Long term conditions in Scotland
A great deal of work is currently underway to improve the lives of people living with a long term condition in Scotland
A useful summary of work currently being carried out around long-term conditions in Scotland is given in the Improving Health and Wellbeing of people with Long Term Conditions in Scotland: A National Action Plan (2009).
Better Health, Better Care Action Plan December 2007
Better Health, Better Care Action Plan December 2007 is the Scottish Government’s action plan for health in Scotland. It describes the aspiration of a 'mutual' NHS in Scotland and sees people as co-owners of the NHS rather than patients or service users. There is an agenda of health promotion, addressing health inequalities, improving access to services and improving the quality of those services. Long term conditions and self management are seen as key priorities. Better Health, Better Care: Action Plan is available to download here.
Improving the Health and Wellbeing of People with Long Term Conditions in Scotland:- A National Action Plan 2009
Improving the Health follows on from Better Health Better Care, focusing particularly on long term conditions. The overall vision for the plan is that ‘throughout Scotland, those with long term conditions and those who support them, feel valued, confident and able to enjoy full and positive lives’. (The Scottish Government 2009 p6). The plan focuses on several themes:
- integration both between people living with long term conditions and health teams and between service providers (primary care, hospitals, social work, housing and the voluntary and community sector) (p9). This section of the plan highlights the importance of multi-disciplinary teams and the importance of those teams listening to the personal stories of people living with a long term conditions;
- The Self Management Strategy ("Gaun Yersel!") is available here;
- integrated Care - services should be properly structured and integrated. Distinct levels of care are identified:
- Level 0:- health promotion/prevention
- Level 1:- self management
- Level 2:- condition management - a greater level of professional support is needed than for level 1
- Level 3:- case management - where an intensive level of care is needed, or where the person's needs are complex;
- managed clinical and managed care networks - to support quality improvement through clinical and public engagement, audit and best practice;
- increased use of telehealthcare;
- workforce promotes identification of learning needs and the importance of extended scope practice;
- highlights the importance of information systems to support service improvement;
- the aims of the plan are to be achieved through five Health, Efficiency Access and Treatment (HEAT) targets (more are being developed) as well as through the Long Term Conditions Collaborative (LTCC).
Seven key changes are described (p15) which Boards will need to deliver over the next few years. Part 2 of the Plan then gives the key actions which will be needed to accomplish the identified changes. The National Action Plan is available to download here.
Promoting Self Management
- The self management strategy for LTC in Scotland - developed by LTCAS for the Scottish Government and is available to download here.
- ALISS - Access to Local Information to Support Self Management is a project supported by the Scottish Government, NHS Scotland and the Long Term Conditions Alliance Scotland. A key aim is to make information for self management available and easy to access at the local level, in a ‘user friendly’ way.
- The Self Management Fund is available to voluntary organisations and community groups throughout Scotland to support work to encourage people living with long term conditions to learn more about the management of their condition, and to become active partners in their own care. The fund is initially set at £2 million per year, over 2009/10 and 2010/11
Services which meet the needs of individuals
Better Together is Scotland's Patient Experience Programme. It aims to bring together NHS Boards, frontline staff and patients in order to improve services. The programme is focusing on 3 main areas, one of which is people with long term conditions.
Promoting quality
The April 2010 Quality Strategy builds on previous health policy, 'Better Health, Better Care', in terms of building a 'mutual NHS', with patients being co-partners in their own care. The strategy aims to deliver measurable quality improvements that people who use services see as important. The dimensions of quality are defined in 'Better Health Better Care Action Plan' (2007) as:
- patient centred
- patient safety
- effectiveness
- efficiency
- equity
- timeliness
The NHS Quality Improvement Scotland supports improving the quality of services by providing advice and guidance on clinical practice and assessing NHS performance.
Programmes, Strategies and Frameworks
Other useful sources of information
Long Term Conditions Alliance Scotland has useful pages on consultation responses and briefings. A key partner in developing the LTC Action Plan, also in developing Gaun Yersel! LTCAS is based at the long term conditions 'hub'.
Long Term Conditions Collaborative was launched in 2008, and is run by the Scottish Government Improvement and Support Team. It is designed to support the NHS Boards and their partner agencies to deliver sustainable improvements in the management of long term conditions, including self management, specialist condition management, and complex care/case management. It is one of 3 national improvement programmes (the others being the mental health collaborative and the 18 weeks referral to treatment programme)
