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Hepatitis C Action Plan for Scotland: Phase II: May 2008 - March 2011

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Co-ordination

For Phase I of the Action Plan, co-ordination, management, governance and communication arrangements were established to ensure the effective implementation of actions; these actions, however, mostly involved awareness-raising initiatives among professionals concerned with the prevention of, and management of persons with, Hepatitis C, and the generation of evidence to inform Phase II of the Action Plan; further, only a modest amount of funding (£4 million) was made available to NHS Boards during the two-year period of the Plan (2006-08).

In contrast, Phase II actions are designed to dramatically improve prevention, diagnosis, treatment, care and support services for Hepatitis C throughout the country and are associated with an investment of approximately £43 million, over three years, the bulk of which will be allocated to NHS Boards. Accordingly, the existing Phase I co-ordination, management, governance and communication arrangements need to be reshaped to ensure the effective and timely delivery of Phase II actions.

In Phase I, the Action Plan Co-ordinating Group - supported by the three Working Groups for i) Testing, Treatment, Care and Support, ii) Prevention and, iii) Education, Training and Awareness-raising - was accountable to the Scottish Government for delivering the great majority of the actions, the most important of which was the generation of the Phase II Plan; in this respect, much of the work involved was strategic in terms of gathering and interpreting evidence and then making recommendations.

Accountability and Reporting

The Phase II Plan, in contrast, mostly concerns the development of services by NHS Boards and other organisations, all of which will receive funding for this purpose. Accordingly, these lead organisations will be directly accountable to the Scottish Government.

Lead organisations will report progress on, and performance of, actions they are responsible for to the Scottish Government; to ensure this process is consistent and managed well, a Project Management approach (see Project Management below) will be employed. An Action Plan Governance Board (see Action Plan Governance Board below), run by HPS and comprising representatives of lead organisations, will facilitate/co-ordinate the reporting process. The Scottish Government will establish an Action Plan Advisory Board (see Action Plan Advisory Board below) to advise on progress with, and issues concerning, Action Plan delivery.

Co-ordination: National and Local

HPS is responsible for co-ordinating the Action Plan nationally and the NHS Boards are responsible for its co-ordination locally.

Health Protection Scotland

HPS, through National Services Scotland, its parent body, is responsible for co-ordinating the Action Plan nationally. National co-ordination involves the following key roles:

  1. establishing and maintaining national networks to support NHS Boards and other organisations delivering different aspects of the Action Plan (see National Networks below),
  2. monitoring Action Plan progress and performance so that the plan is delivered in a timely, effective and efficient way; HPS will preside over an Action Plan Governance Board to facilitate this role (see Action Plan Governance Board below),
  3. communicating Action Plan progress to, and getting feedback from, stakeholders nationally (see National Communications below),
  4. employing a Project Management (see Project Management below) approach to undertake the above actions.

NHS Boards

NHS Boards, through their Hepatitis C Executive Leads, are responsible for co-ordinating the Action Plan locally. Local co-ordination involves the following key roles:

  1. establishing and maintaining local (though they could be regional) networks to support the planning, development and implementation of services (see Local Networks below),
  2. supporting HPS in monitoring Action Plan progress and performance,
  3. communicating Action Plan progress to, and getting feedback from, local/regional stakeholders and supporting HPS in doing the above at a national level,
  4. commissioning services,
  5. employing a Project Management (see Project Management below) approach to undertake the above actions.

National Networks

The following networks will be established so that experience, best practice and progress on the delivery of the Action Plan can be shared, and support, advice and guidance can be provided. Each of the networks will be instrumental in supporting lead organisations in the delivery of the Phase II actions they have responsibility for. The establishment of formal Networks does not preclude the formation of other networks; it is anticipated that much communication would be done via e-mail and that the balance between virtual and actual meetings would vary, depending on the demands on, and the requirements of, the Networks.

  • Hepatitis C Executive Leads for NHS Boards and the SPS.
  • MCN Clinical Leads/ MCN Co-ordinators ( i.e. either separate or combined).
  • Hepatitis C Prevention Leads.
  • Leads of national information generating initiatives to gauge the performance of actions.
  • Leads of national education, training and awareness-raising actions (incorporating the workforce development leads).
  • Leads of NGOs (primarily from the voluntary sector) with a major Hepatitis C remit.
  • Local Authority Leads.

Local Networks

NHS Boards will have, or be affiliated to, the following networks which will plan, develop, implement and audit services locally.

  • Prevention Network incorporating Hepatitis C (a Hepatitis C Prevention Lead is to be appointed).
  • A Hepatitis C Managed Care Network (led by a Clinical Lead and managed by a Co-ordinator).

Action Plan Governance Board

An Action Plan Governance Board, comprising all Hepatitis C Executive Leads (including one for the SPS (new appointment)) and the Leads of each National Network (as above) will be established to ensure that the Action Plan is being implemented in a timely, effective and efficient manner by monitoring operational progress (including spend), the performance of actions and identifying and addressing potential and evolving high-level problems. The Board will be presided over by HPS and will report its findings to the Scottish Government, representatives of which will attend in an observer capacity.

Action Plan Advisory Board

An Action Plan Advisory Board, from which the Scottish Government, can obtain advice and comment on progress, and issues concerning, the Hepatitis C Action Plan, will be established.

National Communications

National communication activities to keep stakeholders abreast of, and receive feedback on, Action Plan progress will include:

  • the development of the existing Hepatitis C Scotland website, including stakeholder forum,
  • the production of a Scottish Hepatitis C Action Plan Annual Report,
  • a Scotland contribution to a UK Annual Report on Hepatitis C (with the Health Protection Agency), and
  • the holding of an annual stakeholder meeting.

Project Management

A Project Management approach to co-ordinate the effective, efficient and timely delivery of the Action Plan, will be employed. This will involve establishing a Project Management Team at HPS and appointing Project Managers at NHS Board level; these Project Managers will not be accountable to the HPS Project Management Team but will work with, and be guided by, the Team to ensure a consistent and integrated approach to Action Plan co-ordination.

ISSUE

To ensure that the Action Plan is delivered efficiently, effectively, to timescales, and is governed appropriately, a range of actions at national and local levels will be implemented.

Actions

National

  • An Action Plan Advisory Board to advise and comment on issues concerning Action Plan progress and performance will be established ( Action 25).
  • National Networks to support NHS Boards and other organisations delivering the Action Plan will be established and maintained ( Action 26).
  • Action Plan progress and performance will be monitored; an Action Plan Governance Board will be established to facilitate this action ( Action 27).
  • Communications activities ( e.g. Annual reports, website development and annual stakeholder conference) to keep stakeholders abreast of, and receive feedback on, Action Plan progress, will be undertaken ( Action 28).
  • To undertake the above actions, a Project Management approach will be employed ( Action 29).

Local

  • Local/Regional Networks to support the delivery of services will be established and maintained ( Action 30).
  • Local progress and performance will be monitored and support will be given to HPS and the Action Plan Governance Board to facilitate their national monitoring roles ( Action 31).
  • Communications activities to keep stakeholders abreast of, and receive feedback on, Action Plan progress will be undertaken; support will be provided for national communications initiatives ( Action 32).
  • Services will be commissioned ( Action 33).
  • To undertake the above actions, a Project Management approach will be employed ( Action 34).

Outcome

These actions will ensure the successful delivery of the Action Plan.