An integrated approach
New MDDUS board member Professor Jason Leitch talks to Summons about ongoing reform in Scottish public health and his role in promoting innovation
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INDING new ways to think about healthcare improvement has become a hallmark of Professor Jason Leitch’s
career. Having qualified from Glasgow University in 1991 as a Bachelor of Dental Surgery, he became a consultant in oral surgery based in the west of Scotland. But it was a trip to the US in 2005 to work for the prestigious Institute for Healthcare Improvement (IHI) that he says “turned my career on its head”. He completed a Masters in Public Health at the Harvard T.H. Chan School of Public Health in 2006 and returned home to begin working for the Scottish Government, helping to run their patient safety programme. Ten years later, Professor Leitch is now
the Scottish Government’s national clinical director. He is a fellow at all three UK surgical royal colleges, a senior fellow at the IHI and holds an honorary professorship at the University of Dundee. He also recently joined the board of MDDUS as a non-executive director.
What are your main priorities in the role as clinical director for healthcare quality and strategy? We have a directorate structure within Scottish Government and I am one of a set of directors working in health and social care. As national clinical director I have specific responsibility for quality, planning and improvement, which includes patient safety, person-centred care and a host of other clinical priorities. I also share corporate responsibility for how we spend the nearly £14 billion budget and how we manage the health boards and their
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160,000 employees. I also have Scottish Government responsibility for other areas of improvement and do quite a lot of work in education and criminal justice, looking at systems of delivery across the public service. It’s a broad remit.
What are the key challenges facing healthcare in Scotland in the next 20 years? It’s not dissimilar to the rest of the developed world – the two-pronged challenge of increasing demand at a time of constrained resources. Tere is the well-publicised increase in the elderly population but there is also another unspoken set of increasing healthcare demands from the middle-aged population. Expectations have changed. Tis means we have to adjust the way we deliver healthcare. Te National Clinical Strategy is an attempt to begin that conversation about shiſting the balance of care towards more primary/community- based care and more locality-based delivery, but at the same time having fewer specialist centres for the very high-end expensive care.
Health and social care integration is a major thrust of the recently published National Clinical Strategy. What has changed this year? Te transitions between GP, dental, hospital and social services are the areas where patients and families can fall through the cracks. Tose are the elements that integration is meant to resolve. From 1 April, the Scottish Parliament legislated
to make health and social care integrated at a structural level. But true integration happens at a team level and that’s where we’re now seeing quite dramatic changes in the way health and social care is delivered on the ground. Genuinely, the driver is quality delivery for the user. But if you can make those transitions between health and social care more efficient from a quality perspective then they become more financially efficient too. It’s probably the most important reform in the NHS and social care system in the last 30 years.
What does patient-centred care mean to you? I’d say it means “no decision about me, without me.” It’s fundamentally the inclusion of the patient – or family or carer – in every decision about their health and social care. Tis might be visiting times, decisions about chemotherapy, end-of- life care or vaccinations in children. I’ve been involved in supporting the ‘What matters to you?’ campaign, which is an attempt to focus healthcare teams on the patient and the family. It’s about taking a moment in a consultation – whether GP or
SUMMONS
PHOTOGRAPH: MARTIN SHIELDS/HERALD & TIMES
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