Developing a co-ordinated offer and approach to system-wide transformational change within health and social care, where the transformation has potential to benefit from national support.
The National Collaborative Programme Board
The eight National NHS Boards were brought together to work collaboratively in supporting the priorities described in national, regional and local plans and, identifying where transformational change is required.
To support system wide transformational redesign across health and social care there is need for a coordinated approach, to leverage the unique skills and assets of the National NHS Boards and other key partners (such as the Care Inspectorate, Improvement Service, and third and independent sector) to makes best use of scarce resources.
Healthcare Improvement Scotland and NHS National Services Scotland were asked to work together to lead the National Board Collaboration for Transformational Redesign Project, on behalf of the National NHS Boards Collaborative. You can read the full report here.
The National Board Collaboration for Transformational Redesign Project
This work was delivered in an Agile way, over a preparation phase and three consecutive 'sprints'. To ensure a successful collaboration, and to work at pace, independent support was commissioned to help deliver the sprints.
The project started with a review of the evidence around transformational change which drew out a number of successful features, including: communicating a vision of change, distributing leadership, learning and capability, emergent change in behaviours and processes, and service user and community engagement.
- Sprint 1
Delivered an in-depth report commissioned to support this work.
Over 120 published plans, strategies and policies were reviewed, and 19 key themes identified to be addressed in the work to transform health and social care. These 19 themes are mapped against the four pillars of the Christie Commission and could provide a useful framework to support the work going forward.
- Sprint 2
Initially focused on developing a better shared understanding across the National NHS Boards on the nature and importance of the transformation challenge before further engagement with the potential ‘customers’ and/or ‘commissioners’ of support.
One-to-one stakeholder interviews were held, primarily with the national partners, focussing on:
- The offer
- The approach and methodology
- How support is accessed
- How support is funded
- The available capacity for delivery
- Where it has worked well
- Key challenges
- Sprint 3
The engagements highlighted the need to collaboratively create a collective proposition to inform and direct the model of support for system-wide transformational change.
This was drafted and developed further in a workshop attended by the Chief Executives and senior teams from the National NHS Boards and the Improvement Service and Care Inspectorate. Initial actions were agreed to progress the development of a co-ordinated model of national support for transformational redesign.
The refined and validated proposition:
Service transformation in the Scottish health and social care system could be brought into existence ‘once for Scotland’ by funding service transformation work on a recurrent basis, establishing a single means of prioritising the service transformation work and deploying capabilities, tools and approaches in a coordinated way.
Key Points Identified
For this work to progress quickly the next stage of co-design work will happen in parallel with practical prototyping.
Co-designing the model
Prototyping Collaborative Approaches
Most of the implementation challenges will be around how any model works in practice. It is proposed the following prototyping work moves forward in parallel with developing and validating the overall approach.