The Healthcare Quality Strategy for Scotland

Background

NHS Scotland has developed a draft strategy to create high quality, person-centred, clinically effective and safe healthcare services, and to be recognised as being world-leading in its approach.

This consultation response sets out the Health Foundation’s comments on the strategy. Our comments focus on section five of the consultation document, called ‘The way ahead – the quality strategy’ and the proposed approach to improving the six domains of quality. The annex provides an overview of the Health Foundation’s work in Scotland.

The Health Foundation’s response

We are delighted that the Scottish government is making this significant commitment to improving healthcare quality. We hope that the strategy inspires all those working for NHS Scotland, patients and the public to achieve its aims. Our comments covered the following topics:

Efficiency and equity: we would like to understand more about how efficiency and equity would be addressed by the strategy. We also sought reassurances that the strategy took into account the financial challenges facing the public sector. 

Patient Safety and Patient Centredness: we welcomed the continuing commitment to patient safety by the Scottish government and the work being done by NHS Boards. We are proud to be supporting work to improve patient safety in Scotland and will share learning with the Health Department on new projects involving mental health and maternity care as it emerges. We are also keen to share learning from our new scheme which looks at shared decision making. This will support work to improve patient centredness.

Quality Infrastructure: we are pleased that the strategy gives consideration to the infrastructure needed to improve quality. However, we think that further consideration should be given to the detail of some measures to ensure they match the ambitions of the strategy.

Implementing the strategy and capacity and capability: the strategy is rightly ambitious and its success will depend on its implementation. We think it is important that the difficulties of improving healthcare quality are not underestimated and that careful thought is given to implementation and to developing the skills needed to achieve large scale change. We are exploring this area by developing clinical networks (including a Safer Patients Network) and undertaking research into spread and sustainability of quality improvement. We have also found that developing leadership capacity has been critical for all of our demonstration projects. This is reinforced by the emerging findings from the independent evaluation of our leadership schemes. This is finding that without the right leadership skill set, expertise in quality improvement may have limited impact. 

Conclusion

We are delighted that NHS Scotland has developed this ambitious strategy. We think that it is important that the challenges to achieving its aims are not underestimated and we are keen to share our learning to support its successful implementation.

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