1. Western Isles Strategic Plan Raghnall Culley Priomh Oifigear

2. Visit Scotland

4. Place-based Systems of Care
Emerging evidence that place-based systems of care improve outcomes (King’s Fund, 2015)
Southcentral Foundation Alaska
Established in the mid-1990s - quality of care and outcomes among the worst in the US
Now regarded as one of the most successful examples of health system redesign in the world
Transformation began when it was given control of a single budget and responsibility for a broad range of services for its population
Started with careful consultation with the community, defining mission and values
Established in the mid-1990s - quality of care and outcomes were among the worst in the United States.
Now regarded as one of the most successful examples of health system redesign in the world. Costs are down and quality is up, with health outcomes among the best in the United States.
Transformation began when it was given control of a single budget and responsibility for a broad range of services for its population. It delivered transformation entirely ‘from within’ rather than as a response to top-down performance management

5. Engaging with communities
Five locality areas across the Western Isles
Provides a framework for locality planning
Supports the strategic planning process
Connects directly to communities

6. Developing the Strategic Plan

7. How effectively did we engage?
Supported self-assessment against the National Community Development Standards
Weaknesses:
More work to do to involve communities in planning
Supporting engagement, especially for service users
Strengths:
Working effectively across partner organisations
Methods of engagement
Impact of engagement
Established in the mid-1990s - quality of care and outcomes were among the worst in the United States.
Now regarded as one of the most successful examples of health system redesign in the world. Costs are down and quality is up, with health outcomes among the best in the United States.
Transformation began when it was given control of a single budget and responsibility for a broad range of services for its population. It delivered transformation entirely ‘from within’ rather than as a response to top-down performance management

8. Our Vision and Values…
We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive.
- Atul Gawande, ‘Being Mortal’

9. A human rights based approach
Respect for the inherent dignity and worth of all individuals
Promotion of individual autonomy including the freedom and support to make one’s own choices
Support to ensure full and effective participation and inclusion in society
Respect for difference and a desire to respond to individual needs
Equal access to resources, services, information and opportunity

10. Applying our Values…End of Life Care
Some individual services work well but lack of joined-up approach
Intense capacity challenges
High levels of variation between localities
Dying is a human rights issue

11. Developing our Strategic Plan
Developed in partnership
Population Needs Assessment
Draw on communities’ priorities
Articulation of vision and values
Assess existing service provision
Identify resources
Focus on high tariff reforms
Describe the drivers of change
Measure improvement

12. Sharpening our Focus
Situated 25 ‘Key Deliverables’ within Triple Aim framework:
Quality
Population Health
Value and sustainability
Linked to National Health and Well-being Outcomes
Detailed proposal for each of the deliverables: what, why, how, etc.
Programmed change overseen by Integrated CMT
IJB signed-off March 2016

13. Four Objectives
Developing our locality arrangements, to ensure that our services are responsive and connected to local communities
Working with staff, stakeholders and service users to develop integrated delivery arrangements which are capable of improving the experience and outcomes of the people we serve
Deploying our resources transparently, making sound investment decisions and managing a very fragile budget
Implementing our strategic plan, to ensure that our services change and adapt in response to population need

14. Impact on Care Experience

15. Conclusion Potential of place-based care
Anchor work in community engagement
Spend time on values (human rights) and mission
Let the data guide you
Use strategic planning process to sharpen focus on high tariff change
Link high level objectives to operational integration