Boards on Board The Role of the Board in Quality and Safety

See the problem, own the problem, fix the problem

Derek Feeley22 February 2012

Scotland’s Triple Aim + (or new readers start here)

• Health (prevention and anticipation)

• Healthcare Quality• Value (i.e. quality/cost)• Integration and collaboration

High Ambition – to be a world leader

The ultimate aim of our Quality Strategy is to deliver the

highest quality healthcare services to people in Scotland and through this to ensure that NHSScotland is recognised by

the people of Scotland as amongst the best in the world. We want to achieve this aim in a way this is recognisable and

meaningful to everybody.

Built on people’s priorities

• caring and compassionate health services• collaborating with patients and everyone

working for and with NHSScotland• providing a clean and safe care environment• improved access and continuity of care• confidence and trust in healthcare services • delivering clinical excellence

The Healthcare Quality Strategy Ambitions

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

• Clinically Effective - The most appropriate treatments, interventions, support, and services will be provided at the right time to everyone who will benefit, and wasteful or harmful variation will be eradicated.

• Safe - There will be no avoidable injury or harm to patients from healthcare they receive, and an appropriate clean and safe environment will be provided for the delivery of healthcare services at all times.

Priorities for progress towards our 3 Quality Ambitions – Safe, Effective and Person Centred

• Everyone gets the best start in life, and is able to live a longer, healthier life

• People are able to live well at home or in the community• Healthcare is safe for every person, every time• Everyone has a positive experience of healthcare• Staff feel supported and engaged• The best use is made of available resources

Strategic Narrative; ‘20:20 Vision’

Everyone is able to live longer healthier lives, at home, or in a homely setting

Vision for Adult Health and Social Care

• Older people are supported to live well at home or in the community for as much time as they can

• They have a positive experience of health and social care when they need it

Integration of Health and Social Care

• Legislation:– nationally agreed outcomes– joint accountability– integrated budgets across primary care, community health and social

care, and some of acute care

• CHP committees will be taken off the statute book and replaced by Health and Social Care Partnerships – joint and equal responsibility of the NHS and Local Authority

• Jointly appointed senior accountable officer will report to the Chief Executives of the NHS and Local Authority

• Annual accountability meetings will enable accountability through Boards to Ministers

Implications for Boards

Quality and Efficiency

Via

bilit

yThe 3 curves?

ModelsAdapted from The Second Curve, Ian Morrison 1996

Time

Optimizing the Current Model

Transforming the Organization

12

Patient

Inflection Point

Under the first curve…

• Financial Position?• HEAT Performance?

What about….

• Medication • Do you know how many medication errors occurred – last month, last quarter, last year?

• Has the number gone up or down

• Do you know where they occurred

Under the 2nd Curve; Acute Emergency Admissions by Practice for >75 population2007/08

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61

£/w

eig

hte

d h

ea

d

Board 1, Hospital 2 – 17.8%

0.5

1.0

1.5

Oct-Dec2006

Apr-Jun

2007

Oct-Dec2007

Apr-Jun

2008

Oct-Dec2008

Apr-Jun

2009

Oct-Dec2009

Apr-Jun

2010

Oct-Dec

2010p*

Apr-Jun

2011p

Sta

ndar

dise

d M

orta

lity

Rat

io

Board 1, Hospital 1 – 5.2%

0.5

1.0

1.5

Oct-Dec2006

Apr-Jun

2007

Oct-Dec2007

Apr-Jun

2008

Oct-Dec2008

Apr-Jun

2009

Oct-Dec2009

Apr-Jun

2010

Oct-Dec

2010p*

Apr-Jun

2011p

Sta

ndar

dise

d M

orta

lity

Rat

io

Public Services Improvement Bundle

Looking ahead to the next 2 days

• Building on firm foundations– Boards on Board – January 2011 and Jim Conway– Developed through SPSP

• Welcome to Jamie Orlikoff• Support from the National Leadership Unit • Recognition of expertise within the audience