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IMPROVING OUTCOMES AND SUPPORTING INNOVATION. Dr Margaret Whoriskey Director, Joint Improvement Partnership Board. A Scottish Approach to Public Service Reform. Prevention – decisive shift: Reduce future demand by preventing problems arising or dealing with them early on.

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Presentation Transcript
improving outcomes and supporting innovation


Dr Margaret Whoriskey

Director, Joint Improvement Partnership Board

a scottish approach to public service reform
A Scottish Approach to Public Service Reform
  • Prevention – decisive shift: Reduce future demand by preventing problems arising or dealing with them early on.
  • Partnership – Bringing public, third and private sector partners together with communities to deliver shared outcomes that really matter to people.
  • People – We need to unlock the full creativity and potential of people at all levels of public service, empowering them to work together in innovative ways. We need to help create ways for people and communities to co-produce services around their skills and networks.
  • Performance – To demonstrate a sharp focus on continuous improvement of the national outcomes.
our 2020 vision
Our 2020 Vision…

By 2020 everyone is able to live longer healthier lives at home, or in a homely setting.

health social care integration
Health & Social Care Integration
  • Underpinned by Legislation:
    • nationally agreed outcomes;
    • Healthier
    • Independent Living
    • Positive experiences and outcomes
    • Carers are supported
    • Services are safe
    • Engaged workforce
    • Effective resource use
principals defining outcome focused approach
Principals/Defining Outcome Focused Approach

Understand outcomes as the impact or end result of support and/or services on a person’s life:

BUT start by defining expectations and outcomes with the person

Focus on strengths and capacities more than deficits

Identify the person’s role as well as other people in their life and services

Outcomes can be measured both for the individual and for the service as a whole

Believing that the participation of the person is core to practice

what do we mean by outcomes
What do we mean by outcomes?

The “So what?” question – if we have provided support or service to someone, what did that achieve? Did the person benefit and how do they see it?

This requires both the services, and the person themself to think through together what matters and how it can be best achieved.

The big challenge is to develop what we often do well at the individual level to be the basis of our whole organisational approach – keeping people and what they want at the heart of everything we do. We refer to this as a personal outcomes approach.


“Most older people (89.5%) do not receive ‘formal’ care in NHS continuing care, a care home or a home care service organised by social work agencies.”

reshaping care integration in action
Reshaping Care: Integration in Action

10 Year National Programme 2011-2021

£ 300 million Change Fund 2011 - 2015

32 Partnership Change Plans agreed by:

NHS: primary, acute and mental health services

Local Authority: social care and housing

Third sector

Independent sector

Reshaping Care and Integration Improvement Network to support partnerships to transform care

the change fund and rcop
The Change Fund and RCOP
  • 2012/13– CF built on current initiatives and developments - Only 1-2% of total spend
        • build on wide range of other innovative work underway
        • early reflections on Joint Commissioning
  • 2013/14 – Joint Commissioning Strategies with a 10 year horizon to shift the balance of care
  • Change Plans as lever to change :
        • Investing to maximise improvements in outcomes
        • Maximising potential for resource shifts by bridging to new service models
        • Investing to lever otherwise inaccessible resources
going forward joint strategic commissioning
Going Forward: Joint Strategic Commissioning
  • “all the activities involved in assessing and forecasting needs, links investment to agreed desired outcomes, considering options, planning the nature, range and quality of future services and working in partnership to put these in place.”
  • First iteration prepared for 13/14 focusing on older people
  • Will be a legislative requirement from 2015 onwards for all adult care groups
  • National support programme launched
joint commissioning plans
Joint Commissioning Plans

Increasing focus on dementia

Post diagnostic support

Focus on Physical environment , housing, adaptations, telecare

Training for all

Anticipatory care


what needs developed
What needs developed

Need for better integration across mental health, older people services and support

More focus required on post diagnostic support

Support for care homes

8 Pillars – needs to be integrated in wider work

Dementia friendly communities

More opportunities for telecare

More recognition and support for carers

learning from demonstrators
Learning from demonstrators

Communication tool app for phones and tablets for people with dementia

Care and repair

Perth and Kinross open access memory clinic and disinvestment from community hospital beds to alternative NHS services in the Strathmore locality

Midlothian family group conferencing initiative and detailed IRF work with primary care

North Lanarkshire dementia cafe work (for which they have received an award); reminiscence initiative re football; dementia friendly community work in Motherwell involving local traders and other statutory agencies; outreach from day care work.

Housing initiative with all sites


expanding range of telecare equipment
Expanding Range of Telecare Equipment



Medication Reminder


Epilepsy sensor

In five years to 31/3/2012, 325 users of the Renfrewshire Care 24 telecare service had dementia; over 30% of all users. The Service has provided a range of equipment including door contacts, pressure mats and bed monitors, operates a Responder service in the event of an alarm being triggered and has a specific dementia pathway; all with the aim of keeping these vulnerable people safely at home.
The Renfrewshire Telecare service estimated 114 hospital and 88 care home admissions were avoided by this group because of telecare.
for more info

For more info: