Health Department
Performance Management Division

NHS MEL (1999)89

Dear Colleague

Summary

1.   Guidance on the content and submission of these documents is attached.

Action

2.   All Health Boards and NHS Trusts, with their planning partners, are expected to take account of the guidance as they go through the current planning round.

3.   This MEL is available on the Scottish Executive web site: http://www.show.scot.nhs.uk/dtc.

Yours sincerely

DR KEVIN J WOODS
Director of Strategy and Performance Management

29^th December 1999
______________________________

Chief Executive, Scottish Ambulance Service

General Manager, CSA

1 . Priorities and Planning Guidance for the NHS in Scotland for 1999-2002 was issued under cover of NHS MEL (1998)63 on 25 September 1998. The aims and clinical priorities in that document continue to map the strategic direction that the NHS should follow.

HIPs 2000-05

2. Health Boards, Trusts and their planning partners will wish to take account of the other key initiatives set out in The Scottish Executive's "Making it Work Together - A Programme for Government" in order to:

i) Improve the health of the people of Scotland;
ii) Provide a modern, high quality, responsive NHS in Scotland;
iii) Develop new approaches to speed treatment and shorten waiting times;
iv) Deliver person centred health and community care; and
v) Work in partnership with the people who deliver health and social care, in order to make a reality of, and to build upon, the seminar held on 5 November.

3. HIPs should clearly demonstrate a collaborative approach with Trusts, clinicians, GPs, local authorities and others. Partnership working remains a fundamental requirement for the development of genuinely inclusive and responsive HIPS. It is vitally important that staff and the wider public are at the heart of the decision making process. The NHS must increase the pace at which this style of working is being adopted. The development of a strategy for communicating effectively with patients under the Patients' Project in 2000 will be an important catalyst for improvement.

4. Particular areas where progress and further action should be outlined in the HIP are set out below.

Health Improvement

5. The "Review of the Public Health Function in Scotland" published on 20 December 1999 requires Health Boards to develop as public health organisations. Acting in that capacity, Health Boards have the central role in protecting and improving population health and should begin to develop the role envisaged by the Review. In doing so, Health Boards must be proactive in forging effective links with Local Authorities and others so that they can maximise the impact of their role on tackling health inequalities and other key elements of the Executive's social inclusion strategy published in Social Justice - A Scotland Where Everyone Matters.

6. MEL (1998) 63 gave heightened emphasis to improving the health of children and young people and the health services that are provided for them. Consideration is currently being given to proposals for giving fresh impetus to protecting and improving the health of these groups. In the meantime, Health Boards and NHS Trusts, should work with their planning partners, to ensure the co-ordinated planning and implementation of interventions that are known to be effective at different phases in the development of children and young people.

Service Modernisation

7. To continue to meet the needs of the population of Scotland into the 21st Century, the NHS must press on with modernisation of health care services. Gaining support for new patterns of care and treatment from both the public and staff is vital if modernisation is to be implemented successfully. The involvement of key interest groups in constructive dialogue must be a key characteristic of the modernisation process. Formal consultation about proposals at a later stage is no longer sufficient. Health Boards and Trusts must ensure effective means of communication to engage the public and staff in modernisation initiatives from the outset. For its part, the Health Department will continue to facilitate change, for example, by supporting organisational development and, where appropriate, creating Expert Support Forces.

8. One such Group has been working and consulting with the NHS on how best to reduce delays throughout the health care system - a key aim of the modernisation programme. As you will be aware, the Minister announced on 16 December that over the coming months the Health Department will be working with the NHS to establish national maximum waiting times to be met by March 2001 in the clinical priorities of heart disease, cancer and mental illness. Much of this work will be achieved through the redesign of services which must become a key component of health service delivery. This work will include services for primary hip and knee joint replacement and cataract extraction. Initiatives of this type, including those running under the Joint Investment Fund banner, are expected to play an increasingly prominent part of HIPS.

Other

9. More generally, each HIP must include a robust financial section demonstrating how the 5-year Programme of improvement will be delivered (separate guidance on financial planning will be issued) and Health Boards who secure services from Trusts outwith their area should include them as appropriate.

10. Health Boards, the Scottish Ambulance Service and the State Hospital should submit their HIPs by E-mail to NHSTIPS@Scotland.gov.uk in accordance with the timetable set out in paragraph 15 below. Not withstanding the guidance in paragraph 13 below, it will be acceptable for a Health Board's Corporate Contract to be either a separate document or an integral but discrete part of the HIP.

TIPs 2000-01

11. The expectation is that TIPs are currently being developed in conjunction with HIPs and will include clear programmes to deliver the HIP. Like the HIP process, creation of the TIP should be based on an open and inclusive process and set within a viable financial framework.

12. NHS Trusts should submit their TIPs by E-mail to NHSTIPS@Scotland.gov.uk in accordance with the timetable set out in paragraph 15 below.

CORPORATE CONTRACTS 2000-01

13. Health Boards, the Scottish Ambulance Service, the State Hospital and the Common Services Agency should continue to agree annual Corporate Contracts with the Health Department. Specific output and outcome measures, which show progress against the objectives, must be included. Last year a number of core indicators were suggested that could be used to monitor whether progress was being made in delivering improvements in services. Again Health Boards are encouraged to use them as much as possible. The standardised format for the Corporate Contract (including a section for children and young people) should be used and should include the Performance Template. Corporate Contacts should be submitted by E-mail, to NHSCCS@Scotland.gov.uk in accordance with the timetable set out in paragraph 15 below.

ACCOUNTABILITY REVIEWS

14. A separate letter will be sent outlining the arrangements for the 2000 Accountability Reviews.

TIMETABLE FOR SUBMISSION OF KEY DOCUMENTS

15. Latest dates for the submission of HIPS, TIPs and Corporate Contracts (by E-mail) are:

i)    14 January 2000    Draft HIPs (including those with Corporate Contracts);

ii)   31 January 2000    Draft Corporate Contracts; and

iii)  31 March 2000      Final HIPs/TIPs/CCs.