Date lodged: 18 December 2017
To ask the Scottish Government how many visits to Scotland by non-UK resident personnel it has funded regarding matters related to the NHS in each of the last three years, and how much it spent on each.
Answered by: Shona Robison 18 January 2018
The Scottish Government has a strategic partnership with the Institute for Healthcare Improvement (IHI) based in the USA and, periodically, representatives from IHI visit Scotland. This framework contract covers all public services in Scotland, not restricted to the NHS, and relates to quality improvement work.
While some of the IHI work could be considered non-clinical consultancy work, some costs cannot be easily disaggregated to give an accurate picture of those related solely to the NHS. Where it is possible to disaggregate, the amount spent on non-UK resident personnel visiting Scotland under the IHI contract to help with purely NHS work over each of the last three years is £0 in 2015, £18,867.21 in 2016 and an estimated £63,825.83 in 2017 (the invoice for the final quarter of 2017 is yet to be received). This includes staff time and other costs.
Secondly, the Scottish Government funds a Framework Agreement with the Institute for Healthcare Optimization (IHO), based in the USA. The main objective of the programme is to improve the quality of clinical care by supporting Scottish clinical teams and, through that, the transfer of skills from IHO to NHS Scotland; extending knowledge and skills in NHS Scotland and tapering-off dependence on IHO’s skills and experience.
The majority of the work is delivered virtually, with extensive use of web-enabled communications. The programme has scheduled seven visits over the three year period stipulated, in order to provide additional educational input and to visit clinical units to understand systems and issues at first hand.
It is estimated that this initiative has saved around £2.8 million per annum in the four pilot boards, and has potentially avoided substantial capital spend. These include creating capacity for an additional 1,072 patient admissions, alongside opportunities to increase elective admissions further by about 2,100 per year without adding resources.
This has also increased compliance with the maximum clinically acceptable wait for unscheduled surgery, from around 85 per cent to over 95 per cent, with more patients moving timeously from receiving units to inpatient wards and fewer patients being asked to come to hospital the day before planned surgery.
The Scottish Government is keen to extend the clinical benefits of this work across NHS Scotland.
The costs relating to visits associated with the initiative are as follows: 2015, £27,492; 2016, £38,471; and 2017, £26,224 (2017 estimated, as invoices are yet to be received).
Thirdly, in 2017 an External Expert Panel was established in order to play a key role in advising the Scottish Government and the Strategic Oversight Group for the development of the Scottish Digital Health and Care Strategy on how digital technology can support Scotland’s aim for high quality health and social care services. The purpose of the Panel was to help ensure that a broad knowledge and evidence base was taken into account in the development of the Strategy.
In June 2017, the Panel’s chair visited the Scottish Government to plan work in more detail. Meetings were held with Ministers, and visits were made to a General Practice in Edinburgh and to the Royal Hospital for Sick Children in Edinburgh. This was in order to see at first hand the use of different types of technology and discuss the priorities of staff.
The Panel met seven times by video conference between April and December 2017. However, all Panel members were invited to (although not all were able to attend) a two day face-to-face meeting in Edinburgh, in September 2017, to discuss the Panel’s interim report with the Cabinet Secretary for Health and Sport, senior leads from the Scottish Government and wider stakeholders.
The Panel made its draft final recommendations to the Scottish Government in December 2017.
The costs, to date, for the visits associated with the Panel amount to £6,770.02. However, expenses claims for two panel members attending the September meeting are yet to be received and processed.