Podcast: Target Culture – Measuring success?

Across the UK, the NHS, in particular, has often been accused of using “external stimuli such as targets” when attempting to make significant change.

Recently, the Health and Social Care Academy of the Health and Social Care Alliance Scotland (the ALLIANCE) and The Royal College of Nursing Scotland hosted a round table debate on changing our targets culture.

Following the event the ALLIANCE and RCN Scotland wrote to Shona Robison MSP, the Cabinet Secretary for Health, Wellbeing and Sport, about targets and a Scottish Government review to be led by Sir Harry Burns.

In the latest Academy podcast we hear from Hugh Henry, a former Scottish Executive Minister and MSP, on the challenges of a “target culture” and what we need to do to create a culture that enables change.

We need to talk about targets – Audrey Birt

As part of the portfolio of work I do, I’m proud to be the Associate Director for the Health and Social Care Academy, a programme of the Health and Social Care Alliance. The Academy’s particular purpose is to “drive transformational change in health and social care in Scotland through the lens of lived experience” a focus I strongly believe is a key component of transforming care.

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Making decisions for the long term

Decisions are made to shape health care for generations to come, rather than focussing on short-term goals.

That’s one of the five things which RCN Scotland’s 2016 manifesto Nursing Scotland’s Future: Professional voices, practical solutions asks those standing for election on 5th May to commit to.

Candidates from all parties have added their name to the Nursing Scotland’s Future campaign, but as polling day draws closer, the question is: how far will the next Parliament go to ensure that Scotland’s healthcare services are fit for the future?

Because if there is a genuine will to transform Scotland’s health and healthcare services, tinkering around the edges will not cut it. There needs to be a new definition of success in health, and ensuring that patients’ longer-term outcomes take centre stage is a good place to start.

Last year, for the first time, RCN Scotland and the Academy of Medical Royal Colleges and Faculties in Scotland spoke with a single voice on the urgent need to ensure the future sustainability of the NHS.  One of the arguments RCN put forward was that targets – and other measures that shape priorities in our health and care services – need an urgent overhaul. Why? Because RCN believes that success should mean better outcomes for patients, and the sustainable improvement of services.  And current targets don’t work like that.

In the past, targets have improved care in the NHS, but what we see and hear from our members is that those same targets are now leading to waste and skewed priorities. When funding is tight and demand is growing, Scotland’s services simply can’t afford to keep working in the same way.

RCN wants the focus to move away from looking at numbers and processes and instead concentrate on sustainable services which deliver better outcomes for patients.

But it’s difficult to know how exactly success should be measured. That’s why this year RCN asked six leading thinkers in Scotland to answer the question ‘If Scotland’s current framework of NHS targets has had its day, what next?’ The responses were all unique and thoughtful.

Lisa Curtice from the ALLIANCE, for example, said we need to radically reimagine Scotland’s health and social care services to focus on relationships, assets and personal outcomes, trusting “that the whole will be bigger than the sum of the parts, that the only outcome that counts is whether the person’s wellbeing is enhanced or maintained”. She also said “that no one discipline or service has all the answers.”

With Lisa’s words in mind, RCN has been out speaking to colleagues from across health and social care – NHS, local authorities and the third and independent sectors. The views, knowledge and experiences that people have shared are now helping to shape RCN’s views on targets and how Scotland can better define, measure and invest in success.

In June, shortly after Scotland’s Parliament sits again and as the Government cogs begin to turn, RCN will set out some principles which could shape the future of targets. That work will hopefully find some common ground amongst health and social care colleagues, as well as with the public and politicians, so that Scotland can adopt a new approach to targets – one which will genuinely, and sustainably, improve the health and wellbeing of people and communities across the country.

Publication: Target Culture Case Study

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Target Culture: ‘Statist Individualism’ in the Nordic Countries

Today’s case study takes a more global view of our Five Provocations. The Target Culture provocation has a double meaning: firstly it calls for a rethink of the way targets are used in our health and social care services and secondly it calls for a cultural shift towards everyone taking responsibility for their health and wellbeing. This case study focusses on the second aspect, looking at what it is about Nordic culture that results in their populations having such high levels of health and wellbeing.

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Publication: Five Provocations for the Future of Health and Social Care

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Following the Academy’s inaugural Think Tank in October 2015, we are pleased to be able to launch our latest publication, Five Provocations for the Future of Health and Social Care. This paper explores each of the themes that emerged from the Think Tank and provides context and a narrative for how change in each of these areas could transform health and social care in Scotland. These provocations will shape the Academy’s future work, as we aim to incite conversation, debate, new ideas and action around these themes. Read More “Publication: Five Provocations for the Future of Health and Social Care”

Report on the Buurtzorg Model of Health and Social Care

The Health and Social Care Academy is delighted to be able to share this Report on the Buurtzorg Model of Health and Social Care. The Buurtzorg Model is an innovative model of care provision pioneered by former community nurse and manager Jos de Blok, which now provides care to 70,000 individuals in the Netherlands.

It is a truly person centred form of care, based on fostering human connections and supporting the individual to flourish within their community. It has also minimised bureaucracy and maximised trust and thereby the quality of care provided.

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