Creating a healthier Scotland - What matters to you

The Conversation

Health and wellbeing are important for all of us. This Government believes everyone should have a say in shaping the future. So we asked for your views - and we've been listening. In August 2015 we began a National Conversation on what a Healthier Scotland would look like. People from all corners of the country and from a wide variety of backgrounds took part.

You talked about lifestyles, diet, mental health, ageing, exercise and lots of other aspects of health and wellbeing - good and bad - that affect you and your families. You talked about caring for relatives and supporting people to live independent lives. You discussed your views and experiences of health and social care, and what you'd like to see happen in the future.

This report is a summary of what you said. The Conversation has given us a fantastic insight into your views and priorities. But it isn't over - in some ways it's really just beginning. In the months and years to come we'll be working to tackle the issues that matter most to you. Importantly, the Scottish public will remain involved and at the heart of further discussions.

WHAT WE ASKED

The Conversation asked three key questions

What support do we need in Scotland to live healthier lives?

What areas of health and social care matter most to you?

Thinking about the future of health and social care services, where should our focus be?

WHO DID WE TALK TO?

Our aim was to engage and speak to as many of you as we could, with a particular focus on those whose voices aren't heard as often.

We heard from many thousands of people including carers, patients, people with long-term conditions and health and social care professionals. We spoke to people from all walks of life and all age groups, in towns, cities and rural communities up and down the country. A truly national event, the Conversation involved people from Shetland to South Ayrshire and everywhere in between. For many, it was the first time they'd had their views on health and wellbeing sought or heard.

We spoke to people across all equality groups as well as those experiencing health inequalities. A summary of our approach to equalities and human rights is available along with a list of all of those who we heard from at www.healthier.scot

"A voluntary group, made up of 12 young people aged 15 to 24 from across Scotland, have been seeking views from their peers through a national survey and workshops. The team has also met with service providers, policy makers and organisations to understand their perspectives. Through the process, the team have developed innovative ideas and recommendations with a focus on individual, social and material change factors to enable their ambitious future vision of a Healthier Scotland."
Young Scot

HOW DID WE ENGAGE?

The Conversation took various forms so that people could share their views in ways that were relevant, convenient and fun for them. We spoke to people in lots of different ways, using whichever format or channel worked best, and promoted our work through digital media to encourage others to join in.

We worked with a group of partner organisations and encouraged them, and many other organisations, to reach out and hold Conversations. We were overwhelmed by the enthusiasm to take part.

A variety of innovative ways were used to gather and encourage feedback, and to make the Conversation an inspiring and open process. You took part in Conversation Café sessions, a creative competition, surveys and discussion groups.

You responded with poems, photos, music, videos and blogs - as well as by simply talking and writing about your views and concerns.

"NHS Health Scotland facilitated conversations in a community setting for those living, working and volunteering in a particular area. To minimise the barriers to engagement we did not use electronic pre-signup, we did not provide name badges, post-it notes, pens or paper. We discouraged people from writing anything down. We simply emphasised the conversation, cup of tea and eye contact with one another. Conversation themes were captured through graphic facilitation, photography and video."
NHS Health Scotland

WHAT DID WE DO WITH YOUR FEEDBACK?

Everyone's voice is equally important. Every contribution to the Conversation was treated in exactly the same way, whether it came from an individual or a national organisation.

We read or listened to every piece of feedback you submitted, whether it was a postcard, a video, an email, a written summary of your event, an organisational response or a comment on social media.

We coded each piece of feedback into categories and specific topics. We received helpful comments from partner organisations. They were able to highlight gaps, and question how we had grouped things, and review the type of language we were using.

We've selected quotes for this report which represent the range of responses we received. This summary is simply a reflection of what we've heard from the broad conversations you've had and does not set out to represent national opinion.

"Carers from across Scotland were asked to write their own prescriptions for a Healthier Scotland at a meeting of the Coalition of Carers. Views were recorded in unusual ways, including writing on a hospital bed, a doctor's coat, prescription pads and on tea bags."
Coalition of Carers in Scotland

AN OVERWHELMING LEVEL OF INTEREST…

Over 9,000 people have taken part in the Conversation at 240 events over a six month period. In addition, many of you provided your views and comments directly by postcard, email or through our social media channels.

Our Twitter, Facebook and blog activity reached over 360,000 people and we registered thousands of visits, 'likes' and retweets.

9,216 people attending conversation events

240 events have taken place from Shetland to South Ayrshire

12,284 visitors to facebook and the blog site

4,999 engagements on social media

365,141 people reached through twitter, facebook and blogs

WHY IS CHANGE NEEDED?

Scotland has a lot to be proud of in terms of health and social care, and a great deal of progress has been made in tackling some persistent problems over recent years. For a start, we're living longer, and that's great news. Twenty years ago people in Scotland could expect to live to 57 in broadly good health. Today, healthy life expectancy is 61.

As more people live longer, we need to support them to live as independently and as healthily as possible. At the moment there are around 430,000 people in Scotland aged 75 or over. By 2039, that number will increase by 370,000 - that's roughly the same as the population of Aberdeen and Dundee put together. As we live longer, our health needs tend to become more complex. About three quarters of people aged 75 or older have a long-term condition. They're twice as likely as those without to be admitted to hospital, and they stay in hospital for disproportionately longer periods. Long-term conditions also account for 80% of all GP appointments in Scotland. So the changing demographics have significant implications for the future.

We cannot ignore the marked inequalities in health which exist between different parts of Scotland. There is a 23 year gap in healthy life expectancy between the richest and poorest areas. That needs to be tackled, but it cannot be fixed by health and social care services alone because our health is influenced by things like poverty and employment, housing, education and childhood experiences.

Meanwhile the pace of scientific and technological developments are quickening. There are great opportunities for Scotland to harness these to help people stay healthy for longer and to self-manage their own conditions better. eHealth tools can allow people to live longer at home and to become more involved in decisions about their own care.

We are also aware of the importance of our children and young people having the best start in life. That means focusing on the early years of a child's life as well as looking at a child's whole wellbeing, not just a single element of what makes them safe or healthy or able to achieve. Preventing illness in the first place - by promoting healthy lifestyles and encouraging wellbeing - has to be at the heart of what we do. Whilst we are making good progress, challenges remain.

We all need health care at some point in our lives. The first point of contact for most people is healthcare in the community, including GPs, community nurses, pharmacists, midwives, optometrists, dentists and allied health professionals such as physiotherapists. When hospital treatment is needed, the focus is to get people back into their homes as soon as possible.

Many people need social care throughout their lives to help them live independently. This might include support with personal care and housework as well as equipment and housing adaptations. Others will need support from social care services to help them stay at home, in their day to day activities, or in their local community as they age and become more frail. For others, this will be transitional support to help them adjust to new surroundings, for example after leaving care or prison.

IT IS CLEAR THAT CHANGE IS NECESSARY.

This Government wants people to be involved in, and to have influence on the decisions that affect their lives. Building on the knowledge and strength of people will lead to the best outcomes. This Conversation has started the process of doing that to create a Healthier Scotland for us all.