Chamber and committees

The Centre for Sustainable Delivery (CfSD) has developed strong clinically-led Specialty Delivery Groups (SDG) which promote multidisciplinary team working and support local adoption of service improvement programmes.

This includes the Cataract Sub-Specialty Delivery Group which brings together key ophthalmology clinical, operational and managerial experts from across NHS Scotland and Scottish Government which has been commissioned to support an increase in surgical throughout across cataract only surgical sessions. This short life working group has supported several new and innovative pathway developments, some of which are now being successfully scaled up in a number of sites across hospital eye services, including: high volume cataract surgery in ring-fenced sessions, and delivering one cataract every 30 mins, as per Royal College of Ophthalmologists’ guidelines.

In tandem with this, The National Eyecare Workstream is undertaking clinically led peer reviews which supports new and efficient ways of working and shares best practices across the country across a number of ocular sub-specialties, including cataracts.

Additionally, the national Trauma and Orthopaedic (T&O) planned care team based within the Centre for Sustainable Delivery (CfSD) are responsible for supporting both scheduled (elective) and unscheduled (emergency) orthopaedic service delivery through implementation of sustainable improvements in Scotland.

The orthopaedic services specialty delivery group is multidisciplinary and clinically led to design, develop and implement consensus driven national clinical pathways with focus on high impact opportunities in outpatient management (active clinical triage and patient initiated review), enhanced recovery and same day arthroplasty and also hip fracture standards of care, whilst reducing unwarranted variation. The National T&O team supports delivery of clinically led peer reviews for Health Boards across Scotland, with the cycle repeating every 3 years. These clinically led peer reviews were initiated from the innovative “Getting It Right First Time (GIRFT)” programme. This programme has been highly successful at leading change, reducing variation, improving clinical pathways as well as significantly reducing costs predominantly through reduction in length of stay and improved procurement.

In conjunction with Public Health Scotland (PHS), the T&O team also supports national audits namely the Scottish Hip Fracture Audit and Scottish Arthroplasty Project. These cost effective audits drive continuous improvements through research, standards of care and by a formal governance programme to monitor outcomes. Annual reports are produced for public information.

Furthermore, as part of our wider work to deliver sustained recovery of our Urgent Care services a whole system improvement approach has been adopted. We are working with local teams through the Urgent and Unscheduled Care Collaborative Programme to develop improvement plans which contain actions for the short and medium term focusing across 5 key areas.

This programme of improvement activity is being driven forward by the Centre for Sustainable Delivery (CfSD), which we have commissioned to support Health Boards implement a range of measures to reduce A&E waiting times and improve patient and staff experience.

Some Health Boards have already started to report improvements. These include:

• Improving urgent care pathways in the community and improving links across the primary and secondary care interface.
• Ensuring patients receive the right care in the right place by optimising Flow Navigation Centres and increasing the routes for professional to professional advice and guidance, signposting and scheduling of appointments to A&E where possible.
• Improving access to Hospital at Home services by supporting Boards and partnerships to adopt evidence-based best practice.
• Optimising assessment and care in our Emergency Departments by improving access to ‘same day’ services, the use of early and effective triage, rapid decision-making and streaming to assessment areas.
• Reducing the time people need to spend in hospital by promoting early and effective discharge planning and robust and responsive operational management.