2. NHS Greater Glasgow and Clyde: background and context
NHS Greater Glasgow and Clyde is one of 14 Health Boards in Scotland (Figure 2.1).
It was formed in April 2006 by combining NHS Greater Glasgow and the Clyde area of NHS Argyll and Clyde. It covers an area of 452.3 square miles in west central Scotland, with a population of 1,190,856, almost a quarter of the population of Scotland (2). Its 44,000 staff deliver services across its home area, as well as regionally and nationally.
The aims of NHS Greater Glasgow and Clyde are to deliver effective and high quality health services and, along with its partners, to improve the health of the population and reduce health inequalities.
The organisation covers a diverse geographical area, including Glasgow, the largest city in Scotland, large and small towns, villages and coastal and rural areas. Within its boundaries are the territories of six local authorities, and parts of the territories of two local authorities (as shown on Figure 2.1.) These are:
Reorganisation of health service provision
Since NHS Greater Glasgow and Clyde was formed in April 2006, it has gone through an extensive reorganisation that reflects the thinking of both its senior management and the Scottish Government Health Directorates. This has resulted in a coherent strategy and structure that recognises that the organisation’s role is as much to promote and protect health and prevent disease as it is to care for the sick, which has been the traditional focus of the NHS. This reorganisation has coincided with the establishment of Community Health (and Care) Partnerships.
NHS Greater Glasgow and Clyde aims to become a public health organisation and, as such, public health responsibility and leadership will be embedded throughout the organisation. The Director of Public Health provides leadership, working closely with all sections of the organisation. This post is, for the first time, a joint post with Glasgow City Council, an acknowledgement of the role of local authorities in improving health. The NHS Greater Glasgow and Clyde Board is developing a comprehensive framework for health improvement and a coordinated approach to planning to address inequalities through its planning and priorities guidance.
Community Health (and Care) Partnerships
These have an important role in bringing together the partners who design and deliver services that are intended to improve the lives of the communities they serve. They work to improve the health of their local populations and to reduce health inequalities. They do this by providing a focus for the integration of primary health care, specialist health services and social services, to ensure that local population health improvement is at the heart of service planning and delivery.
The partnerships work to develop a more locally sensitive provision of health care and health improvement. Their responsibilities include health visiting, district nursing, speech and language therapy, physiotherapy, podiatry, mental health, addiction and learning disability services.
Staff delivering these services work closely with other local health professionals, including GPs, dentists, pharmacists and opticians, to plan and develop services across their partnership areas. All partnerships are responsible for consulting actively with local communities to ensure that their services reflect local needs and demonstrate a more consistent and co-ordinated approach to planning of services through, for example, the community planning process.
Most partnerships have boundaries that match local authority areas. In NHS Greater Glasgow and Clyde, however, the Glasgow City Council boundaries contain five partnerships and there are two areas to the east that are part of two partnerships in two other local authorities (North and South Lanarkshire).
Additionally, the Glasgow City and East Renfrewshire Councils have integrated Social Care services to form Community Health and Care Partnerships, CH(C)Ps. For clarity, this report refers to both these forms of Community Health Partnerships as CH(C)Ps.
As a result of the recent reorganisation, some older datasets in this report reflect the boundaries of the former NHS Greater Glasgow and some reflect the present NHS Greater Glasgow and Clyde. In general, this report will give data for the 10 CH(C)Ps for which it has full responsibility and omit the small parts of North and South Lanarkshire that it shares with NHS Lanarkshire.
The map (Figure 2.1) and following two charts give some indication of the areas and populations served, and the levels of deprivation, of each CH(C)P. The populations range from approximately 170,000 in Renfrewshire to 82,000 in Inverclyde.
There are wide variations in the deprivation levels of the 10 CH(C)Ps. The percentages refer to the population within each CH(C)P that falls in the 15% most deprived areas in Scotland as a proportion of the total population in the CH(C)P area.
NHS Greater Glasgow and Clyde is also responsible for corporate services and acute services as well as partnerships for addictions, mental health, learning disability and homelessness.
The acute operating division includes eight directorates covering emergency care and medical services, surgery and anaesthetics, oral health, women and children’s services, regional services, rehabilitation and assessment, diagnostics, facilities and a directorate managing the acute services within the Clyde area.
Although community services for adult mental health, addictions and learning disabilities are provided in CH(C)Ps, all services for these client groups are overseen by specialist partnerships which ensure a uniform approach to their planning and delivery.
To deliver improved health and health care through its services NHS Greater Glasgow and Clyde also provides leadership in clinical governance, health information and technology across the area. A number of planning groups and managed clinical networks ensure that clinical priorities are planned, managed and co-ordinated across prevention, diagnosis, treatment and care. The organisation also provides leadership on community engagement, through its patient focus and public involvement structures. The organisation is committed to engage with all communities on all aspects of its policy planning and service delivery.
NHS Greater Glasgow and Clyde is working to develop ways of increasing health improvement and decreasing inequalities. It is determined to be a more effective public health organisation, with a significant focus on addressing population health challenges and the inequalities that underlie them. The organisation will not just focus on the behaviours that contribute to poor health but will also recognise and address, in its own responsibilities and in partnership working, the wider social determinants of health. In this way, it will change the way it delivers its own services and influence positive change in its many partner organisations.