1. CIPFA North East Conference 20 November 2015 John Matheson CBE CIPFA President

2. The future ain’t what it used to be. (Yogi Berra)

3. Economic Context

4. cipfa.org Financial context: Short term Total public spending and receipts

5. £39 Estimated Scottish Government DEL Expenditure – June 2010 Budget Results (2010/11 Prices)

6. Changing Structure of Scottish Economy

7. Projected percentage change in Scotland’s population by age group, 2010 - 2035 Health & Social Care Integration

9. Doomed, we’re all doomed

10. Spending Review Short term –v- medium / long term Totality of resource, not just consequentials Health –v- illness focus Working across public sector Sustaining solid foundations

11. Public Service Reform in Scotland

12. Emergent Scottish Model co-produced with service users & communities assets-based systemic and inclusive, working across boundaries focused on clear and measurable outcomes expecting variation in methods and approaches shared improvement methodology in need of some seed- corn funding for change designed with workforce issues in mind ambitious but in it for the long haul

13. 55.3% & 44.7% May 2015: UK Elections Impact May 2016: Scottish Elections First Minister’s Priorities: Social Inequalities Boosting Economy Public Sector Reform Health & Social Care Integration Political Reality

15. Janus x2 = The 4 faces of a Finance Team

16. “Help me to invest better, not stop spending” The Business Partner attitudes and behaviours: Influencing: Clear communication Tell them something they don’t already know Fact based Partnering and Impacting: Integrates multi-functional activities Shared passion for winning Innovation & Change: Generate value from uncertainty Knowledge-sharing Promote best practice Commercial Rigour: Trusted advisor Challenge the business Commercial focus: Problem solver Address business issues Strong external focus Big Picture thinking Proactive and forward-thinking Clarifies direction Leadership & team- building: Motivate and develop Accountability Business Partnering - behaviours are just as important as technical competence...

17. Clarity of communications – know your audience!

18. “The Scottish Patient Safety Programme is without doubt one of the most ambitious patient safety initiatives in the world – national in scale, bold in aims, and disciplined in science. It harnesses the energies and wisdom of Scotland’s health care leaders –NHS executives, QIS experts, clinical professionals, civil servants, and more – all aligned toward a common vision, making Scotland the safest nation on earth from the viewpoint of health care.” Don Berwick Scottish Patient Safety Programme

19. NHSScotland Hospital Standardised Mortality Ratio October 2006 to September 2014

21. To make Scotland the best place in the world to grow up in by improving outcomes, and reducing inequalities, for all babies, children, mothers, fathers and families across Scotland to ensure that all children have the best start in life and are ready to succeed. The Early Years Collaborative - Ambition

23. Vision People are supported to live well at home or in the community for as much time as they can They have a positive experience of health and social care when they need it

24. 1)A guiding principle: “... effective services must be designed with and for people and communities – not delivered ‘top down’ for administrative convenience” The Christie Commission Report Commission on the future delivery of public services, June 2011 2)A single commissioner and budget for health and social care 3)Legislation: –The Public Bodies (Joint Working) (Scotland) Act 2014 Building blocks for integration

25. Integrated Resources: approximate scale

26. High resource individuals

27. High Resource Individuals GP Practice in Perth City South

28. Distribution of Mapped Expenditure

29. High Resource Individuals

31. Innovation in practice

32. Learning from others and sharing good practice. Building partnerships and securing EU funding for Scotland. Enhancing Scotland’s reputation to secure inward investment and create opportunities for Scottish businesses.

34. Key Points Working across Public Sector Innovation & Risk Appetite Transformational not Transactional Approach Twin-track – Short Term & Medium/Long Term Quality Driven Financial Performance Public Sector Pound

35. The Times They Are A-changin'