Realising Realistic Medicine: Chief Medical Officer for Scotland annual report 2015-2016

Introduction from the Chief Medical Officer

I felt I had no choice but to write this report 'Realising Realistic Medicine' following the broad and enthusiastic discussion which ignited around the 6 key questions I asked in my 1st report 'Realistic Medicine'. Much to my delight doctors, nurses, dentists, social workers, clinical psychologists, allied health professionals, patients and their families communicated their strong feelings of support for the changes we were proposing to the practice of medicine including the suggestion that these changes were not only for healthcare but social care as well. These positive comments came from all over the world with the #realisticmedicine reaching almost 10 million Twitter feeds a year after publication.

These conversations have been of enormous benefit in helping to shape thinking as we embark on translating the Realistic Medicine philosophy into actions that justify that interest and enthusiasm.

We have built a collaborative alliance by engaging clinicians from many professions in every Health Board in Scotland, leaders from medicine and public health, as well as stakeholders from a wide group of organisations who can assist in bringing about change.

I know that many within the health and care workforce have been putting into practice Realistic Medicine for years and that others are now developing initiatives focused around embedding this philosophy for the future. This report talks about realising this vision of our future and sets out the multi-professional, national and international support we now have to adopt Realistic Medicine in Scotland. It also outlines our plans, in collaboration with the Scottish Health Council and the ALLIANCE , the national third sector intermediary for a range of health and social care organisations, for engagement with the public during 2017. I hope that the practical examples and shared learning from around Scotland showcase the exciting work underway. I have been told many times that the approach in Realistic Medicine is 'the right thing to do' and I hope that by championing this as the Chief Medical Officer for Scotland, clinicians feel that they have greater latitude to practise in this way.

Realistic Medicine puts the person receiving health and care at the centre of decision-making and encourages a personalised approach to their care. Its aims of reducing harm and waste, tackling unwarranted variation in care, managing clinical risk, and innovating to improve, are essential to a well-functioning and sustainable NHS.

My vision for 'Realising Realistic Medicine' is:

By 2025, everyone who provides healthcare in Scotland will demonstrate their professionalism through the approaches, behaviours and attitudes of Realistic Medicine.

The Annual Report also contains the traditional snapshot of the 'Health of the Nation' - we have chosen to publish only highlights this year. I hope these key headlines will stimulate those who do not generally access this material so they too can share the broad intelligence about Scotland's health. What has struck me from engagement during 2016 is the wealth of knowledge, expertise and talent across all those who support people with their health and care needs in Scotland and I look forward to continuing to collaborate with you.

Thank you to everyone, including members of the public, who provided feedback and offer continuing support for this work. Through this I have come to the conclusion that it is possible to 'Realise Realistic Medicine' in Scotland and I am certain that collectively we will continue to influence the delivery of health and social care worldwide.

Dr. Catherine Calderwood MA Cantab FRCOG FRCP Edin
Chief Medical Officer for Scotland

I'd really welcome your opinion. If you have feedback I can be reached at:

Email: cmo@gov.scot
Phone: 0131 244 2379

You can also interact with me on Twitter: twitter.com/CathCalderwood1 #RealisticMedicine
and via my blog blogs.scotland.gov.uk/cmo/
and via LinkedIn at https://www.linkedin.com/in/catherine-calderwood-691979108.

"You should expect the doctor (or other health professional) to explore and understand what matters to you personally and what your goals are, to explain to you the possible treatments or interventions available with a realistic explanation of their potential benefits and risks for you as an individual, and to discuss the option and implications of doing nothing. You should expect to be given enough information and time to make up your mind. You should consider carefully the value to you of anything that is being proposed whether it be a treatment, consultation or diagnostic investigation and be prepared to offer challenge if you feel it appropriate."