Clinical Strategy • Questions and Answers

1.   What is a Clinical Strategy?
2.   Has NHS Western Isles ever had one before?
3.   Why do we need a Clinical Strategy now?
4.   How does this tie in with the Board’s current financial position?
5.   Is this just a way of reducing services to save money?
6.   What will it mean for the current staff, and how will it affect health service jobs?
7.   How long will it take to develop, and when will we see any change in services?
8.   If this is about improving patient care, why hasn’t the Board done this before now?
9.   We have already gone through Service Redesign and a Clinical Strategy process last year – why are we doing it again?
10.  Who will be able to influence what goes into the Clinical Strategy?
11.  How can I get involved?
12.  What will the Clinical Strategy say?
13.  Will this impact on patient care and choice?
14.  Will this result in a reduction in hospital services, and more care in the community?
15.  What if the local community is unhappy with what the Strategy says?

Q. What is a Clinical Strategy?

A. The Clinical Strategy will set out the strategic direction for NHS Western Isles and the range of clinical services to be provided to meet the existing and future needs of the population.

Q. Has NHS Western Isles ever had one before?

A. This is the first time we have developed a Health Board wide Clinical Strategy.

Q. Why do we need a Clinical Strategy now?

A. Healthcare systems don’t just happen – they have to be designed and planned. The Board needs to continually improve the health of the population and healthcare services we provide to ensure they meet the needs of the population we serve. The population of the Western Isles is changing and so will the health needs. In addition to this:

• We need to ensure that we meet the Scottish Government’s aims for health and healthcare throughout the country;
• We have challenges in relation to an ageing population and workforce, with fewer younger people to take over certain health service roles;
• There are services currently provided on the mainland that we may be able to provide locally in the future;
• Similarly some of the services currently provided here may be more safely and effectively provided elsewhere.

Q. How does this tie in with the Board’s current financial position?

It is well known that NHS Western Isles has faced financial difficulties for the past few years. However, even without a deficit, we would require a Clinical Strategy - because we need to have a clear plan for the future. The aim of the Clinical Strategy is to improve the health of the people of the Western Isles and to ensure that the services we provide are safe, effective, sustainable and affordable.

Q. Is this just a way of reducing services to save money?

A .No. It is about making sure that every pound that comes into this Health Board is used to get the best value we possibly can, and to ensure the services we deliver meet the needs of our population.

Q. What will it mean for the current staff, and how will it affect health service jobs?

A. Staff will have a clear ‘direction’ and a plan for how they can contribute to improving patient care and services—i.e. making the Strategy a reality. As plans for individual services or specialties develop, these will include the details on what staff are required, at what bands, and what their roles and responsibilities will be. In the case of some of those services, where changes are occurring, there will be opportunities for staff to take on different roles or responsibilities. NHS Western Isles has a policy of 'No Compulsory Redundancies' and therefore no one will lose their employment as a consequence of the development of a Clinical Strategy.

Q. How long will it take to develop, and when will we see any change in services?

A. By the end of the summer, the aim is that the Board will have developed a Clinical Strategy, including options for service delivery. This will then be subject to Independent Scrutiny. Following that process, we would then go out for full public consultation from September to December. It is hoped that by February 2009 we would have an agreed Clinical Strategy and way forward. Services are constantly changing to respond to need anyway, and will continue to change, develop and improve. Major clinical change will not take place until we have an agreed Clinical Strategy. A detailed plan of the Clinical Strategy timescales are on the Clinical Strategy website.

Q. If this is about improving patient care, why hasn’t the Board done this before now?

A. The Board has been continually improving patient care through a variety of local and national initiatives, but recognises the importance of having one overarching strategy.

Q. We have already gone through Service Redesign and a Clinical Strategy process last year – why are we doing it again?

A. The process to develop a Clinical Strategy for the next three to five years started last year and the current work is a continuation of that process. There had been, previously, a Service Redesign process which generated a number of excellent ideas and potential models of care, but was not set against a clear Clinical Strategy which set out an agreed direction for NHS Western Isles. However, the extensive work undertaken will be taken on board as we develop our Clinical Strategy.

Q. Who will be able to influence what goes into the Clinical Strategy?

A. All staff, GPs and the public will be able to directly influence the thinking, debate and decisions, along with partners such as Comhairle nan Eilean Siar and voluntary agencies.

Q. How can I get involved?

A. Many people have already contributed to the process through a number of consultation meetings – however you can still get involved in a number of ways:

• Through future stakeholder and consultation events;
• By joining the People’s Health Network (contact Janet MacSween on 01851 708020);
• By posting comments on the website www.seurbeatha.org by emailing comments to Clinical.Strategy@wihb.scot.nhs.uk or contacting Stephen Moore on 01851 708160;
• Through the Clinical Reference Group.

Q. What will the Clinical Strategy say?

A. We don’t know yet. No-one knows best and no-one has all the answers – so what we need is a synthesis of ideas from everyone involved. It will be patient focussed, evidence based, maximise the use of technology and provide value for money.

Q. Will this impact on patient care and choice?

A. The overall aim will be to improve patient care as far as possible. The element of patient choice is an important matter which will be discussed and addressed during the process.

Q. Will this result in a reduction in hospital services, and more care in the community?

A. The decision on where services can be most safely and effectively provided will be a matter that will be carefully considered during this process. However, the government policy of providing services closer to home wherever possible will also be a main driver for the Strategy.

Q. What if the local community is unhappy with what the Strategy says?

A. After options are identified, there will be a full public consultation process, before any final decisions are made – so everyone will be given an opportunity to have their say.