Realistic Medicine - Feedback Report

Foreword by CMO

I used the publication of my first annual report as Chief Medical Officer for Scotland ( CMO) in January 2016, entitled Realistic Medicine, to encourage discussion with clinicians as collaborative leaders, to influence approaches to care and to be a driver for change.

The report laid out many of the challenges facing healthcare and the profession today and started a conversation with doctors about how these could be addressed. Since publication I have engaged with clinicians on how together we can successfully realise these aims contained in Realistic Medicine, by: changing our style to shared decision-making; building a personalised approach to care; reducing harm and waste; reducing unnecessary variation in practice and outcomes; managing risk better; and becoming improvers and innovators.

My purpose in writing to you today, is to update you on the discussion and share some of the further work already taking place in Scotland that assists making Realistic Medicine a reality.

Realistic Medicine was received well not only in Scotland but also internationally on social media - with #realisticmedicine reaching over 6.7m Twitter feeds and its infographic being shared globally. I welcome that Realistic Medicine has been accepted not only by clinicians but other professionals and practitioners in health and social care who want to embrace and adopt the philosophy and strengthen the movement. This is helping with the next steps, which will rely on collaboration from many across the health and care sector, with individuals themselves acting as role models and leaders.

I believe the engagement process has helped foster a collective and inclusive approach to realising Realistic Medicine. We have built a collaborative alliance by engaging clinicians in every Health Board in Scotland as well as stakeholders from health and care workforce education, professional membership organisations, registration and standards bodies, improvement and scrutiny bodies, shared services including data analysts, health promotion agencies, leaders and managers at regional levels, unions including those with responsibility for litigation and of course organisations that provide a patient and public voice.

Individual clinicians have told me they welcomed being able to connect with me, my team and with colleagues on these issues. I also think there has been a wider sense of Realistic Medicine as a "movement" that has enabled people, not only clinicians, in NHS Scotland to have authentic conversations about the way we improve quality of care. I am grateful that I now have invaluable evidence - set out in this report - from those who will be crucial to implementing Realistic Medicine, including what the barriers to change really are and how best to remove these. I will continue to lead with collaboration from my colleagues within Scottish Government and all my partners who have embraced Realistic Medicine and have all an important role to play in its delivery.

Catherine Calderwood