NHS recovery plan

Innovation & Redesign

During the pandemic many new and different ways of working were developed to support the continued delivery of critical services. These new ways of working were borne out of necessity but in many cases they also delivered improvements. So we want to build on this work.We will support innovation in and redesign of services to ensure that more patients receive person centred care in the right place, at the right time, and in a way and that helps staff deliver high quality care and treatment.

Research, innovation and the redesign of services will be integral to the recovery of NHS services.There are a range of partner organisations that are central to research, innovation and service redesign - these include the new National Centre for Sustainable Delivery, NHS National Services Scotland, the Digital Health and Care Innovation Centre, Healthcare Improvement Scotland, and the Scottish Health Industry Partnership. We will support these organisations and ensure that their work is rooted in the principles of Realistic Medicine and aligned with our broader care and wellbeing programmes.

The increase in digital - planned for before the pandemic, and significantly accelerated as part of our response to the pandemic - means the time is now right to ensure that Digital is always available as a choice for people accessing services and staff delivering them. This will allow more people to manage their condition at home, to be able to carry out pre and post-operative assessments remotely, and to continue to manage their recovery from home. We will set out in more detail how this will be delivered in our forthcoming Digital Health & Care Strategy.

The new National Centre for Sustainable Delivery for Health and Social Care (CfSD) will be particularly important in driving innovation. It has been established to pioneer and deliver new, better and more sustainable ways of delivering services and improving access for patients. It will be key to supporting NHS recovery and will aim both to reduce unnecessary demand for services, and also to develop new pathways of care that are more efficient and better for patents. This will include enhanced delivery of services in community settings, transformation of hospital pharmacy services, reducing the variation in and waiting times for planned and unplanned care, and improving overall patient experience. Not only will it maximise value for patients by avoiding waste, it will provide access to consistently high quality healthcare across Scotland.

As early priorities, the CfSD will build on and seek to accelerate work on developing alternatives to endoscopy for assessing patients, increasing diagnostic capacity, and optimising theatre capacity.The additional capacity delivered by CfSD will be over and above that delivered through initiatives in NHS Boards and through the network of National Treatment Centres.The work of CfSD will be central to our ambition to ensure that we are able to continually identify new ways to increase our capacity, and to respond to demand.We will update this plan to reflect that work as we review it each year.

The CfSD will work collaboratively with NHS Boards, health and social care partners, third sector, academia and industry to identify and implement improvements to care pathways across Scotland. This will include:

Improvements

• Extending new approaches to delivering care that minimise the requirement for patients to travel, and provide services more efficiently – for examplevirtual appointments, virtual fracture clinics, and digital dermatology.
• Accelerating the adoption of new technologies that support improved access to healthcare, such as cytosponge, colon capsule endoscopy, and the use of artificial intelligence.
• Improving theatre efficiency by re-designing how services are delivered, for example streamlined cataract theatres.
• Ensuring better senior clinical triage in secondary care so that patients are signposted to the care that best suits them at an early stage, rather than facing multiple waits to determine the care that is right for them.
• Maximising the use of community services, such as community pharmacies, opticians and dentistry to ensure services are provided close to people’s homes and to reduce avoidable pressure on acute care.
• Ensuring resources are used efficiently by avoiding unnecessary or inappropriate healthcare interactions, grounded in the principles of realistic medicine.This includes:
  • making sure that all patients on a surgical waiting list have a definite clinical indication for surgery.
  • making sure that pathways through care are designed to support individual needs
  • helping patients have access to appropriate, clinically relevant information, to inform their decision making
  • making sure that patients are aware of alternatives available to them including non-operative interventions
• Reducing procedures that deliver little clinical benefit, with corresponding investment in alternative pathways.
• Supporting the NHS Academy to train more staff to enhanced practice levels to provide additional capacity within certain specialties.