Derek Feeley, director of healthcare policy and strategy at the Scottish Government Health Directorate, addressed the conference, held in Crieff in September. He said best value was a key issue in the discussion paper Better health, better care. ‘We need to move forward with the efficiency agenda and get the incentives properly aligned,’ he said. ‘But we need to find a way of making [efficiency] real at the front line. It needs to be embedded in the quality agenda. Improving efficiency is about improving quality.’
Mr Feeley said that variations across Scotland – for instance a three-fold difference in emergency admissions by GP practices – could not all be due to clinical need. He said that finance managers had to get better at challenging such variations.
Mr Feeley accepted that meeting the efficiency challenge and some of the changes would require upfront investment with a longer term pay-off. But he said waste could be cut for some quick wins – reducing X-rays and images taken because earlier images had been lost, for instance.
The conference closed with a panel debate led by BBC Scotland political editor Brian Taylor. John Connaghan, the health directorate’s director of health delivery said that improving ‘do not attend’ rates would unlock a ‘hidden efficiency’. And Scottish deputy chief medical officer Peter Donnelly welcomed good engagement between clinicians and finance managers around Scotland, saying: ‘In some places the dialogue is on-going – the challenge is to make this dialogue the norm.’
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