Better Health, Better Care: National Delivery Plan for Children and Young People's Specialist Services in Scotland

The National Delivery Plan meets a key milestone in the commitments set out in Better Health, Better Care. It establishes a national infrastructure for the sustainability of specialist children's services in Scotland, not just in the specialist hospitals but also in District General Hospitals and in the community: it identifies work that needs to take place at a national and regional level to sustain and develop services, drawing down the additional £32 million commited over the 3 financial year


110. This Delivery Plan, and the significant resources invested in its support, reflects the commitment of the Scottish Government to placing our specialist children's services on a sound and sustainable footing, fit for the future.

111. In order to ensure that the National Delivery Plan is taken forward, and the accompanying resources used to the maximum benefit of children and young people, a Specialist Children's Services Implementation Group has been established. The role, remit and membership of the Implementation Group is included in Annex C.

112. The Implementation Group will operate as a sub-committee of the Children and Young People's Health Support Group and will focus particularly on:

  • The allocation of resources.
  • The identification and completion of additional workstreams.
  • Performance management.

Allocation of Resources

113. Informed by the immediate priorities, which were affirmed during the consultation on the National Delivery Plan, the investment of £2 million for 2008/2009 has been released to Regional Planning Groups and other provider organisations within the NHS in Scotland. Building on that encouraging start the major investment in support of the Delivery Plan will take place during 2009/2010 (£10 million) and 2010/2011 (£20 million).

114. It is essential that this very significant application of new resources is used to the maximum benefit of patients and is distributed across the specialties in a way that most effectively supports service development.

115. The Implementation Group will therefore establish a robust framework in which further investment can be prioritised. In allocating resources the Implementation Group will give priority to proposals that will:

  • Support best clinical practice and offer maximum benefit to patients.
  • Enhance service sustainability.
  • Accord with the agreed priorities and policies of the NHS in Scotland.
  • Represent value for money.

116. This work will be progressed in close collaboration with Regional Planning Groups, National Service Division, NHS Education Scotland and the Scottish Centre for Telehealth. Informed by this Delivery Plan, and the further work of the Implementation Group, these organisations will be responsible for developing costed proposals for service developments.

Further Work

117. As acknowledged in this Delivery Plan the workstreams initiated by the National Steering Group did not encompass all specialties within children's services. Some services are already covered by national commissioning arrangements and others have been the subject of separate prior, or concurrent, work. For example, CAMHS and Emergency care are subject to separate implementation arrangements and frameworks.

118. The consultation for the Delivery Plan has however confirmed that there are a number of additional specialist services in which concerns regarding sustainability, quality or accessibility require to be understood and addressed. These include:

  • Anaesthesia
  • Surgical Sub-specialties ( e.g.ENT)
  • Palliative Care
  • Asthma and Immunology
  • Child Protection
  • Renal and Urology Services
  • Burns
  • Non-malignant Haematology
  • Radiology
  • Pathology
  • Non-interventional Cardiology

119. The Implementation Group will therefore require to consider those specialty areas not incorporated in the initial workstreams and to:

  • Determine the availability of existing information regarding the service.
  • Scope what further work is required.
  • Agree arrangements by which such further work can most effectively be progressed.

120. In parallel there is a need to ensure that any outstanding issues raised through the original workstreams initiated by the National Steering Group have been fully considered. The aim will be to ensure that the implementation of this Delivery Plan, and the investment which accompanies it, adopts a 'whole system' approach to the provision and development of specialist children's services across the country.

Performance Management

121. It is essential that the investment in specialist children's services is used in ways that maximise patient benefit and effectively address the areas of priority concern regarding existing services. The Implementation Group will therefore be required to monitor implementation of the National Delivery Plan including the development of measures by which beneficial effect and added value can be satisfactorily demonstrated. This work will inevitably be synergistic with work on outcome measures described elsewhere in this guidance.

We will:

Ask the Implementation Group to:

  • Develop a robust framework through which the investment in specialist children's services can be effectively prioritised and allocated.
  • Produce and progress an action plan regarding the additional work required to ensure that resource allocation and service development takes appropriate account of the full range of specialist children's services.
  • Work with other parties, including the Scottish Public Health Network, to seek to identify effective arrangements for the demonstration of actual and anticipated patient benefit arising from the increased investment in specialist children's services.
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