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Moving forward together

The way that healthcare and social care services in Greater Glasgow and Clyde are provided is changing.

Over the next 18 months, clinicians including GPs, health and social care managers and planners will work together and will engage with patients, service users, the public and staff to develop plans for a better, changed modernised, healthcare and social care system for Greater Glasgow and Clyde residents.

This new system of care will be organised in the most effective way to provide safe, effective person centred and sustainable care to meet the current and future needs of our population and able to provide best value.

It will be designed to:

  • Support and empower people to improve their own health
  • Support people to live independently at home for longer
  • Empower and support people to manage their own long term conditions
  • Enable people to stay in their communities accessing the care they need
  • Enable people to access high quality primary and community care services close to home
  • Provide access to world class hospital based care when the required level of care or treatment cannot be provided in the community
  • Deliver hospital care on an ambulatory or day case basis whenever possible
  • Provide highly specialist hospital services for the people of Greater Glasgow and Clyde and for some services, in the West of Scotland

Here we explain why we are making these changes and how you can get involved.

In a few months, the NHS will celebrate its 70th anniversary. The NHS has served the country very well over the year...

In a few months, the NHS will celebrate its 70th anniversary.

The NHS has served the country very well over the years and is regarded as one of the best healthcare systems in the world. However, society has changed and expectations of the NHS today are a far cry from those of 1948.

The pace of change over the past twenty years has been particularly striking.

We have seen ground breaking changes in the way cardiac conditions are treated with the introduction of statins and the use of stents for people who have had a heart attack or who may be at risk.

Better treatment for cancer and stroke patients have delivered substantial improvements to survival.

New technology has enabled us to achieve considerable advances in diagnostic imaging and surgical techniques with improved outcomes and day surgery becoming the norm.

The way healthcare is organised has evolved in response to these advances.

Here, in Greater Glasgow and Clyde, two large hospitals have been created specifically to deliver day surgery, diagnostic testing and outpatient activity at New Victoria and New Stobhill Hospital.  We have designed and built two state of the art facilities at the Queen Elizabeth University Hospital and the Royal Hospital for Children in 2015.

At the same time we have a shift in the balance of care aware from long-stay and other institutional care to more care being provided by community-based services.

We have opened new community health and care centres which have supported the delivery of modern high quality integrated community services, where patients receive the vast majority of their care.

We have closed long-stay residential mental health institutions and created modern mental health facilities including the recently opened Orchard View in Greenock.

Of course the health of the population is determined by more than improvements in medicine and healthcare.

A person's health is determined by where they live, whether they work and if they live in poverty, their mental health and wellbeing, their activity levels and lifestyle choices.

Local authorities and other community planning partners, and since their establishment in 2015, the integrated Health and Social Care Partnerships, have been working closely with NHS Greater Glasgow and Clyde on a range of measures designed to address the issues which contribute to poor health – lifestyle, education, economic status, employment and environment.

Advances in medical science and innovations in treatment, together with effective public health interventions, are he...

Advances in medical science and innovations in treatment, together with effective public health interventions, are helping us all to live longer.

This is a real success story, but as more of us live longer, the number of people needing care is increasing.

Dementia, for instance, is strongly related to age. While the majority of people with dementia manage to live at home with input from family and informal carers, the disease is steadily progressive and it is almost inevitable that health and social services will require to provide significant support as the illnesses progresses.

Demand for health and social services will only grow as the proportion of older people in the population increases.

It is estimated that one in two people will be diagnosed with some form of cancer during their lifetime.

The recent increase in the incidence of cancer is likely due to more people living longer. This will have a very significant impact on the demand for healthcare and social services.

The illnesses that people are experiencing are also significantly changing, from short-term life-threatening illnesses towards long-term conditions (i.e. conditions that are present for more than one year and are unlikely to be cured) and disability.

People with long terms conditions are twice as likely to be admitted to hospital and stay in hospital longer than people without them.

The health and social care system in Scotland is struggling to keep pace with these extra demands and to meet patients’ and service users’ needs is an ongoing challenge given the reducing real term funding available for the NHS, local authorities and HSCPs.

Scottish Government predictions:

  • Over the next 10 years the proportion of over 75s in Scotland’s population – who are the highest users of NHS services - will increase by over 25%.
  • By 2033 the number of people over 75 is likely to have increased by almost 60%.
  • There will be a continuing shift in the pattern of disease towards long-term conditions, particularly with growing numbers of older people with multiple conditions and complex needs such as dementia.
  • If nothing changes, over the next 20 years demography alone could increase expenditure on health and social care by over 70%.

Source: Achieving sustainable quality in Scotland’s healthcare – A 20:20 vision

There is a finite budget to spend on healthcare and this increasing demand will simply not be met if we continue to do things the way we do them now and unless we work to change how services are accessed and used.

As well as the obvious financial constraints, increasing reliance on hospital care is simply not in the best interests of all patients.

Too often, older patients in particular are admitted to hospital, sometimes for long periods, which can result in loss of independence and increased levels of confusion through a change of environment.

There is also a concern that for some patients the increased use of investigation and treatment in hospital, including the use of many drugs at one time, may in fact, result in excessive side effects in older people.

For some, a stay in hospital might encourage over-treatment and over-medicalisation when a package of assessment, care, rehabilitation and support in the community would be better for them.

To improve the health of Greater Glasgow and Clyde, and to meet the demands of us all as we live longer, we need a fu...

To improve the health of Greater Glasgow and Clyde, and to meet the demands of us all as we live longer, we need a fundamental move away from a ‘fix and treat’ approach to our health and social care to one based on anticipation, prevention and self-management.

When people need care, this should be delivered wherever possible in the community supported by integrated health and social care services.

We need to put in place arrangements to stop people being admitted to hospital unnecessarily.

Patients who need hospital care should have this done as a day case whenever possible.

Patients should be helped to understand when and how they should use healthcare and social care services and when to use their A&E, GP Out of Hours services or other community services.

It is important to get the right support at the right time by the right people to do this. We need to:

  • focus on prevention by allowing the public to manage their own health better
  • support better use of pharmacies
  • avoid unnecessary admissions to hospital
  • create a better flow through hospitals
  • develop specialist hospital care
  • have a highly skilled workforce, using skills in the right way to make a difference
  • educate the public on what service to access so that they get the right support at the right time

In striving to provide relief from discomfort, illness and death, modern medicine can sometimes over-reach itself and provide treatment that is of little long-term benefit to the patient.

This is especially true when a person has multiple conditions, each of which has its own list of recommended medicines and treatments.

We need to move away from the ‘doctor knows best’ culture and more fully involve patients in the decisions about their care. Our clinicians need to to involve and discuss with their patients what is important for them as individuals – which may be deciding not to have treatment.

Health and Social Care Partnerships have been introduced to change the way key services are planned and delivered, with greater emphasis on supporting people in their own homes and communities and less inappropriate use of hospitals and care homes.

The development of these partnerships has created real opportunities to make better use of resources and to provide alternative care outside of hospital settings and in the community and deliver better support for the growing number of older people and people with long-term conditions.

HSCPs work to support people to improve their own health and wellbeing and live in good health for longer, remaining at home or closer to homes, connected to their families and their communities.

Most people need care that can be provided in settings other than hospitals which should provide care that can’t be provided anywhere else.

Health and Social Care Partnerships are now working across the whole of Greater Glasgow and Clyde, integrating local services provided through GPs, district nurses and community services through local authorities with those provided by our acute hospitals – actively bringing care closer to home or at home for everyone who needs it.

Within Greater Glasgow and Clyde, there are six Health and Social Care Partnerships. Together with NHS Greater Glasg...

Within Greater Glasgow and Clyde, there are six Health and Social Care Partnerships.

Together with NHS Greater Glasgow and Clyde, and our six Local Authority partners, third sector and community planning partners, they have now embarked on a major programme to transform health and care services for the future.

This programme will be taken forward over the next 18 months and will result in a clear plan for change to make the Scottish Government’s vision for health and social care a reality.

Delivered in partnership with the Scottish Government, neighbouring NHS boards, the Scottish Ambulance Service, education, the secure sector and the third sector, the programme will ensure that our health and social care services keep pace with national and regional developments.

New ways of working will be developed which provide safe, effective and patient centred care, make best use of available resources and the oprtunities created by innovation and technology.

Delivery of the Moving Forward Together Programme will see improvements in care and outcomes for everyone.

There is a Core Team made up of doctors, nurses, allied health professionals, Health and Social Care Partnerships, hu...

There is a Core Team made up of doctors, nurses, allied health professionals, Health and Social Care Partnerships, human resources, e-health, analytical services, planners, engagement and communications staff. They are responsible for pulling together all relevant data and information to underpin the delivery plan that will be prepared by the end of June 2018.

The Core Team is responsible to the NHSGGC Medical Director, Dr Jennifer Armstrong, who in turn is the Executive Director responsible to the Board for this programme.

The views of patients and the public will be important as we develop these plans and a Stakeholder Reference group is being established to advise on our communications and engagement with our communities. Listening to the views of communities is central to success.

The group will include representatives from patients and carers groups and organisations.

A Workforce Reference Group with trades unions, professional organisations and staff representatives will also be set up to contribute to an effective engagement plan for staff working within NHSGGC and within the health and social care partnerships.

The national Scottish Government blueprint to which we are working is drawn from best practice from across the globe....

The national Scottish Government blueprint to which we are working is drawn from best practice from across the globe. There is evidence and experience to prove that it is effective.

This evidence can help us understand what works best to ensure we deliver safe, effective, person centred and sustainable services for our people.

We all want to build on the excellent services we have already.  We want to ensure we continue to change and transform where there is evidence we can do even better.  But we need to give ourselves the time and space to do that. 

This programme will be vital to ensuring we keep pace with the demands for our services and the demands made on us by the advent of new/upgraded technology – ensuring excellence for the future.

It is too early to know or predict the specific changes that will be necessary.   There are however already a lot of ...

It is too early to know or predict the specific changes that will be necessary.   There are however already a lot of examples of transformational change that have taken place or are currently being pursued across Greater Glasgow and Clyde and in a variety of differing clinical specialties and service provision.

 

When we have a more developed plan we will discuss it more fully however if you get involved we would like to hear from you.

We’re at a very early stages of the Programme and initially have set up a website to keep everyone up to date. As th...

We’re at a very early stages of the Programme and initially have set up a website to keep everyone up to date.

As the Programme develops this will set out how you can take part and give us your views.

You can also register to receive regular updates as part of our online community.

We view all the people of Greater Glasgow and Clyde as stakeholders - health service users, patients, staff, members ...

We view all the people of Greater Glasgow and Clyde as stakeholders - health service users, patients, staff, members of the public, carers, volunteers, and the voluntary organisations which represent them.

We welcome opinions and feedback.

Opportunities to participate in specific events for staff and the public will be advertised through these web pages.