Developing the Scottish Learning and Improvement Framework for Adult Social Care Support and Community Health (SLIF) Digital Tool

Background to the Draft SLIF

The SLIF has been developed collaboratively with a multi-agency Steering Group, led by COSLA, SOLACE, NHS and the Scottish Government. The work was informed by people who use and work in services, sharing what matters most to them.

The aim of the SLIF is to support improvements in adult social care support, social work, and community health services. It seeks to support a new approach to improving outcomes, to address the implementation gap identified in the Independent Review of Adult Social Care, and to ultimately improve the experiences and outcomes for people who use and work in them.

The SLIF outlines a shared vision and agreed priorities for improvement. It sets out an approach that moves away from targets and measurement alone, to one that builds on learning and focuses improvement on the outcomes that matter to people.

The purpose of the SLIF is to:

• Improve experiences and outcomes for people who use and work in social care support and community health
• Build more learning into the system
• Support joint effort across the system towards the outcomes that matter to people

The SLIF has been developed around the:

• Scottish Government National Performance Framework.
• PANEL Principles - which support a human rights-based approach to the development of the framework.

PANEL stands for Participation, Accountability, Non-Discrimination, Empowerment and Legality. (Annex C gives an analysis of the SLIF digital tool’s contribution to the PANEL Principles)

• The Health and Social Care Standards.

The SLIF will be an iterative document that will be reviewed and developed to support local and national improvement activity and, align and support policy to bridge any implementation gap.

The SLIF will support the ambition of the Health and Social Care Service Renewal Framework (SRF) to ensure people of all ages can live well, with the right support, and lead healthier and more fulfilling lives. It will do this through coordinating improvement towards the outcomes that matter to people and expanding the focus from performance management to an approach that builds ongoing learning, improvement and quality management into the system.

It is a tool that will enable local areas to approach improvement interventions in a way that is informed by local needs and evidence. It will help gather information about the impact of these activities for learning and to inform future decisions. Finally, it will provide assurance by tracking how these activities contribute to outcomes that matter to people.

In the work to develop the SLIF digital tool there was a strong message about not creating further work for the sector so importantly, the SLIF is not an additional thing to do. The framework will interface with existing service-level improvement frameworks to aid integration and support a flexible approach to delivery at all levels of the system.

Wider Improvement System

The SLIF sits within the wider improvement system. It is a universal framework designed to support improvement initiatives at all levels across the system. It will be supported by an Improvement Collaborative which will focus on the SLIF priority themes and coordinate action to improve how social work, social care and community health services are delivered.

An approach to provide additional targeted support to help improve how services are delivered when evidence shows that is needed to meet expected standards is currently under development. This will be separate from the SLIF and the Improvement Collaborative but work in synergy with them.

The SLIF is not intended to be a performance management framework and moving from a predominant focus on data for performance management and scrutiny to an improvement approach, is a fundamental pillar of the framework.

It will not replace performance management or scrutiny but will provide an additional richness to the data to support learning and improvement in the system. It will allow services to understand the impact of activities, in order to target improvement activity where it is needed.

Performance management and improvement are both part of any well-functioning system, while the SLIF will support the use of data for improvement and learning, performance management will continue to be an important part of governance in the system.

Operationalisation of the SLIF

During the development of the SLIF, representatives from Health and Social Care organisations identified a range of challenges that might get in the way of effective implementation. These included:

• Current pressures in the system.
• The existing predominant focus on scrutiny and performance management, which can create a data reporting burden and limit the capacity to move to data collection for continual learning.
• Multiple unaligned improvement frameworks, standards and outcomes which apply within service areas, creating duplication and reporting challenges.
• Limited sharing of practice and learning between areas and partners.
• Lack of appropriate tools to support effective data use for learning and improvement.

It was clear that work was required to operationalise the SLIF in a way that would address these issues and help bridge the implementation gap. To respond to these, two core elements of this work were identified:

1. Development of a digitally hosted SLIF digital tool (prototype version) accessible across partnerships that breaks down the high-level aspirations and outcomes of the SLIF into meaningful improvement actions and supports tracking the outcomes of this work.

2. An operating model for the SLIF digital tool that addresses the challenges outlined above.