Making better decisions on public health spending: A Scottish perspective Neil Craig NHS Health Scotland Making better decisions on public health spending: Getting to grips with value for money The King’s Fund 18 th September 2014
Outline • The context for public health spending in Scotland? • The role of NHSHS • The wider health system • How are these arrangements working in practice? • Looking ahead
Context • Improving health…. • …. . but persistent and widening health inequalities • Financial pressures • Emphasis on prevention
What is NHS Health Scotland? • • NHS Special Health Board Role: national agency for health improvement Priority: reducing health inequalities Aim: to improve Scotland’s overall health record by focusing on the persistent inequalities that prevent health being improved for all
Local delivery…. . • Delivered by Community Planning Partners • Configured in Community Planning Partnerships • Expressed in Single Outcome Agreements
…… National direction • Directed by Scottish Government through - statement of ambition and community planning guidance - National Community Planning Group - broad priorities
Priorities - strategic • Faster shift to prevention • More joint resourcing • Co-production and assets-based approaches
Priorities - specific • Early Years • Outcomes for Older People (including health and social care) • Safer Communities and Offending • Health Inequalities (including physical activity opportunities) • Economic Growth and Recovery • Employment (especially youth employment)
In practice? • Community planning: a work in progress • National steer vs local freedoms: is the balance right? • Multiple objectives of prevention: - are they shared? - are they mutually compatible?
Cost-effective/VFM Potential savings from reduced ‘failure demand’ Likely to reduce health inequalities
Building relationships • With SGs, CPPs and 3 rd sector • With COSLA e. g. through an Inequalities Action Group • Through a knowledge-into-action strategy • Through a SG-sponsored Health Economics Network for Scotland => Early days
Themes • Balance between central guidance and local autonomy? • Local implications of national (or international) evidence? • Complexity vs accessibility “Tell us, clearly, what the evidence says we should be doing but don’t tell us what to do…. . ”
Скачать презентацию Making better decisions on public health spending A
eacdc3bf861bb0beea69b4997cae9740.ppt