WHAT IS SHIFTING THE BALANCE OF CARE?
Shifting the Balance of Care (SBC) is a strategic objective for the Scottish Government, NHS and Local Authorities. Demographic pressures (particularly the projected rise in the number of older people); workforce issues; the need to improve health and social care outcomes, and the increasing cost of institutional care means that current patterns of care delivery are not sustainable.
SBC describes changes at different levels across health and social care – all of which are intended to bring about better outcomes for people, providing services which reduce inequalities, promote independence and are quicker, more personal and closer to home. This means we need to develop clinical and care pathways that may involve shifting location, shifting responsibility; shifting care and preventing or delaying more intensive and expensive interventions. These three components are not mutually exclusive.
· Shifting the focus of care onto prevention – by increasing the rate of health improvement particularly in deprived communities by anticipating and addressing the need for care at an earlier stage; changing the emphasis from services focused on acute conditions towards systematic and personalised support for people with long term conditions; developing continuous, integrated care rather than disconnected episodic care. This means identifying individuals earlier who might benefit from interventions that might sustain their independence and avoid/delay adverse events or illness.
· Shifting who delivers care – providing more care and treatment in the community, requiring professionals and staff to develop their skills, expertise and roles. This means moving away from the “independence” of individual practices and professionals towards extending primary and community care teams, which make better use of general and specialist expertise. This requires partnership working between organisations and professionals, and agreement on outcomes and care pathways delivered by community based multi agency teams. It means shifting our view of individuals as passive recipients of care towards full partners in improving their health and managing their conditions.
· Shifting the location of care – by improving access to care and treatment through changes in the location of services; providing a wider range of diagnosis and specialist services in communities and maximising the use of new technologies. Here we expect to see some changes in clinical and hospital based activity as we develop the community infrastructure, information systems and workforce capacity.
Short life SBC Clinical Pathway Groups were established for:-
This pathway work is now complete and work documents prepared.
Shifts were also identified in orthopaedics and dermatology and has been documented.
For more information contact
Brenda McFall, Service Development & Redesign Manager
Contact Brenda McFall online