, Scottish Government and other stakeholders to analyse patent pathways, consider options and develop specific proposals; 8th August 2014 – Consultation closes 1st October 2014 – NHS Lothian Board receive definitive Strategic Plan for approval.

15. How to get involved • Discuss with your colleagues • Respond to the consultation questions: • - Does this plan address the most important issues? • - Have we missed anything really significant? If so what? • - Is there anything else you would like to tell us before finalising the plan? • Comment on the proposed criteria for making decisions • Comment on the NHS Lothian Health Inequalities Plan • Comment on the NHS Lothian Strategy for Cancer

16. How to get involved • Complete the on-line questionnaire at: www.nhslothian.scot.nhs.uk/OurOrganisation/ourHealthOurCareOurFuture • Respond to the consultation questions – Email us at OurHealth.OurFuture@nhslothian.scot.nhs.uk • Write to: Professor Alex McMahon, Director of Strategic Planning, NHS Lothian, Waverley Gate, 2-4 Waterloo Place Edinburgh EH1 3EG