NHS Dumfries & Galloway.........
………….Putting You First
2014 January
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INFORMATION BOOKLET
This information booklet is designed to provide applicants with relevant
background information about Dumfries and Galloway NHS Board, the
healthcare services it delivers and some of the key challenges to be faced
in the future.
Additional
information
can
be
found
by
logging
in
to
www.nhsdg.scot.nhs.uk and keying in the link to Dumfries and Galloway
Health Board. Should you require additional information please refer to
the section on “ Useful Contacts”. Detailed information on ‘Putting You
First’ is available via www.puttingyoufirst.org.uk
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CONTENTS
Page No
Health Services in Dumfries and Galloway at a glance
4
Dumfries and Galloway NHS Board
6
Corporate Aims and Objectives
8
Organisational Structure
9
Our Four Dimensions of Success
9
An Introduction to the Corporate Directorates
10
‘Putting You First’ Strategic Change Programme
13
Quality and Patient Safety within NHS Dumfries and Galloway
15
Service Developments
17
Useful Contact Details
18
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Health Services in Dumfries and Galloway at a glance
NHS Dumfries and Galloway is responsible for making sure the people of Dumfries
and Galloway receive community and primary care health services from:
 almost 135 General Medical Practitioners and their Practice Teams providing a
full range of general medical services across 35 practices, stretching from
Stranraer In the west to Langholm in the east and Sanquhar in the north;
 more than 60 General Dental Practitioners providing NHS dental services at
more than 30 locations,
 more than 34 Community Pharmacies providing a range of pharmaceutical
services, including minor ailment services and public health services, across
Dumfries and Galloway; and
 20 Optometry practices providing services ranging from NHS eye tests to
Diabetic Retinopathy Screening and cataract follow-up across the region with
several practices providing care in people’s homes.
Health Care in a hospital setting is delivered through:
 1 District General Hospital in Dumfries, providing a range of acute services;
 1 Community Hospital in Stranraer (Galloway Community Hospital); and
 8 Cottage Hospitals across the region (Langholm, Moffat, Lochmaben, Annan,
Castle Douglas, Kirkcudbright, Newton Stewart, Thornhill)
The structure in which NHS Dumfries and Galloway provides health care is through:
Operational Directorates, which work together as an integrated team across
traditional geographical and departmental boundaries, deliver services through:
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Acute Services and Diagnostics;
Mental Health;
Women & Children’s;
Primary and Community Care; and
Support Services.
These are supported by corporate directorates:
 Public Health Directorate;
 Medical Directorate (including Pharmacy & Information Management &
Technology);
 Nurse Directorate;
 Finance Directorate;
 Workforce Directorate; and
 Joint Strategic Planning, Commissioning and Performance Directorate
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Key External Partners
Health Care
The Dumfries and Galloway population relies on the health care services provided by
both NHS Greater Glasgow and Clyde and Lothian hospitals for tertiary and regional
specialities.
Residents in West (Stranraer area) may access health care services from hospitals
in Ayrshire and Arran, residents in the South East (Canonbie, Gretna area) may
access services in Cumbria and residents in the North of the region (Sanquhar area)
may access services in Lanarkshire.
Community Planning Partners
NHS Dumfries and Galloway has strong partnership working with:
 Dumfries & Galloway Council
 Police
 Fire and Rescue Services
Our boundaries are co-terminus with the Council. These partnerships are important
for:
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Child and Adult Protection;
Civil Contingencies;
Community Safety;
Community Planning; and
Health and Social Care Integration
The partnership with Dumfries and Galloway Council is key to delivering integrated
services in the future and links closely to the ‘Putting You First’ Change Programme.
Universities
University of the West of Scotland is a key partner in providing education and NHS
Dumfries and Galloway has a Memorandum of Understanding with the University.
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Dumfries and Galloway NHS Board
Dumfries and Galloway NHS Board is one of fourteen territorial NHS Boards across
Scotland which provide the strategic framework to ensure the management of
healthcare in each region. As a Board of governance NHS Dumfries and Galloway
is responsible for issues including health improvement, strategic planning and
resource allocation, and oversees a wide range of activities which balance national
priorities with the healthcare needs of the people of our region.
Dumfries and
Galloway NHS Board is responsible for spending circa £300 million per year in its
healthcare services.
NHS Dumfries and Galloway is responsible for meeting the health needs of more
than 147,000 people living in a largely rural setting across some 2,500 square miles
stretching from Langholm in the east of the region through to Stranraer in the west of
the region.
The principle centres of population are centred around Dumfries
(catchment population in excess of 37,000) and Stranraer (catchment population in
the region of 20,000). NHS Dumfries and Galloway employs approximately 4,500
staff and provides a comprehensive range of primary, community based and acute
hospital services for the population.
During year 2013-2014, NHS Dumfries and Galloway has:
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Delivered on targets that improve patient experience of our services;
Delivered improvements to patient care and treatment;
Delivered on service re-design;
Worked closely with our local partner organisations to improve service
delivery;
 Delivered our services more efficiently; and
 Gained approval for an Outline Business Case to build a new District General
Hospital for the region by 2017 / 2018.
Putting You First – our strategic vision
Towards the end of 2009 and into early 2010, the NHS Board consulted widely
across the whole of Dumfries and Galloway region on the future shape of our health
services. In March 2011, the NHS Board determined its vision for the future delivery
of high quality, community based healthcare services throughout our region. That
vision is person-centred, safe, reliable, effective and efficient healthcare – in short –
Putting You First ….across the NHS Board’s whole area of responsibility.
Full
details of the Putting You First programme are detailed later in this information pack.
Board Composition and Committee Structure
NHS Dumfries and Galloway was one of two Boards in Scotland selected by the
Scottish Government in 2009 for a pilot project to test the concept of directly elected
members to Health Boards. The pilot was drawn to an end at 31 December 2013,
resulting in the recruitment round to attract appointed members to the Board.
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NHS Dumfries and Galloway has a number of committees with a defined role and
function to support the governance and scrutiny of the Board’s activities as follows:

Audit Committee

Performance Committee

Healthcare Governance Committee

Staff Governance Committee

Remuneration Sub-Committee

Community Health and Social Care Partnership Board

The Area Drug and Therapeutics Committee

Pharmacy Practices Committee

Person Centred Health and Care Committee (formerly Spiritual Care)
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Corporate Aims
Our Purpose:
 to deliver excellent care that is person-centred, safe, effective, efficient and
reliable.
 to reduce health inequalities across Dumfries and Galloway
Our Outcomes
 Improved outcomes for patients that reflect learning from patient experience in
order to ensure a person-centred approach is maintained;
 Improved staff experience; and health and wellbeing of staff;
 The delivery of continuous quality improvement and sustainability through
services that are effective and efficient;
 All children have the best possible start in life through a variety of
interventions, sometimes targeted at vulnerable groups; and
 A population in Dumfries and Galloway who are enabled and assisted to have
more control over all aspects of their life, health and wellbeing.
Corporate Objectives:
 To reduce inequalities across NHS Dumfries and Galloway
 To promote and embed continuous improvement by connecting the range of
quality and safety activities which underpin delivery of the three ambitions of
the Healthcare Quality Strategy, to deliver a high quality service across NHS
Dumfries and Galloway
 To review the model of service delivery across Dumfries and Galloway to
deliver person–centred services as close to home as clinically possible.
 To ensure that NHS Dumfries and Galloway has an engaged and motivated
workforce that is supported and valued in order to deliver high quality service
and achieve excellence for the population of Dumfries and Galloway.
 To maximise the benefit of the financial allocation by delivering clinically and
cost effective services efficiently.
 To continue to support and develop partnership working to improve outcomes
for the people of Dumfries and Galloway.
 To meet and where possible to exceed, goals and targets set by the Scottish
Government Health Directorate for NHSScotland, whilst delivering the
measurable targets in the Single Outcome Agreement.
The Board is committed to testing these objectives against the principles of best
value, patient focus / public involvement and partnership working.
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Organisational Structure
The Board is organisationally structured to enable single system working and our
services are delivered through three streams:
1. Health Services Operational Directorates (Acute Services and Diagnostics,
Mental Health, Women & Children’s, Operations, Primary and Community
Care)
2. Public Health Directorate
3. Corporate Directorates (Medical, Nursing and Midwifery, Workforce, Finance,
Joint Strategic Planning, Commissioning and Performance)
Our 4 Dimensions of Success
We measure our success in delivering our purpose and outcomes against 4
dimensions of success. Each of these dimensions;
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Quality
Service
People
Finance
is integral to our achievement of excellent care that is person-centred, safe, effective,
efficient and reliable.
Achieving balance across the four dimensions in strategic
planning, service redesign and operational delivery means that the patients and
public of Dumfries and Galloway, and our staff, are confident that our decision
making at all levels within the organisation is informed by the quality ambitions,
patient experience and patient safety, appropriate service pathway design and
delivery, an engaged and motivated workforce and effective, best value use of all the
resources available to us.
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An Introduction to the Corporate Directorates
Chief Executive’s Office
The Chief Executive office comprises of the Resilience Planning Department, which
is a shared service with the Local Authority, corporate governance and
administrative support. Working closely with the Operating Directorates, the Chief
Executive office engages with partners, Parliamentarians and Councillors on a
regular basis to support the Chairman and Chief Executive in undertaking their roles
and responsibilities on behalf of the organisation.
Nursing, Midwifery and Allied Health Professionals (NMAHP) Directorate
The NMAHP Directorate has a key responsibility for the delivery of NHS Dumfries
and Galloway’s objectives by ensuring the delivery of excellent, person-centred,
safe, effective and efficient care. As part of this role the Directorate is responsible
for the effective development and application of NHS Dumfries and Galloway’s
Nursing, Midwifery and AHP (Allied Health Professional) resources.
The Directorate is responsible for providing expert advice on AHP, nursing and
midwifery matters to the Board, General Managers and Clinical Directors and to
AHPs, nurses, midwives and other clinical and non clinical staff throughout NHS
Dumfries and Galloway. The Nurse Director is the nominated Executive Lead for
Healthcare Associated Infection, Clinical Governance, Quality and Patient Safety,
Child Protection, Patient Focus/Public Involvement (including the management of
patient feedback and complaints), Spiritual Care and Communication in NHS
Dumfries and Galloway.
Medical Directorate
The Medical Directorate covers the provision of advice to the Board on medical
matters including professional standards, staffing issues, training and education, via
the Medical Director, Associate Medical Director for Acute Services and Clinical
Directors. The Medical Directorate also provides a professional line management
structure for dentists, pharmacists and optometrists and has responsibility for
managing the Board’s prescribing budget (approximately £39 million).
The
Directorate also includes the Primary Care Department, the IT Department (including
Information Governance and Caldicott Guardianship functions), the Research and
Development Department, Cancer Services and the Managed Clinical Networks in
Respiratory Medicine, Palliative Care and Diabetes
Workforce Directorate
The Workforce Directorate comprises HR services, Learning and Organisational
Effectiveness, Occupational Health and Safety and Equality and Diversity.
The Directorate team enable and support the delivery of excellent, safe, personcentred health and healthcare by creating an environment which fosters a healthy,
productive, motivated and engaged workforce. We achieve this through embedding
staff governance, diversity principles and our organisational Code of Positive
Behaviour as core organisational values.
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Finance Directorate
The Finance Directorate plays a central role in providing timely, accurate financial
and statistical information to support decision- making within NHS Dumfries and
Galloway. Finance offers a wide range of services and support across the
organisation and is made up of four key areas; Accounting and Treasury, Payroll,
Procurement and Management Accounting. The Directorate supports the
organisation to deliver good financial governance and achieve the twin financial
targets of:
1. Perform our activities within the available financial resources at its disposal; and
2. Conduct our activities in a manner that is cost-effective and demonstrably
secures value for money.
Capital Plan
The Board’s Property Strategy is focused on delivering improvements to the quality
of the built environment and the range of service provision. The Board has an
annual formula capital allocation of £4 million. The funding is primarily utilised to
support backlog maintenance and equipment replacement programmes. A number
of GP capital developments are also in progress.
The key capital development
within the current strategy is the £200m NPD (Not for Profit Distribution) replacement
project for the Dumfries and Galloway Royal Infirmary.
Joint Strategic Planning, Commissioning and Performance Directorate
The Joint Strategic Planning, Commissioning and Performance Directorate is
responsible for work across both the NHS and within Social Work Services for
Dumfries and Galloway Council. The Director of Planning reports directly to both
the NHS Chief Executive and to the Director of Social Work, supporting both
organisations in their aims and ambition to work in more integrated ways and
maximise the total available resource to do this and has a small team of health
planners and a jointly funded team of strategic planning and commissioning
managers to support.
Public Health Directorate
The Directorate of Public Health covers a variety of functions including health
protection, health improvement, health intelligence, health services planning and
monitoring, and aspects of emergency planning. The Health Protection Team also
takes responsibility for the planning and co-ordination of immunisation and screening
programs. The Health Intelligence Team provides a service for the whole of NHS
Dumfries and Galloway, and not just for the Public Health Directorate. This has
allowed the team to develop considerable expertise and provide a resilient service.
A major development in the health improvement team was the formation, in June
2011, of “DG health and well-being”, a unit jointly funded and supported by both the
Health Board and the Local Authority, who have contributed both financial resources
and staffing resources to the new unit. We believe this arrangement to be unique in
Scotland.
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Health Services Directorate
The Directorate of Health Services comprises of five ‘Operational’ Directorates:
1.
2.
3.
4.
5.
Acute Services and Diagnostics;
Women and Children’s Directorate;
Primary and Community Care Directorate;
Mental Health Services Directorate; and
Operational Services Directorate.
Acute Services and Diagnostics Directorate
This Directorate is responsible for scheduled and unscheduled care together with
diagnostics, anaesthetics and associated drugs, and has a total budget of £69.8
million.
Women and Children’s Directorate
The Women and Children’s Directorate is responsible for the integrated Maternity
Services including Child and Adolescent Mental Health Service (CAMHS).
Public
Health Nursing and Speech and Language Therapy are also included in this
Directorate, with a total budget of £17.3 million.
Primary and Community Care Directorate
This Directorate joins the localities across the region (Annandale and Eskdale,
Nithsdale, Stewartry and Wigtown), together with associated prescribing costs.
Included in the Directorate’s responsibilities will be Managed Clinical Networks
(MCNs), Allanbank, Specialist Substance Misuse Services, Family Planning and
Sexual Health, Out of Hours and also include costs related to Primary Care. The
Directorate has a budget of £98.5 million.
Mental Health Services Directorate
The Directorate brings together Mental Health, Learning Disability and Psychology
and has a total budget of £18.9 million
Operational Services Directorate
Operational Services are responsible for all support services across NHS Dumfries
and Galloway and have a budget of £16.8 million.
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‘Putting You First’ Strategic Change Programme
Introduction
Dumfries and Galloway recognise that more integrated, proactive and co-ordinated
approaches to the planning and delivery of care is critical if we are to address
successfully the demographic and fiscal challenges we are facing now and will face
for the foreseeable future.
To achieve this, NHS Dumfries and Galloway, Dumfries and Galloway Council, 3rd
and independent sector partner organisations, the public, service users and their
carers have come together to develop and deliver ‘Putting You First’ - a five year
programme of change for health and care services in Dumfries and Galloway.
Putting You First is our response to ‘Reshaping Care For Older People’ and the NHS
Quality Strategy. It does not look to develop services by delivering more of the
same. Nor does it look to deliver marginal change at the edges of what already
exists. Rather, it seeks to deliver transformational change at scale, identifying that
we must significantly shift the way in which we think about planning and delivering
services. It is in this transformational change that we look to meet the challenge of
delivering more effective, more efficient services that will also, most importantly,
deliver higher quality services to the people of Dumfries and Galloway and support
the achievement of Scottish Integration of Health and Social Care, in line with
government policy.
Putting You First Aims
The main focus of Putting You First is that service delivery will be person centred
putting the person firmly at the centre of the services that they receive.
The
outcome should be an experience of care that is seamless, compassionate, flexible
and provides them with choices and information at every stage in the journey.
People in Dumfries and Galloway will retain their independence for as long as
possible experiencing a better overall quality of life - building on the work of
‘Building Health Communities’ and the development of the new Joint Health and
Well-Being Unit, developing and promoting models of self care, and working with
colleagues and partners in the Council, Social Work Services and the 3 rd and
Independent sectors to deliver this
Care will be safe with no avoidable injury or harm to people
Effective utilisation of resources and skills and capacity of staff – taking a ‘whole
system resource’ approach to planning that enables us to identify and act on
opportunities to streamline, avoiding duplication wherever possible and enabling us
to realise the full potential of existing resources across our services and
communities.
Services delivered at or as close to home as possible – achieved through
effective utilisation of technology, robust reablement services, exploring the use of
cottage hospitals and wider partnerships to deliver this.
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Delivering Putting You First
All of the above aims will be underpinned by more effective application of Telehealth
and Information Technology from end to end of care pathways, promoting and
supporting the personalisation agenda, developing flexible and responsive rapid
response services appropriate to the needs of individuals and the service.
Putting You First is committed to working with Communities. This means going out
into communities, meeting with community leads, staff and other partners and
discussing and agreeing with them those areas of service that might be progressed
within the context, aims and outcomes of Putting You First. It is also committed to
co-production methods and to developing, in partnership, personal and community
resilience as an approach.
Putting You First looks to deliver transformational change by taking a ‘tests of
change’ approach. This is a model whereby innovation is enabled to be tested,
robustly measured, its impact on the whole system evaluated and scaled up, rolled
out or discontinued as appropriate. These tests of change will be partly supported
by the Reshaping Care for Older People (RSCOP) Change Fund.
Working Together with the Local Authority, Stakeholders, Public and Patient
Representatives
NHS Dumfries and Galloway’s area of responsibility is coterminous with the physical
region administered by Dumfries and Galloway Council.
As a Board, NHS Dumfries and Galloway is fully committed to working with all
stakeholders, statutory and 3rd Sector organisations to deliver on the exciting
opportunities being presented to us as a Board. We are committed to involving our
communities as we take forward our future plans.
Informing, Engaging, and
Consulting is a key requirement in service change and development, and NHS
Dumfries and Galloway works closely with the Scottish Health Council in taking
forward that process. Our current plans to implement the Quality Strategy, the
Change Fund and Health and Social Care Integration align closely with those
principles.
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Quality and Patient Safety within NHS Dumfries and
Galloway
The Quality Strategy
The Healthcare Quality Strategy for NHSScotland was published in May 2010. It
contains three clear quality ambitions designed to ensure improvement in the
standards and outcomes of healthcare delivered and received in Scotland.

Person-centred:
Mutually beneficial partnerships between patients, their
families and those delivering healthcare services which respect individual needs
and values and which demonstrate compassion, continuity, clear communication
and shared decision-making.

Safe: There will be no avoidable injury or harm to people from healthcare they
receive, and an appropriate, clean and safe environment will be provided for the
delivery of healthcare services at all times.

Effective: The most appropriate treatments, interventions, support and services
will be provided at the right time to everyone who will benefit, and wasteful or
harmful variation will be eradicated.
Within NHS Dumfries and Galloway we are proud that a significant amount of activity
has historically already been driven by these ambitions.
In order to make this
connection more explicit we have reviewed and reshaped the support structures
within the organisation to align with delivering on these three ambitions, with an
Associate Director taking the Lead for and one of the ambitions on behalf of the
Medical and Nurse Directors. Achievement of our corporate purpose, aims and
objectives depends on the organisation being able to demonstrate that we have
implemented and delivered on each of these quality ambitions.
Importantly, we believe that delivery against each of these ambitions does not stand
alone, as activity associated with one ambition will also influence and impact on the
other two. Using the principle of a balanced score card, it is only possible to achieve
sustainable and reliable quality improvement in standards of patient care if we focus
on the ambitions collectively.
Patient Safety – Our Priority
In November 2006 NHS Dumfries and Galloway, in partnership with NHS Ayrshire
and Arran, was selected to work with the Health Foundation and Institute of Health
Improvement (IHI) on a programme designed to dramatically improve patient safety.
This work has now flowed forward into the Scottish Patient Safety Programme.
Improving the safety and reliability of healthcare is a global challenge.
NHS
Dumfries and Galloway are committed to making our healthcare system the safest
and most reliable in the country. We are committed to realising a vision whereby no
patient suffers unnecessary harm, pain or suffering whilst in our care.
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Spreading and sustaining the energy, the enthusiasm and the real time changes
made in the process of care is about embedding a culture of safety in how we plan,
how we behave and how we deliver services. This requires sustained engagement
of the front line and the absolute commitment of leaders.
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Service Developments
NHS Dumfries and Galloway is undertaking one of the most significant service
developments for a generation that will be seen in this region.
Dumfries and Galloway Royal Infirmary Redevelopment Project
Following submission to the Scottish Government, we have received approval to our
Outline Business Case (OBC) for a new 350 bed district general hospital for the region and
are progressing to Full Business Case (FBC) and procurement. This is a really exciting
opportunity for NHS Dumfries and Galloway and the decision by the Scottish Government
will bring the biggest ever single capital investment (over £200 million) in healthcare for our
region. The project will be delivered under the Scottish Government’s Non Profit
Distributing (NPD) funding and procurement model. This is an exciting opportunity to
challenge the way we deliver our services not just within Dumfries and Galloway Royal
Infirmary but across our whole health system here in Dumfries and Galloway.
Other Recent Service Developments Include:
 Completion of our new state of the art £28 million acute mental health facility,
Midpark Hospital in Dumfries, consisting of 14 rehabilitation beds, 65 in-patient beds
and 6 intensive care beds. The new build facility provides modern, fit for purpose,
mental healthcare facilities for the 21st century and incorporates many innovative
ideas and elements which relate back to the original Crichton Royal Hospital
 The Mill Hill Centre, Kelloholm, Upper Nithsdale Opened in March 2011 – a
community facility incorporating GP surgery facilities, council and community
services jointly funded and developed by NHS Dumfries and Galloway and the
Council – embodying the principles of Putting You First.
 A £5million primary care centre at Lochfield Road, Dumfries to provide modern fit for
purpose facilities for two GP practices, the region’s Adult Drug and Alcohol Service
and also the region’s Integrated Substance Service for Children and Young People.
A number of other primary care healthcare services are also delivered from the
premises.
 Land acquisition has been completed for development of primary care centres
serving GP practices in Dalbeattie and Dunscore
 Kirkcudbright Satellite Renal Dialysis Unit - a nurse-led, Low Maintenance Dialysis
(LMD) unit based at Kirkcudbright Cottage Hospital. The unit provides an additional
3 Haemodialysis (HD) stations for the west of the region, providing haemo-dialysis
(HD) for 9 patients, dialysing 3 times per week.
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Useful Contact Details
Dumfries and Galloway Health Board
Mid North
Crichton Hall
Bankend Rd
Dumfries DG1 4TG
Tel: 01387 246246
Vice Chairman – Andrew Johnston
Tel: 01387 272743
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Dumfries and Galloway
NHS Dumfries & Galloway,
Putting You First
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