Health Implementation Plan 2007

Briefing No. 164 September 2007

Background

On 16 August 2007 the Health & Well- being Secretary, Nicola Sturgeon, launched a nationwide discussion document, "Better Health, Better Care" that sets out the Government's Action Plan for Health and Wellbeing.

Main Initiatives

• Step up efforts to tackle health inequalities, including the impact of chronic liver disease, suicide, drug misuse and violence on young men
• Develop community services for people with long term conditions
• Protect local access to healthcare through a presumption against the centralisation of hospital services.

• Increase the accountability of health services through direct elections to NHS Boards
• A greater voice for patients and their carers in the design and delivery of services

• Targeted early interventions to give Scottish children the best possible start in life
• Extend free school meal provision
• Improve the quality of services, including the introduction of new waiting times guarantees that are appropriate to needs
• Abolish prescription charges
• Improve access to dentistry

The Challenge

The 2005 report, Building a Health Service: Fit for the Future, by Professor David Kerr (The Kerr Report) identified the challenges to health from an ageing population, persistent health inequalities and a growth in long term conditions.

Since the publication of the Kerr Report new evidence and experience have emerged which need to be reflected upon.

In particular, there are new insights into the contribution of drug misuse, chronic liver disease, suicide and violence to premature deaths amongst young men.

In addition, there is now evidence about the links between the social, psychological and biological causes of inequalities and the links between risks in early childhood and chronic disease in later life.

Public concern about the over-centralisation of services, particularly in the provision of emergency care, also needs to be taken into account.

The bringing together of key determinants of health, such as sport, housing, regeneration, social and financial inclusion, homelessness and poverty will produce a more radical and inclusive approach to achieving shared objective.

The Issues:

Improving the Experience of Care

• Define patient's rights; guarantee waiting times, healthcare plans; better

access to information

• An integrated transport system to specialist centres
• Provide integrated and sustainable services
• Develop primary care and community hospitals; more flexible opening hours for GP practices and walk-in access to a wide range of services

Best Value

• Efficient, Effective and Sustainable Services with resources directed to support frontline services
• Raise standards across Scotland and ensure best practice.
• Introduce new and different roles such as Nursing, Midwifery and AHP Consultants, supported by appropriate changes in regulation and monitoring
• Improve and integrate workforce planning for all staff groups
• Greater use of regional contracts or shared posts; challenge the traditional boundaries between public sector organisations, sharing premises and resources with other organisations
• Build on public sector services, supported by the use of the voluntary sector and the social economy, whilst ensuring the best possible deal from private sector suppliers.

Taking Responsibility

• Taking greater responsibility for one's own health
• New action plans on tobacco control and alcohol problems through new
• Increase participation in sport and physical activity.
• Help people back to work and provide safe and health-promoting workplaces, including those in NHSScotland

Tackling Health Inequalities

• Greater targeting of resources for disadvantaged communities and those with complex needs
• Promote the equality and diversity agenda.
• Build on the "Choose Life" strategy to help reduce the number of people who commit suicide.

Anticipatory Care and Long Term Conditions

• Greater availability of screening and health checks; individual Care Plans and support for Carers
• With local government and voluntary sector deliver services at home.
• Reduce anti-depressant prescribing by 10%
• Improve health for school pupils and increase school nurses
• Support nursing midwifery and AHPs to become enablers and supporters of self care and self management

The Best Possible Start

• Early intervention through a child's first 3 years with Cross-Government support
• Effective support services for parents and children in deprived areas
• Tackle drug misuse and support for children of drug-taking parents.
• Improve infant nutrition and increase rates of breastfeeding in all communities.

UNISON Summary

This discussion document generally does not signal a radical change in health policy, reflecting a welcome degree on consensus on this issue. However, it does include specific proposals on direct elections to health boards, prescription charges and free school meals that UNISON has strongly supported. Balancing public expectations on how locally acute services can be delivered will be more problematic.

Branch Action

• Discuss issues raised in the consultation document in your branches

• Forward comments to Diane Anderson by no later than Monday, 12 October. A draft response will be considered by the Scottish Committee on 6 November.

Further Information

Better Health; Better Care

http://www.scotland.gov.uk/Publications/2007/08/13165824/0

UNISON response on the Kerr Report

http://www.unison-scotland.org.uk/healthcare/kerrreport.html

Contacts list:

John Gallacher -
j.gallacher@unison.co.uk

Diane Anderson -
diane.anderson@unison.co.uk

UNISON
14 West Campbell St
Glasgow G26RX
Tel 0845 355 0845
Fax 0141-307 2572