About the Project

Every year in the UK there is a significant increase in demand for health and social care services over the winter. Every year the system prepares for the bulge in demand, manages to cope, and then reviews lessons learned to improve the system for the following winter.

But there is a growing realisation that this routine is approaching its limits. There is little left to squeeze out of the system in terms of efficiency or productivity gains - and the threat of swine flu this winter increased fears that this time the system would not be able to cope. We are reaching the limits of a strategy that concentrates exclusively on getting more out of the existing system. We need at the same time to start investing in a better system, more likely to be viable in the longer term.

This is the challenge of redesigning the plane whilst flying it. We must invest in keeping the existing system going, meeting the bulge in demand this winter. But at the same time we need to start some alternative practice that holds the promise of greater viability in the future.

In August and September 2009 a group of partners led by NHS Fife and with funding from the Scottish Government came together 'To challenge our thinking and give ourselves some longer term strategies for dealing with the limits to the capacity of our current health and social care system.'

The workshop identified a number of innovation pathways that might help manage the transition from today's overloaded system to a more viable future system over time whilst maintaining quality and effectiveness throughout. For more detail see the full report available for download below.

The 13 promising pathways identified at the workshop were reduced to six priorities as follows:

1. Invest in our strategic intent by:
   • Aligning long-term investments with our aspiration and
   • Bending resources towards the most promising pathways
2. Evolve technology with a human face
3. Grow the workforce to support and participate in the new system
4. Grown up conversations - about living and dying, about love, care and compassion, about human limits and human potential
5. Focus on person/patient experience as our most powerful learning tool
6. Nurture community and relationships recognising most recovery from illness and longer-term care take place at home, with family, friends and neighbours to help.

Partners

NHS Fife,

Scottish Government Health Improvement Support Team,

NHS Education Scotland,

Scottish Government Joint Improvement Team

Southcentral Foundation, Alaska

Last updated: 17 Apr 2013

Status

With initial guidance from IFF, a subset of members of the group have now established an action learning set meeting monthly to support a range of initiatives putting the promising pathways identified in the workshop into practice. This work is supported by NHS Education Scotland. It was presented at an Institute of Healthcare Managers conference in October 2010: the summary poster is available for download below.

In addition NHS Fife hosted a very successful visit from South Central Foundation (SCF), Alaska in June 2010 in order to share experiences in transformative approaches to health and social care. Fife was selected as host by the Scottish Government partly as a result of interest in this novel approach to health and social care planning. The visit was supported by Scottish Government's Joint Improvement Team.  The visit has stimulated a growing interest in the theory and practice of the 'Nuka' model of care in Fife and more widely in Scotland - as a response to the presssures on our existing NHS systems.

Documents for download

Click on the documents below to download them to your hard disk.

Project Summary Poster - for IHM Conference

A summary of the project to October 2010 for the Institute of Health Management conference

Date: 01 Oct 2010  Size: 734kB

Three Horizons of Winter Planning in Fife

Short report of a workshop and subsequent analysis/ action planning to design promising initiatives to tackle the winter bulge in demand for health and social care in Fife.

Date: 07 Jun 2010  Size: 333kB