Healthcare Science in Scotland: Defining Our Strategic Approach: Fairer Scotland Impact Assessment

Stage 2 – Evidence

What does the evidence suggest about existing inequalities of outcome, caused by socio-economic disadvantage, in this specific policy area?

What does the evidence suggest about any possible impacts of the policy/programme/decision, as currently planned, on those inequalities of outcome?

There is insufficient evidence about the economic impact of healthcare science on the NHS in Scotland, and the country more widely.

We are aware of persistent health inequalities more generally as a result of socio-economic background and deprivation. In 2019-2021, male Healthy Life Expectancy (HLE) at birth was 46.3 years for those living in the most deprived areas, 25.8 years lower than those living in the least deprived areas (72.1 years). Female HLE at birth was 47.3 years for those living in the most deprived areas, 25.7 years lower than those living in the least deprived areas (73.1 years) - Long-term Monitoring of Health Inequalities: March 2023 Report (www.gov.scot).

Mortality rates are almost twice as high in the most deprived areas compared to the least deprived areas, and for some specific causes of death there are even larger inequalities (Scotland's Population 2021 (nrscotland.gov.uk)).

Changes to how healthcare science is used in the NHS in Scotland in the future will then potentially have a direct and indirect impact on inequalities.

There is also evidence of higher mortality from specific conditions, such as Coronary Heart Disease and Cancer for those living in Scotland’s most deprived areas (Long-term Monitoring of Health Inequalities: March 2023 Report (www.gov.scot)). The scientific workforce has a direct impact on diagnosis and treatment of these conditions and as such, future work on actions to be undertaken should consider the ways in which health inequalities due to socio-economic disadvantage can be reduced.

Is there any evidence that suggests alternative approaches to the policy/programme/decision?

Both England and Wales have strategic direction which is outlined in the following papers:

science-in-healthcare-delivering-the-nhs-long-term-plan.pdf (england.nhs.uk)

and Healthcare science in NHS Wales | GOV.WALES

Previous work carried out in Scotland under HCS strategy papers have resulted in a lack of significant strategic outcomes. It is hoped that by taking a continual improvement approach, the profile of HCS in Scotland will be raised and the contribution of HCS will be recognised providing more opportunities to align with the recovery, reformation and transformation of NHS Scotland.

What key evidence gaps are there?

Is it possible to collect new evidence quickly in areas where we don’t currently have any – consultation focus groups?

As already noted above, there is insufficient evidence about the economic impact of healthcare science on the NHS in Scotland, and the country more widely.

We are committing to undertake future work to more fully understand the landscape of healthcare science in Scotland – that is the purpose of the paper to which this impact assessment relates. This landscape mapping will allow gathering of data which will inform the direction of actions to be taken under the key themes which have been identified.

How could you involve communities of interest (including those with lived experience of poverty and disadvantage) in this process?

The voices of the people and communities are likely to be important in identifying any potential improvements to the prog/policy/decision?

Work under each key theme will be directed by a robust governance and delivery structure which will consider the inclusion of communities / lived experience. Stakeholder engagement has been clearly defined in the proposal for future governance and delivery.