Living well in communities

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Living well in communities

Living well in communities is a new portfolio of improvement work which aims to support people to spend more time living at home or in a homely setting, which would otherwise be spent in hospital. This work will involve a range of stakeholders across the health and social care landscape, including health and social care partnerships, housing associations, third sector organisations and private sector social care providers.

Our work

Improvement activity will focus on the following areas, which have been identified as areas in which the pace and scale of improvement can be increased if additional improvement support is provided:

  • frailty pathways and falls management and prevention
  • anticipatory care planning
  • improving links between the housing sector, health and social care
  • elements of delayed discharge, and
  • pathways for high-resource users of health and social care services.

Some strands of work, including frailty and high-resource individuals, will involve work with selected health and social care partnerships to test improvements and identify good practice to share with other health and social care partnerships, while the work on anticipatory care planning aims to increase the use of anticipatory care plans across all partnerships.

The work will be informed by testing from related programmes both within Healthcare Improvement Scotland and from other organisations, and will use a range of approaches to capture and share knowledge to increase the pace at which this learning is applied in practice.

Background

The Scottish Government's vision is that by 2020 everyone is able to live longer, healthier lives at home, or in a homely setting. It promotes prevention, anticipation and supported self-management, and an emphasis on ensuring that people who are admitted to hospital are able to return to their homes or a community environment as soon as is appropriate, with minimal risk of readmission.

In November 2014 Alex Neil, the former Cabinet Secretary for Health, Wellbeing and Sport, declared an ambition "to give back at least 200,000 days to individuals, families and communities" that would otherwise be spent in hospital. This goal is to be achieved by December 2017.

More information

For more information contact:
Thomas Monaghan
Improvement Advisor
thomas@monaghan@nhs.net
Twitter: @LWiC_QI