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Scotland sets out health and social care blueprint for next decade

National clinical strategy aims to modernise delivery of care

Caroline White

Thursday, 18 February 2016

The Scottish government has set out a blueprint for the future of health and social care services over the next 10 to 15 years.

The National Clinical Strategy aims to deliver a range of improvements and reforms to modernise the way care is provided, taking account of the nation’s ageing population, the shift to more multidisciplinary working, and rapid advances in research and technology.

The strategy outlines the need to provide more care where people need it, with as much care as possible delivered locally, and the transformational change taking place within primary care, which will be delivered by multi-disciplinary teams with strong links to local authority social services.

To give patients the best possible outcomes, complex treatments may be delivered in specialist centres, with follow up treatment available locally, it says, and it emphasises the importance of supporting patients to fully understand and manage their health needs, with a focus on rehabilitation and independence.

It also outlines proposals to support smaller and rural hospitals to deliver for their communities, including the deployment of clinicians working in more than one hospital to allow specialist input to be delivered to remote and rural locations.

The development of the National Clinical Strategy was led by medical director and former GP, Dr Angus Cameron, with input from the National Clinical Director, Chief Medical Officer and Chief Nursing Officer.

It has also been shaped by the views of the patients, the public and clinicians who have contributed to the Scottish Government’s ongoing Healthier Scotland conversation.

At its launch in Dundee, health secretary Shona Robison said: “As the population of Scotland changes over the next 15 years, our health and care services must evolve with it. We’re committed to ensuring services are of the highest quality and provide the best possible care for patients.

“While we’re already making good progress, with record numbers of staff and a record health budget of almost £13 billion, there are still areas that can be improved to support our aim of providing exemplary health services long into the future.”

She added: “The foundation of this strategy is to provide care as locally as possible. A whole-team, community-based care approach is vital to the future of the NHS, and will mean that people continue to be treated close to home, or even in their home, in the majority of cases.”

RCN Scotland Director Theresa Fyffe commented: “Over the last two years, we have been consistently arguing for the Scottish government to take a whole-system approach to ensure our health and care services are sustainable for the future. We have also – along with the Medical Royal Colleges in Scotland – said publicly that the status quo is no longer an option and that significant changes are needed to how services are delivered to make them fit for the future. 

“This high-level document brings the government firmly behind the voice of those calling for change.”

But she said: “What’s missing, however, is any explicit detail on how these changes could be delivered…To transform how services are delivered and turn this strategy into reality, we will need robust long-term workforce planning across all health and care services and professions, with all having an equal voice in decisions about how and where services are delivered.” 

She continued: “We also believe that it’s important that services are designed around patients, not around professionals. It’s good to talk about local technology-enabled care and using technology to support long-distance services. But those living in our most deprived communities or in remote and rural areas do not have access to the technology to enable this, nor the right infrastructure – such as reliable transport and broadband – to support these changes. These issues will need to be addressed in the ‘route map’ for implementation.”

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