Transformations and challenges – Dame Denise Coia reflects on her time as Chairman

Beginnings and endings. They are often the only time that we can stop and take stock of our achievements and see just how far we have come, in particular, when at times it feels like we can never do enough.

The recent NHS birthday celebrations have provided an opportunity to recognise the changes in health and social care provision over the past 70 years, but also to reflect on the challenges that we continue to face as an organisation and within the wider system. My own retirement as Chair of Healthcare Improvement Scotland has also encouraged me to do the same.

As a public sector organisation, we will always face scrutiny about what we do and how we do it and rightly so. Everyone is entitled to have and air their views. However, it is encouraging that the Kings Fund and Nuffield Reports in 2016 highlighted our unique approach in bringing improvement and quality assurance into one organisation and the impact it can, and is, making. This approach is admired throughout the world and we need to hold onto it. We talk about our organisation as having ‘many parts, one purpose’. To achieve truly better care for the people of Scotland, we need to use every part of the Healthcare Improvement Scotland jigsaw to maximise the opportunities and contribution we can make towards transformed health and social care services.

As we introduce the Quality of Care Approach, and our new methodology in reviewing a whole system and not just a specific hospital or ward, we will be helping people, patients and clinicians to better understand what is happening in our hospitals and NHS boards and enable Healthcare Improvement Scotland to provide tailored support and insight on the improvements needed to make care better.

Reflecting on my time with Healthcare Improvement Scotland I am struck by the difference in how our work is now seen and reported on by the media, compared with when we first came into being. Whilst there is still some way to go, we have gone from crisis-stricken headlines telling us how bad and dirty our hospitals are to balanced reporting of the issues we face in acute care. I believe both NHS boards and the public value our reporting and there is a great deal of support for our role as we call out the challenges and areas for improvement.

I am particularly proud of the contribution being made through the Scottish Patient Safety Programme (SPSP) over the past 10 years. It is a resounding NHSScotland and Healthcare Improvement Scotland success story, and has played an important part in making our hospitals safer for patients. The significant achievements of SPSP – especially in moving from acute care to cover mental health, primary care, medicines and care for mothers, babies and children – are not only felt in Scotland but also internationally, as others come to learn from our success and how to achieve it.

The integration of health and social care has changed how we think and design health and care services. We all know it is challenging and is likely to remain so as we navigate difficult financial and operating environments for integration authorities, local authorities and the NHS. But I think this is an important and necessary step for our health and social care system. It demonstrates Scotland as a leader in this area and demonstrates our commitment and understanding that health and wellbeing doesn’t simply mean going to a GP or to A&E.

Across our organisation we are supporting integration, delivering improvement support to the health and social care sector and extending our partnership working across the third and independent sectors.

Although I’ll be moving on from Healthcare Improvement Scotland in the next few weeks, I’ll still be very much involved in health and social care as I embrace new challenges. I look forward to working with Healthcare Improvement Scotland, rather than being a part of it, and to cheering it on as a beneficiary of its work as the organisation reaches greater heights.

Denise Coia is Chairman of Healthcare Improvement Scotland.