According to QIS Scotland COPD is the only major cause of death in Scotland on the increase. There are thought to be about 100,000 people in Scotland living with COPD, with a predicted increase of 33% in the next 20 years. It accounts for over 122,000 bed days and 4,500 deaths every year.
National health strategy
NHS Scotland has a quality strategy focusing on effective care, safety and patient-centredness. It encourages relationship-based care that works for "every person every time". Better long term conditions care is one of the primary drivers.
Following on from work in England, there is a national collaborative improvement programme and work on improved productivity; a patient support programme (Better Together), a strategy for self-management - Gaun Yersel, and support for community health partnerships with the voluntary sector.
The HEAT performance management system sets out the targets and measures against which NHS Boards are publicly monitored and evaluated to deliver Better Health, Better Care
NHS Boards produce Local Delivery Plans based around the HEAT targets that set out their delivery trajectories, key risks, workforce challenges, and financial plans. Guidance for the 2010/11 Local Delivery Plan was issued in November 2009.
- Health Improvement
- Efficiency
- Access
- Treatment
2010-11 there are 24 targets. The respiratory relevant ones are:
H6: Through smoking cessation services, support 8% of your Board’s smoking population in successfully quitting (at one month post quit) over the period 2008/09– 2010/11
E4: NHS Boards to deliver agreed improved efficiencies for
• 1st outpatient attendance DNA,
• non-routine inpatient average length of stay,
• review to new outpatient attendance ratio,
• same-day surgery,
• pre-operative stay
E5: NHS boards to operate within their agreed revenue resource limit; operate within their capital resource limit;meet their cash requirement.
E6: NHS boards to meet their cash efficiency target.
E7: To increase the percentage of new GP outpatient referrals into consultant led secondary care services that are managed electronically to 90% from December 2010.
A8: Provide 48 hour access or advance booking to an appropriate member of the GP Practice Team by 2010/11
A10: Deliver 18 weeks referral to treatment from 31 December 2011. No patient will wait longer than 12 weeks from referral (all sources) to a first outpatient appointment from 31 March 2010. No patient will wait longer than 9 weeks from being placed on a waiting list to admission for an inpatient or day case procedure from 31 March 2011.
T6: To achieve agreed reductions in the rates of hospital admissions and bed days of patients with primary diagnosis of COPD, Asthma, Diabetes or CHD, from 2006/07 to 2010/11.
T8: Increase the level of older people with complex care needs receiving care at home.
T10: To support shifting the balance of care, NHS Boards will achieve agreed reductions in the rates of attendance at A&E
T12: By 2010/11, NHS Boards will reduce the emergency inpatient bed days for people aged 65 and over, by 10% compared with 2004/05.
Timescales
NHS Boards will ensure that the final Local Delivery Plans are published on their local websites during April 2010.
Respiratory: In March 2007 Quality Improvement Scotland published Asthma Services for Children and Young People Clinical Standards This identifies seven areas for standards:
• organisation of asthma care
• healthcare professional training and education
• schools
• linking care
• high risk asthma groups
• clinical review, and
• emergency care.
in March 2010 Quality Improvement Scotland (NHS QIS) published national clinical standards for COPD services encompassing 7 key areas :
1. Organisation and delivery of COPD services
2. Case finding
3. Diagnosis and periodic review of COPD
4. Pulmonary rehabilitation
5. Oxygen therapy
6. Home support, intermediate care and supported discharge services
7. Palliative care services
For further information click here This includes an evaluation tool (previously known as a self-assessment tool).
End of life care: Living and Dying Well a national action plan for palliative and end of life care in Scotland was published in October 2008. Click here for the document.
Smoking: Clearing the airs website for more information.
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