Health Improvement Performance Management for the National Health Service in Scotland
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1 Health Improvement Performance Management for the National Health Service in Scotland Julia Murphy Policy Evaluation and Appraisal NHS Health Scotland
2 Health Improvement Performance Management Review Aims Develop a performance framework for health improvement that focuses on the results (outcomes) of service delivery Focus on priority outcomes for health improvement Identifying the unique contributions of different sectors to high level national outcomes, and contributions that need to be delivered in partnership Align performance management of short-term outcomes of service delivery with high-level national outcomes
3 Scottish Government Outcomes Model External Outcomes Outcomes Outcomes LONG-TERM HIGH LEVEL OUTCOMES Tie-in with SG strategic objectives INTERMEDIATE OUTCOMES Tie in with objectives of services or programmes SHORT-TERM OUTCOMES The immediate benefits and changes resulting from service delivery Outputs Processes Inputs
4 What do we mean by an Outcomes Approach? Results chain 5 CROSS GOVT STRATEGIC OBJECTIVES High level Outcomes Long term or final consequences e.g. reduced alcohol-related hospital admissions Intermediate Outcomes Objectives of a programme/strategy e.g. Reduced consumption of alcohol Short-term Outcomes The benefits & changes resulting from the outputs Eg increased awareness & reflection on drinking behaviour; increased referrals for treatment Outputs The goods & services delivered Eg brief interventions in primary care with those drinking excessively Processes What the service/programme has to do to deliver outputs e.g. Work with primary care to develop capacity to deliver Inputs The resources needed to run a service or programme including partner inputs Eg govt investment in brief interventions
5 Healthier Scotland to help people sustain and improve their health, esp. in disadvantaged communities ensuring better, local and faster access to health care. Well-being Public Reporting National Performance Framework Performance management Population health Health inequalities Individual behaviours Social, economic, and physical environments Outcomes related to service delivery LONG-TERM HIGH LEVEL OUTCOMES INTERMEDIATE OUTCOMES SHORT-TERM OUTCOMES Outputs Processes Inputs
6 Principles Performance management ideally at the level of short-term outcomes (more) directly under partners influence Focus PM on areas where there is a strong evidence pathway between service/intervention delivery and longer-term HI priority outcomes NHS targets relating to NHS contributions Alongside indicators for Community Planning Partners that reflect partners complementary contributions as part of a whole system
7 Agreed Priority Outcome Areas Inequalities and health Mental wellbeing Smoking Alcohol Obesity Early years
8 NHS Review The most effective NHS contributions to these priority outcomes Revised NHS health improvement targets Year 1: Tobacco Alcohol Early Years Healthy Weight Year 2: CHD Mental health Oral Health
9 Tobacco Reduced burden of disease, disability and premature death due to tobacco Life expectancy Inequalities in HLE <75s CHD mort. in deprived areas Smoking-related deaths Deaths from CHD and cancer HIGH LEVEL OUTCOMES Reduced adult smoking rates - Reduced uptake of smoking by young people INTERMEDIATE OUTCOMES Social norms Accessibility of tobacco (YP) Smoke-free environments Access to SC services Outcomes related to service delivery SHORT-TERM OUTCOMES
10 Tobacco National indicators Long term Outcomes Life expectancy and reduced inequalities in HLE Reduced inequalities in CHD mortality Reduced tobacco-related morbidity and mortality Deaths from CHD and cancer Intermediate Outcomes Reduce the proportion of the adult population who smoke new HEAT target Short-term Outcomes 8% of Boards smoking population quit at 1 month by Reach (target population) Smokers who want to quit (key sub-groups) Outputs Smoking cessation services Processes What the NHS has to do to deliver effective SC services in key settings Inputs Budget, trained workforce and data needed to run and monitor smoking cessation services
11 Questions?
12 Health Improvement Performance Management for the National Health Service in Scotland Julia Murphy Policy Evaluation and Appraisal NHS Health Scotland
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