Derek Feeley Director General and Chief Executive, NHSScotland

ACHIEVING SUSTAINABLE QUALITY IN SCOTLAND’S HEALTHCARE A ’2020’ Vision

Our ‘2020 Vision’ Our vision is that by 2020 everyone is able to live longer healthier lives at home, or in a homely setting. We will have a healthcare system where we have integrated health and social care, a focus on prevention, anticipation and supported self management. Whatever the setting, care will be provided to the highest standards of quality and safety, with the person at the centre of all decisions. There will be a focus on ensuring that people get back into their home or community environment as soon as appropriate, with minimal risk of re-admission.

How can we keep people like Margaret at home?

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. 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. The Healthcare Quality Strategy for Scotland

WHY BOTHER? 90% of patient contact in primary care 89 Million Prescriptions pa. Adverse events in primary care cause: –1 in 20 deaths in hospital –5 -17% of admissions linked to adverse reaction to medication –67-75% preventable To Err is Human 1999 Howard et al Br J pharmacology 2006 Zhang et al BMJ 2009 Howard et al qshc 2003

Barriers “we’re too busy” –Smaller test, avoids re-work “we’re doing it already” –Measure to prove it, failure free –Ask five people “doesn’t fit our priorities” –Align test with priorities

Barriers 2 “we don’t measure” –Smaller test, count anything “we’re different” –No you’re not “no money” –Waste, harm and variation

Roger’s Innovation Adoption Curve

Programme Ambition To reduce the number of events which cause avoidable harm to people from healthcare delivered in any primary care setting.

By April 2014, 95% of practices undertaking Safety Climate Surveys, and Trigger Tool Reviews 95% of practices implementing systems for reliable prescribing and monitoring of high risk medications, by % of practices have safe and reliable systems for medicines reconciliation following discharge, by % Health Boards and practices have safe and reliable systems for handling results, by 2016 Aims

Next Steps for Patient Safety in Primary Care Start testing! Start recruiting – get your practices engaged Start planning for your first local learning session Build that burning platform

... And help us deliver our 2020 Vision

Thank You