5. Delivering sustainable quality: preventative spending strengthened and user and carer experience enhanced
Scotland's ambition to become an acknowledged leader in health care quality will be underpinned every day by the consistently person centred, effective and safe clinical encounters delivered by AHPs and their multi-disciplinary colleagues. Partnerships with patients is an acknowledged strength in the way AHPs work and it will be important to build on this in shaping services for the future.
(From Strength to Strength, Scottish Government 2011)
AHPs have a significant contribution to make towards the delivery of high quality, best value services, and this aspect of measuring impact will be key to practice development and the future evolution of high quality services across health and social care.
A key aspect of this is the AHP contribution to preventative spending. Work has already been commissioned to explore the health economic benefits of the falls prevention work being led by AHPs in communities and in the care home setting. In addition a similar approach is being used to explore the impact of increasing access and self referral to MSK services through the use of NHS 24 technology.
Service users and carers consistently tell us that AHP services make a real difference to their health and wellbeing and, importantly to their quality of life. For individuals and their families coping with the challenges of caring for a loved one with increasing complexity, frailty and illness, or confusion, this is a welcome support that enables them to stay resilient and also get support when they need it most.
This approach is fully aligned with the 'personalisation' philosophy promoted in social care. A personalisation approach seeks to promote a focus on personal outcomes so that services can be designed around a person and their family. This individualised approach to service provision will be key to the wider delivery of self directed support for service users. The Self Directed Support Bill will be introduced into the Scottish parliament in February 2012. The Bill is intended to introduce a duty to give each individual as much choice and control as they wish over the support or care services they get. While the Bill does not encompass mainstream NHS care, the principles are reflected in the mutual NHS element of the Quality Strategy. 'Mutually beneficial partnerships which respect individual needs and values and which demonstrate compassion, continuity , clear communication and shared decision making' aligns completely with this personalisation approach. This is one of the three key ambitions of the Quality Strategy for NHS Scotland which supports both 'Mutuality' and 'Personalisation'.
To underpin a better understanding of the healthcare experience for patients 'Better Together', Scotland's patient experience programme collects annual data on the experiences of service users in hospitals and in communities. AHPs are also gathering local information on user and carer experiences using 'Emotional Touch Points' or 'Talking Points'. AHPs across Scotland have also begun to use the Consultation and Relational Empathy (CARE) measure - which has been validated for AHP use and which reflects the presence of empathy and engagement for the user in their consultation/clinical encounter.
Enhancing carer support is also a key strand of the commitment to use the Change Fund effectively across Health and Social Care. AHPs are already doing a lot of work in this area, however, using tools to measure user and carer experience and engagement they will be able to evidence their effectiveness and impact as well as support ongoing service improvement.
Our questions are: How can AHP Directors and leads better engage with the Change Fund initiative? What support might AHPs need to grow their evidence base and data for improvement? What would support better partnerships for quality across health and social care?
- AHP directors will work with local authority lead OTs and partners in the Change Fund to drive and evidence improvements in support for carers and families.
- AHP directors will work in partnership with analytic and research colleagues to grow the health economic base for AHP interventions across health and social care.
- AHP services will implement the national data set for NHS Scotland in the form of a dashboard, with full support from e-health to ensure robust data capture to inform reporting by 2013.
- AHP directors will work with AHP partners in local authorities to develop a quality matrix that will underpin the delivery of high quality, best value AHP interventions and ensure positive outcomes for people who use services and their families.
Email: Susan Malcolm