Our Dynamic Delivery Context
This Delivery Plan recognises the unprecedented economic upheaval of the past few months: much like the 2022 Programme for Government, although we cannot guarantee that increased uncertainty and rising costs will not impact our plans, our ambition and our intentions to deliver on our Strategy are unchanged.
Although our ambitions and intentions are unchanged, the unique pressure our health and social care system continues to be under – with winter 2022/23 expected to be one of the most challenging our NHS and social care sector has ever faced – has led to a necessary change in priorities. Some actions detailed therefore focus on those immediate priorities that we believe should be driven forward with urgency in the face of current challenges.
This includes ensuring that Health Boards, local authorities, independent and third sector social care providers, are supported to take the steps required to ensure that contingency measures are in place where necessary, recognising the appropriate use of digital and data can support preparations this winter. Some of this work is foundational – maximising investment in Microsoft Office 365 to support the integration of NHS and local authority teams, enhancing the digital monitoring capabilities of Hospital@Home services, as well as supporting the availability of Near Me video consultations – and some offers long term transformation opportunities.
This re-prioritisation to focus on system pressures has meant we have had to scale back some of our activity. For example, whilst we are on track to deliver our Programme for Government commitment on digital prescribing by 2025, we have re-phased the delivery of programme milestones. We also have to flex to respond to emerging situations, such as the recent cyber attack on one of NHS Scotland's key suppliers. This necessitates significant investment in time, effort and resources in alternative ways of working and in the work required to safely restore affected systems, all of which impacts on planned programmes of work. This flexibility means that the plan is a dynamic one.
This first Delivery Plan does not address every commitment in our Strategy. Instead, we have focused on activities that will make a difference to people using and delivering health and social care services. We have also highlighted 'behind the scenes' work likely to lead to a direct change in health and social care over the next 12 to 24 months. We also show examples of the work we are doing to support local service providers, such as Health Boards and local authorities, to improve the services they offer.
It is not, however, a 'crisis' response plan – it also confirms the important foundational activity being invested in for long-term transformation. As such, it has been fully developed to integrate with the Care and Wellbeing Portfolio of Scotland's health and care services. This is a wider area of work aiming to improve healthy life expectancy, achieve fairer outcomes, and reduce health inequalities, all enabled by the use of digital. This overall mission for our health and care services lines up with the existing vision of 'Care in the Digital Age' to 'improve the care and wellbeing of people in Scotland by making best use of digital technologies in the design and delivery of services.'
The work of the Scottish Government's Digital Health and Care Directorate will be fully integrated with the Care and Wellbeing Portfolio, and this will be evidenced in each of the Portfolio's annual delivery plans. A digital approach is about more than just the technology and systems; it is about a cultural shift toward thinking and planning as digital organisations. By ensuring the correct digital foundations are in place in line with the commitments set out in our Strategy, we can improve the overall experience for everyone who uses health and care services. We will separately produce an illustration showing how our work maps to the Three Horizons, a common model and language of change that brings both our Digital Strategy and the Care and Wellbeing Portfolio alive.
It will highlight the work prioritising the here and now, whilst showing the transformational programmes that lead to our long-term aims being realised. Work is under way on developing a critical path that charts the key technological and other developments that are necessary to achieve the third horizon, and what can be expected and by when. This, along with a sharper focus on innovation and prioritisation, will form the basis of the 2023-24 Delivery Plan.
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