A National Clinical Strategy for Scotland

Foreword

Over the last ten years there have been significant changes in Scotland's population and in the needs and demands placed on our health and social care services. In 2010, in the Quality Strategy, the Scottish Government set out its strategic vision for achieving sustainable quality in the delivery of healthcare services across Scotland, in the face of the significant challenges of Scotland's public health record, our changing demography and the economic environment. In 2011, the Scottish Government committed to integrating health and social care, to address in particular the changing needs of our growing population of people with multiple complex needs, many of whom are older. This was followed in 2012 by publication of the 2020 Vision which provided the strategic narrative and context for taking forward integration and implementing the Quality Strategy, and the required actions to improve efficiency and achieve financial sustainability.

In 2015 the Scottish Government set out the need for transformational change in NHSScotland to meet people's health and social care needs by 2020 and beyond. The Scottish Government's Draft Budget for 2016/17 proposes significant new investment in health and social care services to pursue ambitious reform. This National Clinical Strategy is an important contribution to the provision of clarity on the priorities for that reform. The Strategy is underpinned by the following set of key principles:

• Quality must be the primary concern - all developments should seek to ensure that there is enhancement of patient safety, clinical effectiveness and a person-centred approach to care.
• Developments should be guided by evidence where available: evaluation of any changes should be considered before making the changes.
• We will continue to provide caring health and social care services that will recognise the central importance of the role of people using services, their carers, and their community in providing support. This allows people and communities to manage their own health more. A system that seeks to build on this, rather than supply alternatives, is likely to improve population health and wellbeing, as well as the individual experience and outcome of illness.
• Services will be based around supporting people, rather than single disease pathways, with a solid foundation of integrated health and social care services based on new models of community-based provision.
• Where clinically appropriate we will continue to plan and deliver services at a local level. Where there is evidence that better outcomes could only be reliably and sustainably produced by planning services on a regional or national level, we will respond to this evidence to secure the best possible outcomes.
• The impact of health inequalities will be minimised by ensuring equitable access to health and social care support, removing barriers that make people less likely to access care.

The Strategy makes proposals for how clinical services need to change in order to provide sustainable health and social care services fit for the future. It sets out a vision that is both ambitious and challenging as a basis for further engagement with clinicians and the public.

Scotland has a long tradition of providing high quality health and social care services to our population and we believe that we are well placed to achieve the transformational change required.

There has been extensive engagement with clinicians, professionals and stakeholders in the preparation of this draft of the National Clinical Strategy. However, we recognise it's not the finished article and that we need to engage further about it. The national conversation on "Creating a Healthier Scotland" provides the ideal opportunity for that engagement. So we will, through the national conversation, engage with those interests but also with the public whom health and social care services serve.

Professor Jason Leitch
National Clinical Director

Dr Catherine Calderwood
Chief Medical Officer

Professor Fiona McQueen
Chief Nursing Officer