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TitleTransformational Change Delivery Plan
Author
LanguageEnglish
File Size1.1 MB
Total Pages97
Table of Contents
                            1. Introduction
2. Transformational Change
	2.1. Strategic Service Change Programmes
		Unscheduled Care including Older People and People with Complex Care Needs and Acute Services - IHO (Institute of Healthcare Optimization) Whole System Patient Flow Programme
			Unscheduled Care
			Older People and People with Complex Needs
			Acute Services - IHO (Institute of Healthcare Optimization) Whole System Patient Flow Programme
		Primary Care - Ambitious for Ayrshire
			NHS 24
		Planned Care: Improving Access – The Modern Out Patient (including DCAQ)
		Technology Enabled Care
		Acute Services - >>FastForward
		Acute Services - Performance Intelligence Support to Acute Service Planning
	2.2. Best Value Programmes
		Directorate Restructuring – Corporate and Clinical Support Services
		Directorate Restructuring - Human Resources
		National Shared Services Initiatives
		Realistic Medicine - Effective Prescribing
		Realistic Medicine – Better Quality Better Value
		Workforce – including Medical Workforce, Nursing Workforce
		Estates Master Plan
		Enhanced Performance Framework
		Best Value initiatives
	2.3. Collaborative Working
		Acute Services: Patient Flow – SAS
		Transport
3. Local Delivery Plan 2017/18
	3.1. Increasing Healthy Life Expectancy
	3.2. Prevention and Early Years
	3.3. Public Health Priorities – Tobacco, Alcohol and Obesity
	3.4. Scheduled Care Access Standards
	3.5. Regional Planning
	3.6. Targets and Indicators for Health and Social Care
	3.7. Financial Planning
	3.8. Workforce Planning
                        
Document Text Contents
Page 1

NHS Ayrshire and Arran


Delivery Plan
2017-18

















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Final Draft at 5 June 2017

Page 2

1. Introduction ................................................................................................................... 4

2. Transformational Change .............................................................................................. 5

2.1. Strategic Service Change Programmes ...................................................................... 5

Mental Health ................................................................................................................ 6

Unscheduled Care including Older People and People with Complex Care Needs and
Acute Services - IHO (Institute of Healthcare Optimization) Whole System Patient
Flow Programme .......................................................................................................... 14

Unscheduled Care ................................................................................................... 15

Older People and People with Complex Needs ..................................................... 18

Acute Services - IHO (Institute of Healthcare Optimization) Whole System
Patient Flow Programme ........................................................................................ 25

Primary Care - Ambitious for Ayrshire ......................................................................... 28

NHS 24...................................................................................................................... 34

Planned Care: Improving Access – The Modern Out Patient (including DCAQ) .......... 36

Technology Enabled Care............................................................................................. 41

Acute Services - >>FastForward ................................................................................... 52

Acute Services - Performance Intelligence Support to Acute Service Planning .......... 56

2.2. Best Value Programmes ........................................................................................... 57

Directorate Restructuring – Corporate and Clinical Support Services ........................ 58

Directorate Restructuring - Human Resources ............................................................ 59

National Shared Services Initiatives ............................................................................. 62

Realistic Medicine - Effective Prescribing .................................................................... 64

Realistic Medicine – Better Quality Better Value ........................................................ 70

Workforce – including Medical Workforce, Nursing Workforce ................................. 71

Estates Master Plan ..................................................................................................... 78

Enhanced Performance Framework ............................................................................ 82

Best Value initiatives .................................................................................................... 83

2.3. Collaborative Working ............................................................................................. 88

Acute Services: Patient Flow – SAS .............................................................................. 89

Transport ...................................................................................................................... 91

3. Local Delivery Plan 2017/18 ........................................................................................ 92

3.1. Increasing Healthy Life Expectancy .......................................................................... 92

3.2. Prevention and Early Years ...................................................................................... 92

3.3. Public Health Priorities – Tobacco, Alcohol and Obesity ......................................... 93

3.4. Scheduled Care Access Standards ........................................................................... 94

3.5. Regional Planning ..................................................................................................... 95

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Page 48

Introduce Florence Text messaging within
addictions to transform the current detox
pathway.



Improve quality of the current service
for people with multiple addictions and
poly-substance abuse.


Improve access to this service
Contribution to increasing planned
appropriate admission for 100
people.

Contribute to psychological services delivery
plan by Introduce Florence SMS Text system and
electronic Cognitive behavioural therapy for
patients with mild to moderate mental health.

Contribution to Improved access and
waiting times across the
Psychological Specialties.

Increases in the number of patients
able to access support and self-
managing their own condition.

Improvements in appointments and
quality of appointments. Patients are
more likely to make appropriate
appointments and optimise face to
face contacts if required.

Improved mental health and well-being


Reduction in General Practice
contacts


Reduction in waiting times to mental
health services.

Improved quality in hard to reach
vulnerable group.

Development of baselines and
improvement trajectories in Y1


Development of Virtual Clinics

Introduce Attend Anywhere (Telehealth Web
Application) between General Practice and
Respiratory Consultants.

Establish VC links between Prison Service in East
Ayrshire and General Practice

Establish video conferencing ability between 3
General Practices, TEC Hubs and Care Homes.


GP and Respiratory Consultant will be
able to plan and discuss complex
patients care.










Contribution to reduction in
avoidable hospital admission by 10%
over next 5 years (This includes
readmissions)

Reduction in emergency Admissions
from Care Homes.

Improvements in medicines
utilisation and prescribing for
excellence.


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Implement TEC within structured discharge
planning from CDU/CAU and wards in UHA.

Establish Attend Anywhere Video Consultation
system across the three Primary Care Treatment
Centres (PCTC’s) Ayr, Crosshouse & ACH to
ensure equity of the OOH service. During the
summer months 2017 when the shortage of
clinical cover is at its peak.







Three Primary Care Treatment Centres
(PCTC)remaining open to the public
help to address the doctor shortage
and creating three TEC centres as pilot
sites to be evaluated internally and
externally by the patients/clinicians
using it.


Establish TEC Hub alongside Single Point of
Contact and Intermediate Care and Rehabilitation
Teams in North Ayrshire as currently available
within South Ayrshire. The TEC Hub provides the
specialist support and governance to enable
clinicians and patients to adopt TEC Solutions
alongside assessment, self-management and care
planning.










Specialist assessment at earliest
opportunity if hospital admission is
required.

Effective ambulance pathways
Supported discharge to reduce length
of stay and enable patient return to
homely environment as promptly as
possible.

Deliver of care bundles consistently to
facilitate improved patient knowledge
and condition management that will
reduce length of stay and avoid future
admission.


Admission avoidance through liaison
of Integrated Care Teams and
Respiratory, CHD, Diabetes
specialists at earliest opportunity.

Develop and Implement an awareness raising
education and workforce development
programme to embed TEC across Services.
Train new Advanced Nurse Practitioners in North

Learn Pro training module available on
Athena and Local Authority system.

More staff trained and using TEC.

Increased number of staff trained for
TEC.





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pressures and will also complement work on the strategic direction for acute services, which
each Board has been developing to transform acute services, working alongside their
Integration Joint Boards. When taken together with Board level plans this transformational
plan will clearly set out how West of Scotland Boards and their partners will deliver safe,
efficient and sustainable treatment and care over the next 10 to 15 years.

3.6. Targets and Indicators for Health and Social Care
Performance Monitoring of all aspects of our plans is paramount and whilst the national
review of targets and indicators for health and social care is being undertaken we will
continue to monitor progress through the current Local Delivery Plan standards. We will
continue to ensure that clinical priority is given to patients including unscheduled care,
cancer and other patients referred with urgent status. Achievement towards these
Standards will be discussed with Scottish Government at both the mid year and the Annual
Reviews. As soon as the new guidance is available we will incorporate this in to our
reporting structures, ensuring this allows us to demonstrate the progress being made
towards the desired outcomes.

Through recent guidance on ‘Measuring Performance Under Integration’ we are working to
agree trajectories in line with the outcomes expected from our programmes of
transformational change described in the Transformational Change Improvement Plan and
in this Delivery Plan. Once agreed, the locally agreed trajectories will be incorporated in to
wider performance reporting structures.


3.7. Financial Planning
Details of our financial plans will be made available under separate cover.

There are areas where advice from Scottish Government suggests that in moving NHS
Ayrshire and Arran’s performance to the Scottish average or to the performance of the
upper quartile of NHS Boards, savings may be secured; this is known as potential productive
opportunity. Work is ongoing to ensure that the data is indeed comparable across Boards
and to understand the drivers for any difference. Where there is scope to realise improved
productivity, it is being pursued as described within the Best Value programmes.


3.8. Workforce Planning
The strategic vision for NHS Ayrshire & Arran as an employer is set out in the Board’s People
Strategy - ‘People Matter’ which was endorsed by the NHS Board in May 2015. The People
Strategy explicitly makes reference and linkage to the ambitions detailed within the
Everyone Matters: 2020 Workforce Vision.

Delivery of the strategic intent of the People Strategy is detailed within the Board’s annual
Corporate People Plan (CPP) which provides the single coherent framework for pulling
together and linking all aspects of the people agenda encompassing both staff governance
improvement planning and the specific Board actions from Everyone Matters, thus avoiding

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unnecessary duplication. Ongoing progress reporting is provided to the Area Partnership
Forum and formally to the Staff Governance Committee.

As the 2017/18 iteration of the CPP is currently being developed, and is not yet available,
the table below provides a summary of how the 2017/18 Everyone Matters actions link to
extant implementation plans as well as providing a high level overview of initial progress in
taking these actions forward. Any outstanding actions from previous Everyone Matters
implementation plans will be encompassed within the 2017/18 CPP.


Everyone Matters NHS Board actions
2017/18

Linked local implementation plans (LIP) /
Initial progress

Ensure delivery of their iMatter
implementation plans, involve staff in
decision making and take meaningful
action on staff experience for all staff
(Healthy Organisational Culture)


LIP: CPP, iMatter Implementation Plan
Progress: Full organisational rollout of iMatter
will be completed in 2017 following H&SCP
implementation

Take action to promote the health,
wellbeing and resilience of the workforce,
to ensure all staff are able to play an active
role throughout their careers and are
aware of support available to them
(Sustainable)

LIP: CPP, Staff Health, Safety & Wellbeing
Strategy & Implementation Plan
Progress: Building on achievement of Healthy
Working Lives Gold award

Build confidence and competence among
staff in using technology to make decisions
and deliver care by encouraging active
participation in learning (Capable)

LIP: CPP
Progress: Work has commenced and will be
progressed in 2017/18.

Work across boundaries to share good
practice in learning and development,
evidence informed practice and
organisational development (Capable)

LIP: CPP, Learning Plan, OD programme
Progress: Ongoing close working with LA
counterparts in HR, OD and Learning and close
working with Further & Higher Education
Institutes via Ayrshire Education Partnership

Working with partners, develop workforce
planning capacity and capability in an
integrated setting (Workforce to deliver
integrated services)

LIP: CPP, NHSA&A Workforce Plan, H&SCP
Workforce Plans x 3
Progress: 3 x fixed term Workforce Planning
Leads in post in each H&SCP in Ayrshire

Implement the new development
programme for Board-level leadership and
talent management (Effective leadership
management)

LIP: CPP
Progress: Awaiting information from the
Scottish Government.


We await the publication of the National Health and Social Care Workforce Plan in the
Spring of 2017 and the preceding National Discussion Document which will look at the
practical issues involved. These will allow us to publish our wider workforce plan which will
take into account the mandatory Planning Tools recommended by Scottish Government.


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