Planning for our future
Orkney strategic plan 2019/22
IMAGE: The cover shows people of different backgrounds placing their hands together in the centre. The title “Planning for our future” and subtitle “Orkney strategic plan 2019/22” appear above the Orkney Health and Care logo.
Foreword
I commenced as Chief Officer in September 2018. It has been a year that has passed very quickly. A great deal has happened and this plan focuses on plenty more that needs to be done over the next three years. The plan is meant to be overarching, with greater detail being held within service specific strategies. As strategies are developed or refreshed links will be updated.
When I commenced working as Head of Strategic Inspection with the Care Inspectorate, a colleague gave me a piece of advice. He told me to always ensure that the inspection team realised that the vast majority of people who work in health and care, come into work each day, despite whatever is going on in the own lives - to do the best job that they can, so do not step on their dreams and aspirations! This is advice that has stuck with me. I have, over the last year been really impressed with the level of passion and dedication I have seen in the ‘Orkney Workforce’. I use this term to not only identify those staff employed by NHS Orkney and Orkney Islands Council but that of our Third sector colleagues. We must also never forget our unpaid carers also.
The Strategic Plan has ‘unpaid carers’ as a priority. Recent legislation around support to unpaid carers has seen a locally developed strategy. This strategy needs to be put into action across our communities so that our carers, including young carers, get the support they require in their caring role and support to look after and nurture their own health and wellbeing.
Orkney Health and Care is endeavoring to develop different relationships with individuals and our communities. We need good conversation in order to work more closely together and develop a health and social care system in Orkney that is easy to access and navigate and keeps bureaucracy to a minimum.
Alongside this Foreword are the 9 health and well being indicators. These are indicators by which we are measured, as to how well integration is impacting positively on individuals and our communities. Orkney currently outranks every other Scottish partnership in 8 out of 9 of these indicators. However there is still room for improvement and again support to carers is one of these areas. Although we are reanked first in supporting carers to be able to continue in their caring role – there are still only 49% of carers feeling this is true for them.
I look forward to taking this plan and the strategies that sit alongside it forward. We will continue to set ourselves challenging targets moving forward because we have great ambitions for health and care needs in our communities. I am confident that with the dedication, passion and talent I have seen in our workforce that we can achieve these ambitions.
To help map out our further direction and progress, this plan will be supported by a Strategic Commissioning Implementation Plan. This plan will set out how we currently meet need, describing current service provision and spend and how we will develop services in the future working to a Community Led Support approach.
IMAGE: A portrait of Sally Shaw appears alongside the foreword, with the caption “Sally Shaw - Chief Officer” and her signature.
National Health and Wellbeing Outcomes
People are able to look after and improve their own health and wellbeing and live in good health for longer.
People, including those with disabilities or long term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community.
People who use health and social care services have positive experiences of those services, and have their dignity respected.
Health and social care services are centred on helping to maintain or improve the quality of life of people who use those services.
Health and social care services contribute to reducing health inequalities.
People who provide unpaid care are supported to look after their own health and wellbeing, including to reduce any negative impact of their caring role on their own health and well-being.
People using health and social care services are safe from harm.
People who work in health and social care services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide.
Resources are used effectively and efficiently in the provision of health and social care services.
Getting it right for Orkney
IMAGE: A rural Orkney landscape shows green fields, scattered houses, a winding road and water, with the words “Getting it right for Orkney” across the bottom.
Our Vision, Values, Approach and Priorities
Our Vision
Getting it right for Orkney
Our Values
- Person Centered
- Enabling
- Empowering
- Caring
Our Approach
- Good Conversations
- Community Led Support
- Tech Enabled
Our Priorities
- Develop Community Hubs
- Value and Support Unpaid Carers
- Mental Health
- Support to Children and Young peple
- Improve Primary Care
- Promote Self Management
- Revisit Models of Care
Key Measures
- Investment in Workforce
- Improve Mental Health Services
- A Tech First Approach
- Carers Health and Wellbeing
- Safe Self Management
- Community Focused
- Reviewed and Improved Services
IMAGE: A four-part infographic presents “Our Vision” and the closing statement “Getting it right for Orkney”. It lists the values Person Centred, Enabling, Caring and Empowering; the priorities Develop Community Hubs, Value and Support Unpaid Carers, Mental Health, Support to Children and Young peple, Improve Primary Care, Promote Self Management and Revisit Models of Care; the approaches Good Conversations, Community Led Support and Tech Enabled; and the key measures Investment in Workforce, Improve Mental Health Services, A Tech First Approach, Carers Health and Wellbeing, Safe Self Management, Community Focused and Reviewed and Improved Services.
Contents
Section 1 - Introduction
- This Strategic Plan.
- Priorities
- Our Vision and Values.
- Good Conversations.
- Public Health Priorities for Scotland.
Section 2 - Our Approach
- Community Led Support.
- Tech Enabled Care.
Section 3 - Our Services
- How we deliver services.
- What we deliver.
Section 4 - Our Strategic Aim
- Priorities.
Section 6 - How will we know we are making a difference?
Contact us
IMAGE: Two footprints in sand accompany the contents page.
Section 1 - Introduction
The Strategic Plan
This plan aims to set out the ambitions for health and social care in Orkney for those functions and services delegated to Orkney Health and Care by Orkney Islands Council and NHS Orkney. The plan however, also includes the services provided by the new Balfour Hospital and other functions that remain with NHS Orkney. We believe that this will allow us to make the most of our stretched resources and to ensure that movement in and out of the hospital setting is safe, seamless and efficient.
The plan clearly sets out the principles, values and approach, which will shape all that we do. Our focus will always be on innovation and the continual improvement of the health and wellbeing of all living in Orkney. It will also be about ensuring our activities maximise our ability to reduce health inequalities that exist in our communities.
The plan sets out our new approaches to health and social care. We need to develop different ways of working. Not only will our traditional models of support not be able to withstand the increase in demand for services but the current models are labour intensive - we will not be able to support such models with an adequate number of staff to safely operate them in the future.
We all need to ensure we take greater responsibility for our health and wellbeing. We need to work within our communities to develop this responsibility and to ensure that our communities are adequately equipped to support the needs of their individual populations.
In undertaking the activities set out in this plan and the developing Strategic Commissioning Implementation Plan, we are determined to use all available community assets and also to ensure our third sector colleagues become equal partners. Equal does not just mean sitting at the same table, it means having an equal say in how, what and when we commission, amongst other things.
We also seek to ensure that we break down hierarchy and other barriers that hinder our staff in their day to day work. We want to develop imagination, innovation and a culture where staff feel engaged, enabled and are part of a learning organisation. We see this as essential for driving forward what will be a ‘health and social care revolution’ here in Orkney!
Priorities
Developing Community Hubs
We want to change the culture and practice of community health and social work delivery so that it becomes more clearly values-driven, community focused in achieving outcomes, empowering of staff and a true partnership with local people.
Mental Health
We must prevent and treat mental health problems with the same commitment, passion and drive as we do with physical health problems. That means working to improve:
- Prevention and early intervention;
- Access to treatment, and joined up accessible services;
- The physical wellbeing of people with mental health problems;
- Rights, information use, and planning.
We have developed an Orkney Mental Health Strategy and over the next three years we will seek to ensure this is embedded throughout our communities.
Promote and Support Self Management
Self management can be described as a set of approaches which aim to enable people living with long term conditions to manage their own health and have more control over their health and their care (Scottish Government). Effective self management is key to supporting and improving outcomes for those with long term conditions.
Value and Support Unpaid Carers
The vision set out in our carers strategy is that organisations, communities and citizens work together to ensure that carers’ in Orkney are fully valued, respected and supported and that their vital contribution is recognised.
Revisit Models of Care and Support
We want to explore all service areas to assure ourselves about the quality, effectiveness, efficiency of our services. We know that if we retain the models of services that we currently have, even if every person of working age came into the sector, then by 2035 we would not have the workforce to staff these models of service. Through Community Led Support we will look at how we work with our communities to work in a different way – letting communities make better sense of how to meet need in their own communities.
Support to Children and Young People
We will look at ways to deliver the recommendations from the recent review of services to children and young people in need of care and protection. We want to move at pace to a way of supporting our children, young people and their families that is focused on prevention and early intervention. This is important to ensure children have positive childhoods and families care for their children wherever possible.
The impact of this whole system change can take 3 – 5 years to translate into noticeable change. We will know we are making a difference when our number of children and young people subject to child protection or statutory measures of care starts to decline. This shift will also reflect on the broader children’s services planning agenda and reporting with anticipated improvements being reflected in the measurement of children and young people’s wellbeing.
Improving Primary Care
Primary Care Transformation is focusing on the modernisation of primary care to deliver a safe, effective and person-centred healthcare service. This new approach focuses on multidisciplinary team working, to reduce pressures on services and ensure improved outcomes for patients with access to the right professional, at the right time, as near to home as possible.
Our Vision
Our strategic vision:
Getting it right for Orkney
Our Values
- Caring
- Person Centred
- Enabling
- Empowering
IMAGE: A page titled “Our Vision” states “Our strategic vision: Getting it right for Orkney”. A photograph shows a balanced stack of stones. Beside it, a circular diagram titled “Our Values” identifies Person Centred at the centre and Caring, Enabling and Empowering around it.
Good Conversations
Good conversations is based fully on ‘realistic medicine’. Here in Orkney we have decided to call it good conversations to promote the idea this is about health and social care.
Good conversations puts the person at the centre of any decisions being made. It ensures our staff take time to find out what is important to the person so that any health or social care support fits the persons needs and situation. Having a good conversation demonstrates that a ‘one size fits all’ approach to health and social care in not the most effective path for the individual or those providing services.
Good conversations encourage shared decision making for the individuals care and moves away from the professional being seen as the expert but more of the enabler. Staff will be equipped to discuss with the individual the type of treatment and / or support available and the benefits and the risks associated with each. They should also discuss the option of doing nothing and what the consequences of that might be. It is about giving adequate information in order that the individual can make up their own mind as to what is right for them.
IMAGE: An illustrated “Realistic Medicine” poster says: “When you’re offered tests, treatments or tablets” and “IT’S OKAY TO ASK”. It lists: “Why is this test/treatment important?”, “What are the benefits and downsides?” and “What might happen if I do nothing?” The poster includes the Realistic Medicine logo and the NHS Orkney logo.
Public Health Priorities for Scotland
In the summer of 2018, the Scottish Government and COSLA published the “Public Health Priorities for Scotland”. The principles that underpin these priorities are:
- Reducing Inequalities - tackling health inequalities is a matter of social justice. This principle should run through all public health priorities.
- Prevention and Early Intervention - preventative measures to be prioritised in order to reduce demand and lessen inequalities.
- Fairness, Equity and Equality - everyone has the right to the highest attainable health standard of health and everyone should have equal opportunity to realise this right without discrimination.
- Collaboration and Engagement - effective services must be designed and delivered with, and for, people and communities. Early and meaningful engagement across organisations and with people and communities is essential.
- Empowering People and Communities - supporting services and communities to produce the change they want to see together and co-design the services that they will use. The goal is to put people and communities at the heart of change.
These six guiding principles are aligned closely to those across health and social care services in Orkney. The six priorities that these principles underpin are also closely aligned to our aspirations for our population in Orkney, these are:
- A Scotland where we live in vibrant, healthy and safe places and communities.
- A Scotland where we flourish in our early years.
- A Scotland where we have good mental wellbeing.
- A Scotland where we reduce the use of and harm from alcohol, tobacco and other drugs.
- A Scotland where we have a sustainable inclusive economy with equality of outcomes for all.
- A Scotland where we eat well and have a healthy weight and are physically active.
It is essential that our strategic thinking is inclusive of these priorities and their guiding principles.
IMAGE: The page includes an image of five dandelion seed heads in different colours, representing diversity and the public health priorities.
Section 2 - Our Approach
Community Led Support
Working with individuals and communities will be at the heart of everything we do. We have committed to look at developing Community Led Support and have been successful in securing match funding from Scottish Government to pursue this with the support of the National Development Team for inclusion and Healthcare Improvement Scotlands Improvement Hub. This will build on the already emerging work of our Third Sector colleagues.
The principles of Community Led Support are:
- Coproduction brings people and organisations together around a shared vision.
- There has to be a culture based on trust and empowerment.
- There is a focus on communities and each will be different.
- People are treated as equals, their strengths and gifts built on.
- Bureaucracy is the absolute minimum it has to be.
- People get good advice and information that helps avoid crises.
- The system is responsive, proportionate and delivers good outcomes.
IMAGE: A Community Led Support diagram shows a Community Hub at the centre, connected by arrows to customer services, resolve and signpost, follow-up/review, plan support, home visit and enquiry-referral.
Tech Enabled Care
This strategic plan adopts fully the Scottish digital health and care strategy. This strategy looks to maximise the use of digital health and care solutions in order to reshape and improve services, support person centred care and ultimately to improve outcomes.
This approach as our primary approach to all, focuses on:
- Prevention and early intervention.
- Supported self-management.
- Day surgery as the norm.
- Discharge as soon as the individual is safe to do so.
Local examples
We already use this technology to deliver speech and language therapies via Attend Anywhere which allows patients to have appointment where they want and not dependent on attending a healthcare facility.
Patients with diabetes can also upload their blood glucose results via their home computer and discuss with their specialist nurse or doctor.
IMAGE: A graphic of interlocking blue and turquoise gears represents digital technologies and connected health and care systems.
Section 3 - Our Services
IMAGE: A service-planning diagram links Local Community Improvement Plan, Strategic Plan, Locality / Hub Plans, Medium Term Financial Plan, Strategic Commissioning Implementation Plan and Programme Boards. Logos for NHS Orkney, Orkney Health and Care and Orkney Islands Council appear above the diagram.
Links
Primary Care Improvement Plan - https://www.orkney.gov.uk/Files/Committees-and-Agendas/IJB/IJB2018/03-10-2018/I17__PCIP.pdf.
Carers Strategy - https://www.orkney.gov.uk/Files/OHAC/OHAC_Docs/Carers_Strategy.pdf.
Learning Disability Strategy - Link to be updated.
Mental Health Strategy - Link to be updated.
Medium-Term Financial Plan - https://www.orkney.gov.uk/Service-Directory/S/IJB-medium-term-financial-plan.htm.
Joint Strategic Needs Assessment - https://www.orkney.gov.uk/Files/OHAC/Joint_Strategic_Needs_Assesment_July_2016.pdf.
Housing Contribution Statement - Link to be updated.
Services delegated to Orkney Health and Care through the scheme of integration
- Adoption and Fostering.
- Adult Placement Services.
- Adult Protection and Domestic Abuse.
- Aspects of Housing Support, including aids and adaptions.
- Assessments of Offenders.
- Care Home Services.
- Carers and Support Services.
- Child Care Assessment and Care Management.
- Child Protection.
- Clinical Psychology Services.
- Community Care Assessment teams.
- Community Learning Disabilities and Social Work services for Learning Disabilities and Physical Disabilities.
- Community Mental Health Services.
- Community Physiotherapy, Speech and Language, Dietetics and OT Services.
- Continence Services.
- Day Services.
- District Nursing.
- Diversions from Prosecution and Fiscal Work Orders.
- Early Intervention.
- Family Health Services Prescribing.
- General and Public Dental Services.
- Intermediate Care Team.
- Local Area Co-ordination.
- Looked After and Accommodated Children.
- Maternity.
- Multi Agency Public Protection Arrangements.
- Occupational Therapy and Re-ablement Services, Equipment and Telecare.
- Out of Hours GP service.
- Palliative Care Services.
- Pharmaceutical Services.
- Primary Medical Services.
- School Nursing Health Visitors.
- Services provided by health professionals that aim to promote public health.
- Services to Courts and Parole Board.
- Sexual and Reproductive Health excluding hospital obstetrics/gynaecology services.
- Social Work Services for adults and older people; Children and Young People; Criminal Justice.
- Special Needs/ Additional Support.
- Substance Misuse Services and Drug and Alcohol Services.
- Supervision of Offenders Subject to a Community Based order.
- Support Services.
- Through care and Supervision of released prisoners.
- Through Care Services
- Youth Justice Services.
Hospital Services
- Accident and Emergency.
- Inpatient Hospital Services.
- Macmillan Palliative Care.
- Mental Health Service provide in a hospital.
- Ophthalmic Services.
- Resource Transfer, including Voluntary Services.
Section 4 - Our Strategic Aim
We aim to provide our communities with:
Enabling - to ensure the right support is provided at the right time in the right place for the right reason. We need to ensure that it is easy for all to navigate through what can be a complex health and social care system at present.
Prevention and Early intervention - it is clearly understood by all that if we invest in prevention and early intervention initiatives then this helps to stop crisis, which is generally labour intensive and can have long lasting impacts on both physical and mental health. To ensure that we can develop a suite of prevention and early intervention approaches we must identify barriers to change. Such interventions need to address both physical and mental health. We need to work in full collaboration with all stakeholders across all of our communities to develop a culture that adopts a positive, non-stigmatised approach to areas such as alcohol and drug addiction and mental health.
We have committed to develop a local Mental Health Strategy, which will adopt the principles and aims of the national 10 year strategy but in a manner that makes sense for Orkney and its communities. We will find ways to strengthen mental health support to our children and young people in order that they develop into adulthood with good mental health, that allows them to live well, as part of their wider strong community and contribute to our vibrant economic community.
Resilience - unless we find ways of supporting individuals and communities to cope and where possible overcome the impacts of their health and social care needs, then we will continue to see a rise in the demand for services. We need to work in close collaboration with all our partners to find innovative ways of achieving this.
IMAGE: A silhouette of a person forms a heart shape with their raised arms around the setting sun, illustrating resilience, wellbeing and community.
Section 5 - How will we know we are making a difference?
Orkney is recognised as being the best place to live in the UK - we will ensure that our health and social care services will be a main factor in this recognition, thus sustaining the accolade.
Orkney Health and Care will be nationally recognised as an exemplar of innovative integrated practice.
We will ensure all that we do is about maximising positive outcomes for individuals and our communities.
Our annual performance report will clearly evidence how we are achieving our objectives.
- Community hubs will be developed to become centres of excellence.
- All contracts will be reviewed and smart SLAs¹ developed.
- All staff trained and confident in good conversations.
- Mental health support provided within a suite of quality settings.
- Technology is a primary approach to support.
- Carers remain well and are able to continue in their vital role.
- A suite of forums to support self management of LTC² will be developed.
¹ Service Level Agreements
² Long Term Conditions
Contact us
If you would like to contact us about this plan or require a different format please use the details below:
Email: OHACfeedback@orkney.gov.uk
Telephone: 01856 873535
Orkney Health and Care,
School Place,
Kirkwall,
Orkney,
KW15 1NY
IMAGE: A silhouetted person jumps near the sea at sunset, illustrating wellbeing, freedom and positive outcomes.
© 2019 Orkney Health and Care
IMAGE: The final page includes a small photograph of people placing their hands together and a QR code. The copyright statement reads “© 2019 Orkney Health and Care”.