This seminar, run by What Works Scotland in partnership with ScotPHN and NHS Health Scotland, examined issues around changing the balance of spend to emphasise prevention and to shift the balance of care away from hospitals into social care in the community. It considered the assumptions around disinvestment, and how to measure and realise potential savings in prevention.
There is a current emphasis on prevention and shifting the balance of care away from hospitals into social care in the community. To change the balance of spend in this way, in an era of tight fiscal constraints, depends on releasing resources from current (less valuable) uses of resources to invest in (more valuable) alternatives. But prevention and new forms of care in the community are not just seen as areas for additional investment. They are also seen as offering potential to make the savings necessary to fund that investment.
This seminar discussed some of the beliefs and assumptions implicit in this narrative. It aimed to achieve a common understanding of the different terms used in the discussion: prevention, savings, disinvestment etc. and focused on how to measure and how to realise potential savings, recognising that this raises both economic and political/stakeholder issues.
Our speakers offered a range of perspectives relevant to this policy area:
- Hospital change and closure in Scotland: Studying the policy and politics of disinvestment (PDF) – Ellen Stewart, Usher Institute, University of Edinburgh
- An Economic Framework For Priority Setting (PDF) – presentation by Marissa Collins, Yunus Centre for Social Business and Heath
- What HTA Methods Have Been Used In Disinvestment In Health Care? (PDF) – presentation by Janet Boutell, Institute of Health and Wellbeing, University of Glasgow
The delegates worked in groups to address these questions:
- What do you think may be the most promising methods for freeing up resources for reinvestment?
- What do you see as the main barriers to freeing up resources for reinvestment in Scotland and how might we overcome these?
- What would it take to make processes for freeing up resources for reinvestment socially and/or politically legitimate?
— Laura Turney (@LauraJTurney) April 30, 2018
— lorraine gillies (@GilliesLorraine) April 30, 2018
At event on rebalancing health spending toward prevention. Challenging and political stuff. Illich described healthcare reform as more like reforming a church than an industry. @WWScot @NHS_ScotPHN pic.twitter.com/UlzTCWyyFw
— Colin Sumpter (@Sumpter_PH) April 30, 2018
Great question from floor at @WWScot event: so much discussion of dififculties of disinvestment in NHS. But in social care it is happening constantly.
— Ellen Stewart (@DrEllenStu) April 30, 2018
Event took place on Monday 30 April 2018 at The Lighthouse in Glasgow