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Supporting continuous improvement .

Supporting continuous improvement. Enabling a health improving and inequalities sensitive organisation: a strategic approach. Linda Leighton-Beck Head of Social Inclusion Public Health Directorate. Enabling a health improving and inequalities sensitive organisation. What’s new? Why?

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Supporting continuous improvement .

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  1. Supporting continuous improvement. Enabling a health improving and inequalities sensitive organisation: a strategic approach Linda Leighton-Beck Head of Social Inclusion Public Health Directorate

  2. Enabling a health improving and inequalities sensitive organisation What’s new? Why? Some issues Current examples of supportive practice What are we doing at the moment? What needs to change?

  3. What’s new?

  4. Securing good health for the whole population • ‘We are not tinkers who merely patch and mend what is broken…we must be the watchmen, guardians of the life and health of our generation, so that stronger and more able generations may come after’. Dr Elizabeth Blackwell (1821-1910) The First Woman Doctor

  5. The real art of discovery is not in finding new lands but seeing with new eyes.Marcel Proust

  6. Why? • Some issues • Current examples of supportive practice.

  7. What are we doing at the moment?

  8. Enhancing fitness for purpose:current examples improving capacity & capability • Service provision • Policy & practice • Workforce • Posts to support re-design & delivery • Tools and training

  9. Examples of supportive practice in NHSG • Issue? • Focus? • Action/Policy/Service? • Lead?

  10. Examples of supportivepractice in • Service provision

  11. Service provision (re-design) 1 • Issue: Rationalisation of maternity services in Aberdeenshire • Focus: Provision of appropriate support and safe care to/ within disadvantaged communities. • Action/Policy/Service (Lead): Increased health visitor support for disadvantaged communities (Planning).

  12. Service provision (re-design & new national programme) 2a • Issue: Reducing serious preventable ill health (cardiovascular and related) • Focus: Patients at greatest disadvantage and risk to be targeted proactively • Action/Policy/Service (Lead): Development of Wave 2 Keep Well Pilot Aberdeen City (Public Health/City CHP)

  13. Service provision (re-design) 2b • Issue: ‘At risk’ practice population within the Dufftown Medical Practice. • Focus: Provision of additional specialist supportfor Dufftown patients to maximise self care. • Action/Policy/Service (Lead): Development of pilot, within Well North Programme, in Moray CHP (Moray CHP/Public Health ).

  14. Service provision (3) • Issue: Provision of appropriate primaryhealth care for the homeless • Focus: Healthcare provision in Aberdeen • Action/Policy/Service (Lead): New build, dedicated centre (City CHP).

  15. Service provision (4) • Issue: Effective communication with patients • Focus: Provision of translation facilities • Action/Policy/Service (Lead): Language Line and associated training rolled out; provision of written materials (Corporate Communications & NHSG services).

  16. Examples of supportive practice in • Policy & practice

  17. Policy and practice (1) • Issue: Exemplar role of the NHS -Tobacco Control • Focus: Smoking in uniform • Action/Policy/Service (Lead): Tobacco Policy & Action Plan Consultation 1/09. (Acute Sector/ Public Health).

  18. Policy and practice development (2) • Issue: Gender Based Violence • Focus: Priority Settings e.g. Maternity Hospital (CEL 41, 2008) • Action/Policy/Service (Lead): Implementation of Routine Enquiry; Revision of current policies; Training (Acute Sector/ Public Health).

  19. Policy and practice development (3) • Issue: Homeless presentations at A&E • Focus: Waiting time target. Appropriate discharge arrangements. • Action/Policy/Service (Lead): Protocol developed and implemented in A&E (Acute Sector/ Public Health/City CHP).

  20. Examples of supportive practice in • Workforce

  21. Examples in Workforce • Issue: Effective care for patients with chest pain presenting at ARI. • Focus: Provision of appropriate care. • Action/Policy/Service (Lead): Advanced Nurse Practitioner post in 72 hour unit, with preventive component in core job specification (Acute sector).

  22. Examples of supportive practice in • Development of tools to build capacity

  23. Development of tools (1) • Issue: Intelligence led, needs based planning for health and healthcare • Focus: Development of accessible NHS Grampian planning tool (Traffic Lights) • Action/Policy/Service (Lead): Wide use of tool to provide starting point for prioritisation of action (Public Health).

  24. Development of tools (2) • Issue: Intelligence led, needs based planning for health and healthcare • Focus: System wide, integrated tool to screen policies, programmes practices and developments for impact on health. • Action/Policy/Service (Lead): Tool endorsed for system wide use for health impact assessment (HIA) screening (OMT).

  25. Examples of supportive practice in • Awareness raising and training

  26. Awareness raising and training • Issue: Embedding evidence-based planning for health and health care • Focus: Use of traffic lights tool to provide starting point for prioritisation of action. • Action/Policy/Service/Lead: Staff training across CHPs (Public Health)

  27. Awareness raising and training • Issue: Increasing understanding. Debunking the stereotype. • Focus: Use of DVD to extend the voices of the ‘invisible’, as a starting point for reviewing services. • Action/Policy/Service (Lead): Integrated within Med ChB Phase 1 Community Course. Opportunistic in service training (Public Health)

  28. Examples of supportive practice in • Seconded posts to support delivery

  29. Pilot posts* to support delivery (1) • Issue: Gender Based Violence (CEL 41 ,2008) • Focus: Domestic Abuse ‘presentations’ at A&E • Action/Policy/Service/Lead: Provision of collaborative counselling pilot at A&E with Grampian Police (Acute Sector/Grampian Police/Public Health/Third Sector Organisation)

  30. Posts to support delivery (2) • Issue: Promoting health within healthcare • Focus: Aberdeen Royal Infirmary • Action/Policy/Service/Lead Provision of Health Improvement Officer to embed ‘Health promoting hospital’. (Acute Sector/City CHP)

  31. Posts to support delivery (3) • Issue: Embedding population health in healthcare planning • Focus: Provision of Public Health expertise • Action/Policy/Service/Lead: Provision of Public Health Consultant post to embed population health in service planning (Public Health/ Acute Sector).

  32. Examples of supportive practice in Strengthening intelligence

  33. Strengthening our intelligence • Issue: Embedding population health in healthcare planning • Focus: Equity in cardiac care • Action/Policy/Service (Lead): Development of approach to health equity audit as a tool; identifying any inequity and taking action. (NHS Board, Cardiac MCN, Public Health, Intelligence; Clinical Effectiveness).

  34. Strengthening our intelligence • Issue: Embedding population health in healthcare planning • Focus: Healthy Weight Strategy • Action/Policy/Service (Lead): Development of a needs led approach, modelling pathway - integrating prevention and service (Dietetics/Public Health).

  35. Strengthening our intelligence • Issue: CHPs have a key role to play in improving health [CEL26 (2009)]. • Focus: Inform local planning with detailed information on the health and wellbeing needs of population of South AberdeenshireLCHP. • Action/Policy/Service (Lead): Conduct a Health Needs Assessment. (Aberdeenshire CHP/Intelligence.)

  36. Capturing your examples… • Issue? • Focus? • Action/Policy/Service • Lead?

  37. What needs to change?

  38. Supporting the themes & programmes: fitness for purpose Improving the public’s health and reducing inequalities Delivering safe, effective and timely care in the right place STRATEGY DEVELOPMENT “The design, decisions and actions that result in the formulation of plans to achieve the objectives of an organisation” Involving patients, public, staff and partners towards mutuality (including improving patients’ experience) Developing the workforce & empowering staff Improving efficiency, productivity and sustainability Long Term Conditions Mental Health Better Care Without Delay City Primary Care Redesign Health Campus Intermediate Care

  39. Source; NHSG Corporate Objectives

  40. Sustain & improve the population’s health

  41. Supporting continuous improvement

  42. Enabling a health improving and inequalities sensitive organisation… • Mapping current activity; • Enhancing system awareness and understanding of; • evidence • need • roles • Developing strategic framework; • Identifying performance measures/indicators; • Integrating health with healthcare; • Implementing the corporate scorecard; • Developing ‘fit for purpose’ intelligence; • Developing guidance and training; • Using tools to guide practice; • Maximising partnerships, minimising waste; • Strengthening our approach to mutuality; • Aligning resources to strategic objectives.

  43. Creating a framework for effective whole system delivery… • Partnership • Systematic • Systemic • Exemplars • Expectations • Integrated • Sustained • Capacity • Capability

  44. Work streams to enable a health improving and inequalities sensitive NHSG Policy, strategy, resource Performance Communicating awareness & understanding Capacity & capability Intelligence

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