Health and social care delivery plan: progress report

8 The Actions

8.1 The following table summarises progress for each of the actions in the Delivery Plan. The updated Delivery Plan, available later this year, will provide an update for those actions currently in progress for delivery by 2021.

Health and Social Care Integration

What we said we would do by now

Reducing Inappropriate Use of Hospital Services

• Ensure Health and Social Care Partnerships make full use of their new powers and responsibilities to shift investment into community provision by reducing inappropriate use of hospital care and redesigning the shape of service provision across hospital, care home and community settings.
  • Action in progress
• Agree with partners how to deliver an ambition of raising the performance of the whole of Scotland on delayed discharges from hospitals to the performance of the top quartile of local areas.
  • Action in progress
• Reduce unscheduled bed-days in hospital care by up to 10 percent (ie. by as many as 400,000 bed-days) by reducing delayed discharges, avoidable admissions and inappropriately long stays in hospital.
  • Action in progress

Supporting the Capacity of Community Care

• Continue to take forward a programme of work to deliver change in the adult social care sector, together with COSLA and other partners.
  • Action in progress

What we said we would do by 2021/22

Reducing Inappropriate Use of Hospital Services

• Ensure that everyone who needs palliative care will get hospice, palliative or end of life care. All who would benefit from a 'Key Information Summary' will receive one. More people will have the opportunity to develop their own personalised care and support plan. The availability of care options will be improved by doubling the palliative and end of life provision in the community.
  • Action in progress

Shifting Resources to the Community

• Ensure Health and Social Care Partnerships increase spending on primary care services, so that spending on primary care increases to 11 percent of the frontline NHS Scotland budget.
  • Action in progress

Primary and Community Care

What we said we would do by now:

Building Capacity in Primary and Community Care

• Have increased health visitor numbers with a continued focus on early intervention for children through addressing needs identified through the Universal Health Visiting Pathway. As a result of this, every family will be offered a minimum of 11 home visits including three child health reviews by 2020.
  • Action in progress
• Have commenced Scotland's first graduate entry programme for medicine.
  • Action completed

Supporting New Models of Care

• Negotiate a new landmark General Medical Services contract, as a foundation for developing multi-disciplinary teams and a clearer leadership role for GPs.
  • Action completed
• Test and evaluate the new models of primary care in every NHS Board, which will be funded by £23 million, and disseminate good practice with support from the Scottish School of Primary Care.
  • Action completed
• Taken forward the recommendations from the Review of Maternity and Neonatal Services.
  • Action in progress
• Launch Scotland's Oral Health Plan.
  • Action completed
• Have rolled out the Family Nurse Partnership programme nationally.
  • Action completed

What we said we would do by 2021/22

Building Capacity in Primary and Community Care

• Continue the investment in recruitment and expansion of the primary care workforce which began in 2016, and which will mean that, by 2022, there will be more GPs, every GP practice will have access to a pharmacist with advanced clinical skills and 1,000 new paramedics will be in post.
  • Action in progress
• Have implemented the recommendations of the Improving Practice Sustainability Short Life Working Group, the GP Premises Short Life Working Group and the GP Cluster Advisory Group.
  • Action in progress
• Have strengthened the multi-disciplinary workforce across health services. We will agree a refreshed role for district nurses by 2017, train an additional 500 advanced nurse practitioners by 2021 and create an additional 1,000 training places for nurses and midwives by 2021.
  • Action in progress
• Have increased the number of undergraduates studying medicine by 250.
  • Action in progress
• Have increased spending on primary care and GP services by £500 million by the end of the current parliament so that it represents 11 percent of the frontline budget.
  • Action in progress

Secondary and Acute Care

What we said we would do by now:

Reduce Unscheduled Care

• Complete the roll out of the Unscheduled Care Six Essential Actions across the whole of acute care.
  • Action in progress
• Undertake a survey on admission and referral avoidance opportunities.
  • Action completed

Improve Scheduled Care

• Reduce cancellations and private care spend in scheduled care by rolling out the Patient Flow Programme from the current pilots across all NHS Boards.
  • Action completed

What we said we would do by 2021/22

Improve Scheduled Care

• Complete investment of £200 million in new elective treatment capacity and expanding the Golden Jubilee National Hospital.
  • Action in progress
• Complete investment of £100 million in cancer care.
  • Action in progress

Improve Outpatients

• Have reduced unnecessary attendances and referrals to outpatient services through the recently-published Modern Outpatient Programme. The aim is to reduce the number of hospital-delivered outpatient appointments by 400,000, reversing the year-on-year increase of new appointments.
  • Action in progress

Realistic Medicine

What we said we would do by now:

Strengthen relationships between professionals and individuals

• Refresh our Health Literacy Plan, Making It Easy
  • Action completed
• Review the consent process for patients in Scotland with the General Medical Council and Academy of Medical Royal Colleges
  • Action in progress
• Commission a collaborative training programme for clinicians to help them to reduce unwarranted variation
  • Action completed
• Refresh the Professionalism and Excellence in Medicine Action Plan
  • Action completed

Reducing the unnecessary cost of medical action

• Incorporate the principles of realistic medicine as a core component of lifelong learning in medical education
  • Action in progress
• Develop a Single National Formulary
  • Action in progress

Public Health Improvement

What we said we would do by now:

Supporting National Priorities

• Set national public health priorities with SOLACE and COSLA, that will direct public health improvement across the whole of Scotland.
  • Action completed

Supporting key public health issues

• Continue delivery of the ambitious targets set out in our 2013 Strategy, Creating a Tobacco Free Generation.
  • Action in progress
• Refresh the Alcohol Framework.
  • Action completed
• Consult on a new strategy on diet and obesity
  • Action completed
• Introduce the Active and Independent Living Improvement Programme
  • Action completed

Supporting Mental Health

• Improve access to mental health support by rolling out computerised cognitive behavioural therapy services nationally.
  • Action completed

Active Scotland

• Publish a new delivery plan to support the Active Scotland Outcomes Framework and the Vision for a More Active Scotland.
  • Action completed

What we said we would do by 2021/22

Supporting National Priorities

• Support a new, single, national body to strengthen national leadership, visibility and critical mass to public health in Scotland.
  • Action in progress
• Have set up local joint public health partnerships between local authorities, NHS Scotland and others to drive national public health priorities and adopt them to local contexts across the whole of Scotland.
  • Action in progress

Supporting key public health issues

• Deliver the Maternal and Infant Nutrition Framework
  • Action completed

Supporting Mental Health

• Have evaluated the most effective and sustainable models of supporting mental health in primary care, and roll these out nationally by 2020.
  • Action completed
• Have rolled out nationally targeted parenting programmes for parents of 3- and 4-year olds with conduct disorder.
  • Action completed
• Have improved access to mental health services across Scotland, increased capacity and reduced waiting times by improving support for greater efficiency and effectiveness of services, including Child and Adolescent Mental Health Services and psychological therapies.
  • Action in progress
• Have delivered new programmes promoting better mental health among children and young people.
  • Action in progress
• Have invested £150 million to improve services supporting mental health.
  • Action in progress

Active Scotland

• Have embedded the National Physical Activity Pathway in all appropriate clinical settings.
  • Action in progress

Board Reform

What we said we would do by now:

• Review the functions of existing national NHS Boards to explore the scope for more effective and consistent delivery of national services.
  • Action completed
• Ensure that NHS Boards expand the 'Once for Scotland' approach to support functions.
  • Action in progress
• Put in place new arrangements for the regional planning of services.
  • Action completed
• Start a comprehensive programme to look at leadership and talent management development within NHS Scotland.
  • Action completed