Health Improvement Performance Management (HIPM) Review Proposed Priority Outcomes

1. Health Improvement Performance Management (HIPM) ReviewProposed Priority Outcomes Erica Wimbush, Health Scotland 26 October 2007

2. HIPM Review • HIPM Steering Group – agree priority outcomes for HI that can be shared across the whole system; aligning high level SG outcomes for public reporting with outcomes for service delivery • NHS Working Group – Review of current measures for ‘H’ in HEAT system; performance management focused on short-term outcomes related to effective NHS contributions to priority outcomes

3. Scottish Government Outcomes Model INTERMEDIATE OUTCOMES SHORT-TERM OUTCOMESThe immediate impacts of service delivery on the community Outputs Processes Inputs

4. Well-being Population health Health inequalities Individual behaviours Social, economic, and physical environments Healthier Scotland to help people to sustain and improve their health,especially in disadvantaged communities Public Reporting LONG-TERM HIGH LEVELOUTCOMES National level priorities INTERMEDIATEOUTCOMES Performance management SHORT-TERM OUTCOMES Outcomes related to service delivery Outputs Processes Inputs

5. Well-being Population health Health inequalities Individual behaviours Social, economic, and physical environments Healthier Scotland to help people to sustain and improve their health, esp in disadvantaged communities ensuring better, local and faster access to health care. Public Reporting LONG-TERM HIGH LEVELOUTCOMES National level priorities INTERMEDIATE OUTCOMES Access to health care Performance management SHORT-TERM OUTCOMES Outcomes related to service delivery Outputs Processes Inputs

6. Proposed Priority OutcomesHIPM Steering Group • Need to prioritise - to focus our resources and maximise coverage and impact • Shared priorities across govt and delivery partners – focus our resources on a set of shared outcomes • Selection criteria: • Importance • Potential to intervene effectively • Feasibility • Performance assessment

7. Proposed Priority Outcomes • Inequalities and health • Smoking • Alcohol • Obesity • Early years

8. 5 cross-Govt Strategic Objectives

9. Inequalities and health Reduced inequalities in the wider social, economic and environmental factors that help shape inequalities in health. • Reduced inequalities in: • Healthy life expectancy • Mental well-being LONG-TERM HIGH LEVELOUTCOMES • Reduced inequalities in premature mortality • Infants • Accidents and cancers (2-15) • Suicide, drug-related and assault (16-39) • CVD, cancers and chronic LRD (40-65) Individual behaviours Educational achievement Income Poverty Work Employment Employability EnvironmentAccess to services INTERMEDIATEOUTCOMES Outcomes related to service delivery SHORT-TERM OUTCOMES

10. Smoking Reduced burden of disease, disability and premature death due to tobacco Reduced inequalities in Healthy Life Expectancy LONG-TERM HIGH LEVELOUTCOMES Reduced inequalities in premature mortality due to smoking-related diseases Reduced inequalities in · Smoking prevalence · Uptake of smoking by young people INTERMEDIATEOUTCOMES Social norms Accessibility of tobacco (YP) Smoke-free environments Access to SC services Outcomes related to service delivery SHORT-TERM OUTCOMES

11. Alcohol The increasing burden of disease, harm, distress and premature death due to excessive alcohol consumption is stemmed. Improved Healthy Life Expectancy & Mental Wellbeing LONG-TERM HIGH LEVELOUTCOMES Reduced alcohol-related harm and inequalities in alcohol-related harm Reduced alcohol consumption beyond recommended limits Reduced drink-driving INTERMEDIATEOUTCOMES Sensible drinking culture Accessibility of alcohol Premises & environment Access to services Outcomes related to service delivery SHORT-TERM OUTCOMES

12. Obesity The increasing burden of disease, disability and premature death due to rising levels of overweight and obesity in children and adults is stemmed. Improved Healthy Life Expectancy & Mental Wellbeing LONG-TERM HIGH LEVELOUTCOMES Reduced inequalities in premature mortality due to obesity-related diseases Increased % of adults and children of healthy weight • Increased PA levels among those overweight • Reduced consumption of energy-dense processed foods + drinks Awareness & social norms Accessibility of EDF+D Active environment Access to services INTERMEDIATEOUTCOMES SHORT-TERM OUTCOMES Outcomes related to service delivery

13. Early Years The development of young children and their families, particularly those children most at risk, is healthier. Reduced inequalities in · Pre-school child development LONG-TERM HIGH LEVELOUTCOMES Reduced inequalities in · Parental substance use · Smoking in pregnancy · Breastfeeding rate at 6 weeks · Dental caries · Post-weaning diet · Physical activity levels (ages 2-5) INTERMEDIATEOUTCOMES Social norms Child poverty Home & local environments Access to services for vuln families & LAAC Outcomes related to service delivery SHORT-TERM OUTCOMES

14. Key questions – Proposed priority outcomes • Shared priorities. Do they fit with local priorities? Do they provide a good basis for shared priorities? • Accountability for delivering outcomes. What are the unique contributions of local authorities, NHS Boards, community and voluntary organisations to these outcomes? What needs to be delivered in partnership? • Moving forward on joint planning and performance reporting. How can the forthcoming revised guidance on HI joint planning for CHPs and CPPs best support delivery? What capacity and support is required?

15. Next steps - Engagement Events • 26 October – National event Regional events with CPPs • 26 November, Perth • 30 November, Edinburgh • 3 December, Glasgow

16. Next steps • Health & Wellbeing Action Plan, December • Priorities • Moving to outcome-focused accountability • NHS Working Group • Local authority outcome agreements • Revised joint HI planning guidance for CHPs and CPPs • HIPM Steering Group – whole system reporting and developing leadership and support