Scotland's Population Health Framework: supporting sector summaries - the NHS

Population Health Framework Supporting Sector Summaries: NHS

Overview

To support the implementation of the Population Health Framework, a suite of sector summaries has been developed with key partners. These summaries highlight the vital role that key sectors play in creating good health, recognising that meaningful progress towards our aim can only be achieved through shared responsibility and collaboration.

These summaries cover local government, the NHS, the community and voluntary sector and the business sector. Each reflects the sector’s contributions to realising our aim to improve life expectancy and tackle health inequalities through the delivery of the priorities and actions set out in the Framework.

The following sector summary focuses on the NHS reflecting its unique strengths, perspectives and levers for change. The NHS plays a central role in improving health outcomes, not only in terms of delivery of healthcare, but also as an anchor institution and as a population health organisation that works in partnership to improve the building blocks of health.

Together these sector summaries aim to support dialogue, collaborative working and coordinated action, ensuring that all parts of the system are enabled to contribute fully to the delivery of the Population Health Framework.

The NHS can support a shift to a more prevention focused system by contributing to improved population health in key ways:

Social and Economic Factors - Provide income to local communities through its role as an anchor institution, enabling targeted employment, fair work, career progression and socially responsible procurement.

Places and Communities - Provide local leadership to reduce health inequalities; support collaboration and partnerships to improve population health.

Enabling Health Living - Deliver services, information and support for individuals to maintain physical and mental health and wellbeing.

Equitable Health and Care - Provide value-based, accessible and equitable care to meet local needs and deliver population focused preventative services.

Working Together to Improve People’s Health

The NHS reaches into every part of our lives and is a presence in communities the length and breadth of Scotland. The NHS is a central actor within Scotland’s population health system — collaborating with local government, Health and Social Care Partnerships (HSCPs), Community Planning Partnerships (CPPs), community and voluntary organisations, academia, business and communities themselves to deliver value-based accessible and equitable health and care. Through these partnerships, the NHS helps to drive a whole system approach that places a greater emphasis on prevention and early intervention in order to create, maintain and restore good health.

The Role of the NHS

Fundamental to health and care service reform and renewal – and to the delivery of the Population Health Framework – is a shift in how the NHS sees itself. The NHS in Scotland is now realising the need to shift its identity – from a treatment-focused organisation to one centred on population health: working collaboratively to prevent ill health and reduce inequalities while delivering sustainable, value-based health and care. At a local level, the integrated approach of HSCPs aims to join up services and focus on anticipatory and preventative care.

This shift includes supporting the health and social care workforce to maximise their role in prevention and in delivering the priorities and actions within the Framework. This will require working in tandem with local Directors of Public Health, local public health teams and Public Health Scotland in new ways to improve the building blocks of health – enabling people to live longer, healthier and more fulfilling lives.

As a Healthcare Provider

Everyone in Scotland will engage with the NHS at some point in their life and every interaction is an opportunity to improve health and wellbeing. As such, we must embed prevention, equity and person-led care at every stage of service delivery. This includes:

• delivery of holistic care – ensuring the wide range of health professionals (including doctors, nurses, pharmacists, optometrists, dentists, and more) within the NHS work together to prevent, manage and treat health conditions in a person-centred way
• focusing on outcomes – ensuring care achieves the best possible health and wellbeing outcomes for individuals and communities
• using realistic medicine principles – ensuring the use of evidence, value-based practice and shared decision-making to tailor care to the individual
• tackling healthcare inequalities – by collaborating with communities, local partners and people facing barriers to co-design equitable and accessible services

As a Local Partner and Leader

The NHS has a central leadership role to play, working in partnership with local authorities, communities and community planning partners to prevent ill health and inequalities. This includes:

• collaboration with place-based partnerships – working with local authorities and community planning partners to align action on health, inequality and prevention
• evidence-based decisions – using local insights and impact assessments to influence how resources are allocated
• joint commissioning of service delivery – co-design and co-delivery of services with communities to ensure they meet local needs effectively
• driving inclusive economic growth – by maximising the NHS’s role as a major employer to support local economies, create fair work opportunities and support growth
• shaping wider system reform – by contributing to broader public sector reform in areas such as governance, funding and accountability

As an Employer and Anchor Institution

Beyond healthcare delivery, the NHS holds a unique position to drive positive change within local communities to influence the social and economic conditions that shape health. These roles include:

• fair employment – as Scotland’s largest employer, promoting fair work, inclusive recruitment and career development for a diverse workforce
• local procurement – supporting local economies through community-focused procurement practices
• utilising physical estates – using NHS estates, infrastructure and purchasing power to strengthen communities and tackle poverty

Supporting the NHS to Play Their Part

The Scottish Government, local government and the wider population health system can support the NHS by building capabilities in evidence and resources on prevention and health inequalities to support local planning and decision-making. This includes:

• enabling accountable and collective leadership – by equipping NHS Board Chairs, Chief Executives and leadership teams with a clear mandate for accountability, scrutiny and improvement of population health
• resource prioritisation – by refreshing national funding and allocation models to ensure resources are distributed proportionately to need and deliver maximum value
• enhancing data infrastructure – by strengthening data capacity and capability to guide evidence-based decision making, track progress and drive renewal across health determinants, prevention spend and tackling inequalities
• embedding performance measures – by integrating health inequality outcomes and progress metrics into performance management systems and operational planning, with a focus on prevention and care delivery
• sustaining the voluntary and community sector – by promoting fair, long-term funding for community organisations, enabling them to partner effectively with NHS Boards in improving community health and supporting long-term action

Unlocking this Potential

The Population Health Framework is a ten-year, cross-sector approach to improving health and wellbeing in Scotland. During its lifetime the Framework will set out priorities and tangible actions to improve health and reduce health inequalities. The actions within this will help to support Scotland to have a healthy population, where everyone can actively participate in society and work, engage in social activities and contribute meaningfully to their communities. Many of the actions will require ongoing, collaborative working with the NHS if they are to be delivered successfully.