Quality in Practice Claire Tester Senior Strategic Lead for Quality The Quality Unit Scottish Government Health & Social Care Directorates 7th August 2012 Claire.tester@scotland.gsi.gov.uk

2020 Vision The vision is that by 2020 everyone is able to live longer healthier lives at home, or in a homely setting. Integrated primary and social care, and more effective working with the Voluntary sector A focus on prevention, anticipation and supported self management in order that everyone can live longer healthier lives at home, or in the community as long as possible. When hospital treatment is required, and cannot be provided in a community setting, day case treatment should be the norm and it should be provided in the place which can guarantee highest quality, safety and a good experience. A focus on ensuring that people get back into their home or community environment as soon as appropriate, with minimal risk of re-admission. Care will be provided to the highest standards of quality and safety, with the person at the centre of all decisions

Shared vision and priorities The vision for the future and the action required to attain it needs to be understood and shared by everyone in Scotland – Government, those delivering healthcare services, partner organisations, patients, carers and the public. We must collectively recognise and respond to the most immediate and significant challenges which include Scotland’s public health record, demography and the economic environment.

6 Dimensions Our approach to quality is based upon the Institute of Medicine’s six dimensions of quality. These six dimensions will focus the way we measure healthcare quality to ensure we deliver the right care safely, at the right time, and in a way that is built around the particular needs of the individual

3 Quality Ambitions Person-Centred There will be 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. Safe There will be no avoidable injury or harm to people from healthcare they receive, and an appropriate, clean and safe environment will be provided for the delivery of healthcare services at all times. 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. Through our Quality Strategy we have set ourselves three clearly articulated and widely accepted Quality Ambitions based on what people have told us they want from their NHS: care which is person-centered, safe and effective. We are already seeing real progress in terms of positive impacts for patients.

Quality Outcomes 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

The Quality Measurement Framework

Quality and Efficiency

Its about how we use our energy + our time= our resources for the best service we can provide to people . The 7 categories of WASTE Motion: inappropriate siting of teams or equipment Waiting: failure in processes which causes delays Over processing: performing unnecessary processing steps Over production: doing more of something unnecessarily or at wrong time Transportation: unnecessary movement relating to site of need Inventory: overproduction resulting in too much stock Defects: unresolved problems requiring rework

Behaving in a system – can feel safe but avoidant

Values and person led care Centres around need Needs by the person not the staff Systems are designed around the providers not the users The Quality Strategy (2010) asks us to look at the systems we are in, what works and what doesn’t from the service users view. What impact do we make and how effective are we? From whose point of view? Importance of person led care and partnership working , Patients Rights Act (2011) and staff behaviours

Looking ahead – we need to do more with less and faster We know that the demands for healthcare and the circumstances we shall be operating in will be radically different from anything seen in the past. The action we take over the next few years will need to ensure that we can continue to provide the high quality health service the people of Scotland expect and deserve into the future.