Director's overview

Healthcare Improvement Scotland’s ihub provides support to health and social care organisations to redesign and continuously improve services to enable better health and wellbeing outcomes for people in Scotland.

Putting people at the heart of everything we do.

In 2017-18 we set up our new Place, Home and Housing Portfolio, which is focused on the role that housing plays in enabling independence and supporting improvements in health and wellbeing.

It is interesting to view the challenges in our own system through the perspective of others. The challenges facing our health and social care system are significant and are well understood; increasing demand, ongoing difficulties recruiting to a range of posts, and an ever more challenging financial context.

Over the last year, through the support of The Health Foundation, I’ve been privileged to participate in Sciana, a new European network of Healthcare Leaders. It’s helped me to keep focused on the positives in our context and reminded me that, in the midst of our challenges, we also have so much to celebrate.

To say I was surprised when some colleagues from another European country described their main challenge as having too much money in their system is an understatement. And the reason why they described it as a challenge: they have no incentive to change and they know that the current system is not fit for purpose for today’s health and care needs. It gave me a new perspective on our financial challenges as they are enabling a much needed redesign of our health and social care system. It reminded me of a quote from an integration Joint Board (IJB) Chief Officer (CO) that we highlighted last year “Crises and challenges have created the sense of urgency and the willingness to think the unthinkable that allows us to tackle the wicked issues”.

That is not to say the health and social care system wouldn’t benefit from some additional resource; just that with every challenge comes an opportunity. The improvement and redesign work happening across Scotland every single day is really impressive; evidenced by the regular requests Scotland receives to talk to colleagues from all over the world.

The work we support through the ihub is just a subset of this wider work and this report provides just a snapshot of the work we support.

In this year when we are celebrating 10 successful years of the Scottish Patient Safety Programme (SPSP), I’ve also found myself reflecting whether we are at risk of taking for granted the quality improvement (QI) expertise that has been built up not just in health but also, through the work of Raising Attainment for All and Early Years Collaborative (now merged as the Children and Young People Improvement Collaborative, CYPIC), in the wider social care and educational environments.

We have proved through SPSP that we can do change at scale in Scotland; the data in this report around our safety work speaks for itself. Its success is based on a combination of different factors but as the organisation that has delivered the national programme over the last 10 years we would call out the following:

  • Relentless focus on skilling up those who deliver care in quality improvement techniques.
  • The development of national learning systems which bring those working on common improvement challenges together to share learning and problem.
  • Person-centred, evidence and data informed improvement.
  • The political support for an approach which takes time initially, but delivers sustainable results at scale in the longer.

When we set up the ihub we were clear that the nature of the challenges we were facing meant that we needed to extend our approach from continuous improvement to one which also focused on system and service redesign. We believe that both are vital if we are to deliver the transformation of health and social care that we all aspire to and so desperately need.

Over the last year we have continued to focus on developing our redesign offer. We have some exciting developments in the pipeline for 2018-19, including a new strategic partnership with Nesta, a UK wide innovation agency.

I’m also delighted that 2017-18 saw an ongoing strengthening of our partnerships across Scotland. All our work is co-designed, co-owned and co-delivered with the aim of building local improvement capacity to meet local need. A recent count of organisations we actively worked in partnership with during 2017-18 highlighted 117 separate organisations. This takes me back to where I started, putting people at the heart of everything we do. While we are passionate about the importance of designing processes and systems that enable people to do the right thing at the right time in the right way; we recognise that relationships are the glue that holds our system together. There are amazing people in Scotland working tirelessly every day to deliver and improve our health and social care services; sometimes in very challenging circumstances. I hope the stories in this report inspire you about what is possible when we take a systematic approach to improvement that puts people at its heart.

Ruth Glassborow
Director of Improvement