Introduction
The increasing number of people with long term conditions presents a major challenge for health and social care services and for society. The Long Term Conditions Collaborative ( LTCC) is supporting delivery of sustainable improvements in patient centred services for people living with long term conditions. These improvements are crucial for timely, safe, effective and efficient services and to deliver Better Health, Better Care in Scotland.
The Collaborative supports improvement in clinical systems ( CSI). This approach was originally developed for use in manufacturing and service industries. Its success at improving productivity over many years has led to it being adopted by health care systems internationally. CSI techniques can be applied to improve health outcomes, reduce delays and remove waste by targeting activities which don't add value to patient care. CSI encompasses generic improvement methodology, such as PDSA cycles, lean-thinking, theory of constraints, as well as context specific improvement knowledge to reduce mortality, improve flows, and increase productivity throughout the system. Patients will benefit from receiving better care, with fewer delays and improved reliability.
A key aim of the Long Term Conditions Collaborative is to support NHS Boards and their partners to develop and sustain local capability for continuous quality improvement. The Improvement and Support Team Toolkit, Skills for Improvement Training, and Masterclasses have been developed with this in mind.
Development
We ( LTCC) have developed a set of clear and tangible improvements that we expect to make a big impact on the way people with long term conditions manage their own care and experience the care provided by others. We are calling these High Impact Changes ( HIC). These high impact changes are generic and apply across the long term conditions pathway from diagnosis through living for today, change in condition and transitions of care to end of life care.
Each HIC is made up of a bundle of Improvement Actions, all of which need to be implemented to successfully deliver the High Impact Change. The improvement actions are based on changes that have been tried and tested by health and social care practitioners in the UK and beyond and reflect what patients have said should be done to improve their experience of living with a long term condition. They give some solutions to what can seem like a complex and overwhelming challenge.
This set of HICs is not exhaustive and we will review it throughout the three year programme. Lessons emerging from within the Collaborative, experience of patients and service users and new evidence from elsewhere will be used to update the HICs.