We need to increase the pace and scale of transformation in health and care, says Cabinet Secretary

Jeane Freeman, Cabinet Secretary for Health & Sport, joined a panel discussion at Digital Health & Care Festival 2019 in Glasgow

The pace and scale of digital transformation and integration for health and care services in Scotland needs to be increased, the Cabinet Secretary for Health & Sport said today.

Jeane Freeman, who was addressing delegates at the two-day Digital Health & Care Festival in Glasgow, said she wanted to see a “bit less of sharing good practice and a bit more implementing good practice” when it comes to integrating health and social care services.

Ms Freeman joined a panel discussion at the conference at the University of Strathclyde’s Technology & Innovation Centre; she was speaking alongside Cllr Stuart Currie, COSLA spokesperson for health and care in a discussion that was chaired by Malcolm Wright, Director General, Health & Social Care, Scottish Government and Chief Executive, NHS Scotland, and Annie Gunnar Logan, Director, Coaltion of Care and Support Providers (CCSP) in Scotland.

In a response to a question from Annie Gunnar Logan, who asked how can the pace and scale of transformation be balanced against the needs of individuals who often ‘need time’, reflecting on an earlier point made by Malcolm Wright, she said: “I’m actually genuinely not sure it’s binary like that. When I talk about increasing the pace and scale in terms of integration, what I’m particularly talking about is where we have examples of practice that works, stopping talking about sharing that practice and just lifting it and doing it. That’s what I mean about pace and scale and if we had a bit less sharing good practice, and a bit more implementing good practice we would have got to some of the pace and some of the scale that would make me happier. And I think generally speaking it would make our citizens happier.”

Ms Freeman added that shouldn’t mean you don’t work with “where people are” – in terms of their health and care needs – and she was keen that the discussion was not framed in those terms, saying: “I think it is entirely possible to, for example, to have a much more improved system that we can see in some of our integration authorities of, for example, delayed discharge which also uses digitally enabled care for people at home at a level and a point that suits and works for that individual.”

Malcolm Wright said at the beginning of the morning session that he was keen to increase the pace and scale of a series of health and care reforms instituted by government, including digital, which he described as a “high priority area” but also health and care integration, which he said we are “well down the road with” and also mental health. He said that the collaboration between central government and COSLA – the political organisation which represents Scotland’s local authorities – is “really important” in that work. He announced a key appointment at the event as Caroline Lamb, Chief Executive of NHS Education for Scotland, was unveiled as the “first standalone” director within government charged with delivering the digital health and care reforms. She has taken the role on secondment within Scottish Government and will work with her deputy Jonathan Cameron, who moves from NHS National Services Scotland where he was Head of Service for Strategic Development.

He said: “So I think that’s a very tangible commitment from government to increase the pace and scale of the reforms that are taking place.”

Ms Freeman was also asked about how citizens and communities are made to feel part of the ‘clever technology’ that is now becoming increasingly available to help fill health and care service provision.

In an expansive answer she said: “One of the things that struck me in some recent survey work was in a sense how much further ahead of us the public are, the general public, in their expectation that we should be using digital technology to provide healthcare tools and support them in the managing of their own conditions and finding out credible, reliable information that they want to know about their own health or the health of a member of their family. So, I think that in many, many ways the public is a bit ahead of us and are not going to be anything other than ‘about time, too’ when we start using more of this. But the other thing I think that counters that is that we absolutely mustn’t lose the importance of human contact and human conversation.”

She added that digital technology must be an enabler – because otherwise “what people will fear is that we’re going to start replacing human beings with bits of kit and apps”, saying: “I think that as long as we remember that it is enabled, that it is there to enable person-centred care then we introduce it and deliver it in a way that is centred around the person.”

She gave an example of where she met with patients at a primary care centre in East Kilbride, where not only was a remote blood pressure monitoring technology in place, with text reminders, enabling patients to take their blood pressure at a time convenient to them, but it was also connecting them to their local health and exercise services. When signed off of the service, the patients continued doing exercise and following better diets, she said. She said also that there was good evidence of health boards and local authorities starting to work together to use digital technology to solve some issues around delayed discharge from hospital, freeing up vital bed space, and the approach had benefited from making that service ‘person centred’ and not about the needs of the system.

She urged delegates at the conference to all be leaders and to come to her and say what barriers and obstacles needed to be removed in order to provide better health and care to people in Scotland, but she also candidly said that would be honest about what she can and cannot do, and where she needs to prioritise.

On taking up the role of Cabinet Secretary she said initially she had been struck by the amount of initiatives going on, adding: “What I thought was, ‘there’s lots of stuff going on here, but where is the strategic approach?’ and how does that align with what I am saying are my strategic priorities for transformation in health and social care? That might mean that there are some things that people are absolutely committed to, are really enthusiastic about, that I’m going to say that needs to wait, we need to do this first and make logical decisions about how we undertake our infrastructure investment, our development of digital in a way that maximises our chance of meeting those strategic priorities.”

In that leadership context, Ms Freeman described Caroline Lamb’s appointment as a “big deal, a big signal,” adding: “I think that is a big deal actually and it’s a big signal, then pulling together all the various initiatives and bits of work that are going on and deciding what are the most important.”

Digital Health & Care Festival 2019 is a partnership event involving Digital Health & Care Scotland, Technology Enabled Care, Digital Health & Care Institute, Health & Social Care Alliance Scotland, British Computer Society Health Scotland, Digital Office Scottish Local Government and Coalition of Care & Support Providers (CCPS). For updates see #DigiCare4Scot