NHSScotland Chief Executive's Annual Report 2011/12

CHAPTER 7 FURTHER INFORMATION AND LINKS

DELIVERING HEALTHCARE IN SCOTLAND

NHSScotland consists of 14 Territorial NHS Boards, seven Special NHS Boards^[45] and the healthcare body - Healthcare Improvement Scotland. They are accountable to Scottish Ministers, supported by the Scottish Government Health and Social Care Directorates. The Territorial NHS Boards are responsible for the protection and the improvement of their population's health and for the delivery of front-line healthcare services. The Special NHS Boards support the Territorial NHS Boards by providing a range of important services that are best provided by national organisations. Healthcare Improvement Scotland helps NHSScotland and independent healthcare providers deliver high-quality, evidence-based care and scrutinises services to provide public assurance about quality and safety.

All NHS Boards work together for the benefit of the people of Scotland. They also work closely with partners in other parts of the public sector to fulfil the Scottish Government's Purpose and National Outcomes. Maintaining good health and social and economic participation is vital to sustainable economic growth.

A list of all Territorial and Special NHS Boards along with links to their respective websites, is provided at the end of this chapter.

PERFORMANCE MANAGEMENT IN NHSSCOTLAND

Each year, the Scottish Government sets performance targets for NHS Boards to ensure that the resources made available to them are directed to priority areas for improvement, consistent with the Government's Purpose and National Outcomes, and with the strategic direction set out in, Better Health, Better Care (2007). These targets are focused on Health Improvement, Efficiency, Access and Treatment, and are known collectively as HEAT targets. In 2011/12 there were seven HEAT targets due for delivery. These relatively few, but important targets helped NHSScotland deliver improvements in the quality of care and in health outcomes for the people of Scotland. Through this, they helped demonstrate the contribution NHS Boards made towards delivering the following Scottish Government National Outcomes:

• Our children have the best start in life and are ready to succeed.
• We have improved the life chances for children, young people and families at risk.
• We live longer, healthier lives.
• We have tackled the significant inequalities in Scottish society.
• Our people are able to maintain their independence as they get older and are able to access appropriate support when they need it.
• We reduce the local and global environmental impact of our consumption and production.
• Our public services are high quality, continually improving, efficient and responsive to local people's needs.

The Scottish Government, in partnership with NHS Boards and other stakeholders, carries out an annual review of the HEAT targets - taking account of views and developments from across Scotland.

Once the HEAT targets have been agreed, NHS Boards prepare and publish their Local Delivery Plans (LDPs) which describe how they will achieve their stated objectives,including planned performance improvements for each target, risk management plans and the financial resources underpinning delivery. LDPs also include an overview of the local commitments NHS Boards have made to support delivery of Community Planning Partnerships' Single Outcome Agreements^[46].

Each year, the Cabinet Secretary for Health and Wellbeing holds NHS Boards to account in public. These annual reviews focus on the impact NHS Boards are making in improving the quality of healthcare services, health of the population and value of the services they provide through HEAT targets, standards and other local commitments. HEAT performance data is also reported through the Scotland Performs website^[47], which gives the latest information on progress by the Scottish Government across a range of outcomes.

GOVERNANCE IN NHSSCOTLAND

The existing clinical governance model provides strong assurance of the effectiveness of key processes in the operation of NHS Boards. This is also the case with the staff governance model, which also provides evidence of outcomes, such as improved staff experience as measured by the staff survey. The corporate governance model requires NHS Board Chief Executives to sign off a Statement on Internal Control to provide assurances on a range of corporate processes.

The development of the Quality Strategy provides a timely opportunity to review the current arrangements for governance and consider how these arrangements could be developed and strengthened. This review will also be able to reflect on the use of increasingly sophisticated data to identify where further investigation may be necessary and where enhancements in national performance management and accountability arrangements can be made.

WORKING IN PARTNERSHIP WITH LOCAL AUTHORITIES AND THE THIRD SECTOR

NHSScotland is committed to working closely with partners in local authorities and the third sector. This is crucial to achieving our ambitions for a healthier Scotland and to meeting the challenges of the years ahead. The Quality Strategy provides a basis for NHSScotland to work with partners, through Community Planning Partnerships, to secure progress towards the three Quality Ambitions, and the outcomes agreed locally and nationally through the Single Outcome Agreements and the National Performance Framework. One example of partnership working in action comes from the Keep Well health checks, where public sector partners provide support in the follow-up activities required to promote wellbeing and healthier lifestyles. A further example is Reshaping Care for Older People, a major programme that is being designed, developed and delivered as a partnership across NHSScotland and local government with active engagement from the third sector and community and patient/carer interests. These programmes will form a key part of the implementation of the Quality Strategy.

TERRITORIAL NHS BOARDS

SPECIAL NHS BOARDS

HEALTHCARE IMPROVEMENT SCOTLAND