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Making better decisions on public health spending: A Scottish perspective

Making better decisions on public health spending: A Scottish perspective. Neil Craig NHS Health Scotland Making better decisions on public health spending: Getting to grips with value for money The King’s Fund 18th September 2014. Outline.

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Making better decisions on public health spending: A Scottish perspective

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  1. Making better decisions on public health spending: A Scottish perspective Neil Craig NHS Health Scotland Making better decisions on public health spending: Getting to grips with value for money The King’s Fund 18th September 2014

  2. Outline • The context for public health spending in Scotland? • The role of NHSHS • The wider health system • How are these arrangements working in practice? • Looking ahead

  3. Context • Improving health…. • …..but persistent and widening health inequalities • Financial pressures • Emphasis on prevention

  4. What is NHS Health Scotland? • NHS Special Health Board • Role: national agency for health improvement • Priority: reducing health inequalities • Aim: to improve Scotland’s overall health record by focusing on the persistent inequalities that prevent health being improved for all

  5. Local delivery….. • Delivered by Community Planning Partners • Configured in Community Planning Partnerships • Expressed in Single Outcome Agreements

  6. …… National direction • Directed by Scottish Government through- statement of ambition and community planning guidance- National Community Planning Group- broad priorities

  7. Priorities - strategic • Faster shift to prevention • More joint resourcing • Co-production and assets-based approaches

  8. Priorities - specific • Early Years • Outcomes for Older People (including health and social care) • Safer Communities and Offending • Health Inequalities (including physical activity opportunities) • Economic Growth and Recovery • Employment (especially youth employment)

  9. In practice? • Community planning: a work in progress • National steer vs local freedoms: is the balance right? • Multiple objectives of prevention: - are they shared?- are they mutually compatible?

  10. Potential savings from reduced ‘failure demand’ Cost-effective/VFM Likely to reduce health inequalities

  11. Building relationships • With SGs, CPPs and 3rd sector • With COSLA e.g. through an Inequalities Action Group • Through a knowledge-into-action strategy • Through a SG-sponsored Health Economics Network for Scotland => Early days

  12. Themes • Balance between central guidance and local autonomy? • Local implications of national (or international) evidence? • Complexity vs accessibility “Tell us, clearly, what the evidence says we should be doing but don’t tell us what to do…..”

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