Publication - Progress report

Practising Realistic Medicine: Chief Medical Officer for Scotland annual report

Published: 20 Apr 2018

The Chief Medical Officer's third annual report on applying the personalised, patient-centred realistic medicine approach across Scotland.

72 page PDF

1.7 MB

72 page PDF

1.7 MB

Practising Realistic Medicine: Chief Medical Officer for Scotland annual report

72 page PDF

1.7 MB


1 Realising Realistic Medicine pp 17

2 Second Citizens’ Panel Survey Report, August 2017, pp 22

3 Ibid

4 Realising Realistic Medicine pp 18

5 Stability of Preferences for End of Life Treatment after 3 Years of Follow-Up: The Johns Hopkins Precursor Study;

see also

6 Butow, P. N., Dunn, S. M., Tattersall, M. H., & Jones, Q. J. (1995). Computer-based interaction analysis of the cancer consultation. British Journal of Cancer, 71(5), 1115.

7 Richards, Tessa. The responses to the “cancer drugs scandal” must fully involve patients—an essay, BMJ, October 2017;359:j4956 doi: 10.1136/bmj.j4956

8 McDonald A. A long and winding road: improving communication with patients in the NHS. Marie Curie, London, 2016.

9 Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ 1995; 152 (9): 1422-33

10 Hacking B, Wallace L, Scott S, Kosmala-Anderson J, Belkora J, McNeill A. Testing the feasibility, acceptability and effectiveness of a ‘decision-navigation’ intervention for early stage prostate cancer patients in Scotland - a randomised controlled trial. Psycho-Oncology 2012. DOI: 10.1002/pon.3093

11 Hacking, B., Scott, S.E, Wallace, L.M., Shepherd, S.C. and Belkora, J.. Navigating healthcare: a qualitative study exploring prostate cancer patients’ and doctors’ experience of consultations in usual care compared to a decision support intervention.Psycho-Oncology, 2014 DOI: 10.1002/pon.3466.

12 Bertakis KD, Roter D, Putnam SM. The relationship of physician medical interview style to patient satisfaction. J Fam Pract. 1991;32:175–181.

13 Batterham RW, Hawkins M, Collins PA, Buchbinder R, Osborne RH. Health literacy: applying current concepts to improve health services and reduce health inequalities. Public Health 2016; 132: 3-12.

14 Kinnersley P, Edwards A, Hood K, Cadbury N, Ryan R, Prout H, Owen D, MacBeth F, Butow P, Butler C. (2007) Interventions before consultations for helping patients address their information needs. Cochrane Database of Systematic Reviews: Reviews Issue 3 John Wiley & Sons, Ltd Chichester, UK

15 Ibid

16 Moore PM, Rivera Mercado S, Grez Artigues M, Lawrie TA. Communication skills training for healthcare professionals working with people who have cancer. The Cochrane Library. 2013.

17 Effective Communication for Healthcare

18 Elwyn, G., Dwand, MA, Song, J., et al. A 3 Talk Model for Shared Decision Making: Multi-Stage Consultation Process. BMJ, 2017:359:j4891

19 Centre for Change and Innovation. Talking Matters-Developing the Communication Skills of Doctors

20 Montgomery vs Lanarkshire Health Board 11 March 2015

21 Consent: empowering my patients to make informed choices

22 Scottish Public Services Ombudsman. Informed Consent Learning from Complaints

23 Waddell G, Burton KA. Is work good for your health and wellbeing? (2006). Department of Work and Pensions.

24 Cohen RA. Yerkes-Dodson Law. In: Kreutzer J, DeLuca J, Caplan B. Encyclopedia of Clinical Neuropsychology, p2737-2738 (Springer).

25 Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (2013)

26 Spurgeon P, Mazelan P, Barwell F. Medical engagement: a crucial underpinning to organisational performance. Health Services Management Research (2011) 24, p:114-120

27 KPMG International. (2016) What works: The Trillion Dollar Question.

28 West, Michael & Dawson, Jeremy. Employee Engagement and NHS Performance. The King’s Fund, 2012.

29 Ibid

30 Royal College of Physicians. Being a junior doctor: Experiences from the front line of the NHS. (2016).

31 Audit Scotland. NHS Workforce Planning (2017)

32 The Foundation Programme. Career Destination Report 2016.

33 Smith SE, Tallentire VR, Pope L, Laidlaw AH, Morrison J. Foundation Year 2 doctors’ reasons for leaving UK medicine: An in-depth analysis of decision-making using semi-structured interviews. BMJ Open.

34 2017 national training surveys summary report: initial results on doctors’ training and progression

35 PriceWaterHouse Cooper. NexGen: A global generational study (2013)

36 Bullying and Undermining Campaign

37 Audit Scotland. NHS Workforce Planning (2017)

38 The Kings Fund (2014). West M, Eckert R, Steward K, Pasmore B. Developing collective leadership for healthcare.

39 The Kings Fund (2017) West M, Collins B, Eckert R, Chowla R. Caring to change: how compassionate leadership can stimulate innovation in healthcare.

40 The Kings Fund (2015). Staff Engagement: Six building blocks for harnessing the creativity and enthusiasm of NHS staff.

41 Wenberg, J. Unwarranted variations in healthcare delivery: implications for academic medical centres. BMJ, 2002 Oct 26; 325 (7370): 961-964.

42 Value vs Values – Professor Matthew Cripps.

43 Felitti V, Anda R, Nordenberg D, Williamson D, Spitz A, Edwards V, Koss M, Marks J. Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults. American Journal of Preventative Medicine 1998;14(4)

44 McEwan B, Stellar E. Stress and the Individual. Mechanisms leading to Disease. Archives of Internal Medicine 153(18): 2093-101. doi: 10.1001/archinte.153.18.2093

45 Scottish Government. A Nation with Ambition: The Government’s Programme for Scotland 2017-18 (Sept 2017). ISBN 9781788511919.

46 Sackett D, Rosenberg W, Gray J, Haynes R, Richardson W (1996). Evidence Based Medicine: what it is and what it isn’t. BMJ 1996;312:71

47 Guthrie B, Gillies J, Calderwood C, Smith G, Mercer S (2017). Developing Middle Ground Research to Support Primary Care Transformation. Br J Gen Pract 2017; 67 (664): 498-499

48 Ibid

49 Health and Social Care Alliance Scotland. Going in the Right Direction Toolkit.

50 Berwick, D (2003). Disseminating Innovations in Health Care. JAMA. 2003; 289(15):1969-1975. Doi:10.1001/jama.289.15.1969

51 Crisp, N (2011). A life we have reason to value. OUPblog, 29th September 2011.

52 Poverty Truth Commission and the Scottish Government (2015). Poverty in Scotland. Scottish Government, Edinburgh.

53 Ibid

54 Scottish Public Health Observatory (2017). Scottish Burden of Disease study, 2015. NHS Health Scotland and ISD, Edinburgh.

55 Aether Ltd (2017). Evidence review of the potential wider impacts of climate change mitigation options: transport sector. Report to the Scottish Government. Scottish Government, Edinburgh.

56 Masters R, Anwar E, Collins B, et al (2017). Return on investment of public health interventions: a systematic review. J Epidemiol Community Health. doi: 10.1136/jech-2016-208141

57 McCann A, Mackie P, Conacher A. Social isolation and loneliness: what is the scope for public health action? Scottish Public Health Network, Glasgow.

58 NHS Health Scotland (2016). Inequality briefing 3. Economics of prevention. NHS Health Scotland, Edinburgh.

59 Rezansoff SN, Moniruzzaman A, Fazel S, et al (2017). Housing First improves adherence to anti-psychotic medication among formerly homeless adults with schizophrenia: results of a randomised controlled trial.

60 Aidalaa AA, Wilson MG, Shubert V, Gogolishvili D, Globerman J, Rueda S, et al (2016). Housing Status, Medical Care, and Health Outcomes Among People Living With HIV/ AIDS: A Systematic Review. Am J Public Health. 106(1):e1-e23. doi: 10.2105/ AJPH.2015.302905.

61 Sinclair J (2017). The Deep End Advice Worker Project: embedding advice in general practice. Glasgow Centre for Population Health, Glasgow.

62 Scottish Government (2017) Long-term monitoring of health inequalities. Scottish Government, Edinburgh.

63 NHS Health Scotland (2015) Health Inequalities: What are they? How do we reduce them?

64 Ibid

65 Bellis, M, Cook, P, Jones, L et al (2015). Understanding the alcohol harm paradox in order to focus the development of interventions. Liverpool John Moores University, Liverpool.

66 Couper S, Mackie P (2016). Polishing the diamonds. Scottish Public Health Network, Glasgow.

67 Bellis M, Ashton K, Hughes K, et al (2015). Adverse childhood experiences and their impact on health-harming behaviours in the Welsh adult population. Public Health Wales, Cardiff.$FILE/ACE%20Report%20FINAL%20(E).pdf

68 Scottish Health and Inequalities Impact Assessment Network (2017). 50,000 affordable homes: a Health Impact Assessment. Scottish Public Health Network, Glasgow.

69 Glasgow Centre for Population Health (2015) Evaluating Sistema Scotland – initial findings report. Glasgow Centre for Population Health, Glasgow.

70 NHS Health Scotland (2016). Power: a health and social justice issue. NHS Health Scotland, Edinburgh.

71 Shiels MS, Chernyavskiy P, Anderson WF, et al. Trends in premature mortality in the USA by sex, race, and ethnicity from 1999 to 2014: an analysis of death certificate data. The Lancet 2017; 389: 1043–54.

72 Hiam L, Dorling D, Harrison D, McKee M. Why has mortality in England and Wales been increasing? An iterative demographic analysis. J R Soc Med 2017; 110: 153–62.

73 Marmot MG. Michael Marmot: The UK’s current health problems should be treated with urgency. 2017.

74 Green MA, Dorling D, Minton J, Pickett KE. Could the rise in mortality rates since 2015 be explained by changes in the number of delayed discharges of NHS patients? J Epidemiol Community Health 2017;jech – 2017–209403.

75 Scottish Public Health Observatory. The Scottish Burden of Disease Study, 2015: overview report. NHS Health Scotland and Information Services Division (2017), Edinburgh.

76 Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012 Jul 7;380(9836):37-43. doi: 10.1016/S0140-6736(12)60240-2.

77 Ibid

78 Scottish Diabetes Survey Monitoring Group. Scottish Diabetes Survey 2016. NHS Scotland (2017).

79 Scottish Health Survey 2016. Scottish Government (2017), Edinburgh.

80 Bromley C, Tod E, McCartney G. Obesity and health inequalities in Scotland. Scottish Public Health Observatory (2017), Edinburgh.

81 Ibid

82 Ibid

83 Scottish Health Survey 2016. Scottish Government (2017), Edinburgh. Available at:

84 Thornley C, Cook W. Flexibility for Who? Millennials and Mental Health in the Modern Labour Market. Institute for Public Policy Research (2017).

85 Taulbut M, McCartney G. Health outcomes and determinants by occupation and industry in Scotland, 2008–2011. NHS Health Scotland: Edinburgh; 2017

86 National Records of Scotland. Drug-related deaths in Scotland in 2016. National Records for Scotland (2017), Edinburgh.

87 Information Services Division. The National Drug-Related Deaths Database (Scotland) Report: Analysis of Deaths occurring in 2014. NHS National Services Scotland (2016), Edinburgh.

88 The Expert Working Group on Older People with a Drug Problem. Older People with Drug Problems in Scotland: Addressing the needs of an ageing population. Scottish Drugs Forum (2017), Glasgow.

89 Gillies M. Toward a public health approach for gambling related harm: a scoping document. Scottish Public Health Network (2016), Glasgow.

90 Ibid

91 Gambling Commission. Young People and Gambling 2016: A research study among 11-15 year olds in England and Wales. Gambling Commission (2016), Birmingham.

92 Macpherson LM, Anopa Y, Conway DI, McMahon AD. National supervised toothbrushing program and dental decay in Scotland. J Dent Res. 2013 Feb;92(2):109-13.

93 Anopa Y, McMahon AD, Conway DI, Ball GE, McIntosh E, Macpherson LM . Improving Child Oral Health: Cost Analysis of a National Nursery Toothbrushing Programme. PLoS One. 2015 Aug 25;10(8):e0136211

94 Cameron RL, Kavanagh K, Cameron Watt D, et al. The impact of bivalent HPV vaccine on cervical intraepithelial neoplasia by deprivation in Scotland: reducing the gap. J Epidemiol Community Health 2017;71:954-960

95 Ibid

96 Nandwani R and Valiotis G, on behalf of the Scottish HIV Pre-Exposure Prophylaxis Short Life Working Group. PrEP in Scotland. Scottish Health Protection Network (2016).

97 McCormack S, Dunn DT, Desai M et al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection ( PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet 2016; 387 (10013):53-60

98 Nandwani R and Valiotis G, on behalf of the Scottish HIV Pre-Exposure Prophylaxis Short Life Working Group. PrEP in Scotland. Scottish Health Protection Network (2016).