Since taking over from Scottish Government in 2016, Healthcare Improvement Scotland’s ihub has been responsible for allocating Continuous Quality Improvement (CQI) funds to NHS boards. Many of the boards across NHS Scotland are using the 2018/19 allocation of £1.2m to reach out into their local health and social care partnerships to meet wider needs this year.
The purpose of the allocation is to support strategic, targeted approaches to improving quality and efficiency. Despite budget pressures and cost constraints, this ring-fenced funding has been secured for this year. Feedback from boards on last year’s CQI allocation is overwhelmingly positive as the current financial climate is recognised. The flexibility in particular was welcomed as boards were able to apply the funding to new Quality Improvement (QI) approaches, bigger QI projects and engaging staff who would otherwise be unable to take part because of frontline service pressures.
The need and impact of the funding is clearly shown as boards increasingly report the establishment of systems and structures to support QI capability and capacity. These types of developments strengthen the overall QI infrastructure within Scotland’s health systems, and social care services moving forward.
NHS Ayrshire and Arran stated:
“We have lost substantive posts in recent years due to efficiency savings, but the funding has had a significant impact on the QI Team’s capacity and capability to support service/teams with quality improvement activity.”
The most common use of the allocation funds has been for various staff training and development programmes, allowing staff to take time away from normal duties to lead QI projects and activities that directly impact on current business need. Where more senior management members or Board members are involved, QI is starting to be embedded as part of the strategic planning processes, ensuring capacity and capability to develop and redesign services that deliver a sustainable quality of care.
The CQI allocation has supported a range of other improvement initiatives, some being more of an operational nature while others are aimed at improving QI infrastructure. The impact from this funding investment in 2017 resulted in improvements across NHS Scotland which includes the following:
- NHS Western Isles focused on improving delayed discharge management, and have demonstrated a reduction of 93% delayed discharges in January 2018 compared to January 2017.
- Teams across NHS Grampian are collaborating to test improvements in communities through electronic frailty approaches.
- NHS Borders have had no falls with harm in a pilot ward from May to October 2017 where QI work was implemented to improve management, and NHS Lothian invested in a primary care network where 9 out 14 quality cluster leads attended a Quality Planning Course.
- Orkney used a majority of its CQI allocation to continue investment in training and developing staffs’ QI skills. This has been applied at all levels – the workforce, the Board and the Senior Management Team.
NHS Highland has delivered training to 130 staff and said:
“We would not have managed these numbers without the HIS support.”
During feedback and evaluation from the 2017 allocation, NHS Lanarkshire commented:
“The CQI allocation allows us to invest in some of these areas, particularly building knowledge and skills in improvement science and in supporting clinical engagement in our improvement efforts. The latter is recognised as a vital component in helping to change the culture to one of a high performing organisation.”
Overall, the CQI allocation to Health Boards is a highly valued resource which all Boards recognise has supported them to improve their CQI infrastructure in the year to April 2018.