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TERMS OF REFERENCE/ SCOPE
1. The White Paper "Partnership for Care" set out
Scottish Ministers' aims and ambitions for healthcare services
across the NHS in Scotland. These include a commitment to
safe, high quality, sustainable patient-centred care delivered
close to the patient wherever possible and in appropriate,
modern specialist facilities when necessary. These themes
are supported by increased public investment in the NHS over
the years of the current Spending Review (to 2005-06).
2. The Scottish Executive is responsible for ensuring that
a clear framework is in place for health policy, planning
and resources. This framework must be kept up to date as public
needs and expectations develop and as the capacity of the
NHS to provide modern diagnosis and treatment changes.
3. Against this background, and in order to take forward the
themes contained in "Partnership for Care" about
partnership, integration and redesign, we will undertake a
national planning exercise to;
- explore and advise on strategies to secure a sustainable
configuration of health services in Scotland for the long
term;
- recommend how sustainability might be supported and enhanced
through improved integration of care services; and
- report to Ministers by March 2005.
4. The national planning exercise will support the reform
of the NHS in Scotland by providing a national context for
it. It will draw on a set of values underpinning the modernisation
of health services;
- providing services in a consistent and equitable manner
across the whole of Scotland,
- ensuring that the patient is at the centre of change,
so that they get the treatment they require, when and where
they need it,
- removing barriers from the patient's pathway of care,
and
- working in partnership with patients, staff and other
stakeholders.
5. The aim of the work will be to describe and promote a
number of models that might support sustainable healthcare
services in Scotland. It will consider and make recommendations
on the options for re-configuring and redesigning the NHS.
In particular, it will seek to identify those elements of
healthcare that are most effectively delivered at the national,
regional and local levels and set out what needs to be done
to deliver this strategic framework.
6. The objectives underlying the exercise are as follows;
- to provide a framework for work underway or about to get
underway throughout the NHS on re-configuration and redesign
as a means to ensure coherence across the service,
- to promote opportunities for local access to services
and balance local delivery with the need to have centres of
excellence providing high quality, modern, specialist care,
- to identify exemplars and best practice that can help
shape the future of healthcare in Scotland,
- to bring together proposals for re-configuration and redesign
with current thinking on redefining the roles and responsibilities
of the various players,
and
- to facilitate re-configuration through alternative means
of funding and resource allocation.
7. In delivering the terms of reference, the national planning
exercise will consider and take account of:
- demographic changes and their impact on service demand
- epidemiological trend
- changing public expectations of healthcare
- health inequalities and other social factors
- impacts of key Ministerial objectives and targets such
as those to further reduce waiting times
- the relationships and boundaries between healthcare and
community care
- recent and current developments in the way in which health
services are provided in Scotland and elsewhere
- developments in diagnostic and treatment practice (for
both scheduled and unscheduled care)
- changes in the provision of support services or shared
services
- developments in setting clinical standards
- developments in medical and related technology
- current initiatives with regard to the regional planning
of health services
- the availability of resources, and
- staffing and workforce issues - e.g. the European Working
Time Directive, pay modernisation for doctors and other
staff, changes in the training and deployment of junior
doctors, new roles, career development, team working and
the scope for further flexibilities in staffing,
8. The work described above will form the basis for a report
to Ministers that will provide a strategic overview of the
future shape of the NHS in Scotland. The report will enable
a clearer definition of the level at which services should
be planned, a range of illustrative examples of how services
should be provided at and across each level and some practical
guidance to Boards on what needs to be done.
9. The exercise will be steered by an Advisory Group representing
all NHSScotland stakeholders. It will be carried out by a
team from the Scottish Executive Health Department who will
draw on expertise from across the health service and from
local authorities. There will be engagement with the public
and with community partners. The Scottish Parliament will
be kept informed of progress and will be given the opportunity
to input.
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