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'Partnership for Care': Scotland's Health White Paper - Executive Summary

DescriptionThis is a summary of the Health White Paper 'Partnership for Care'
Official Print Publication Date
Website Publication DateFebruary 27, 2003


    Scotland's Health White Paper: Summary

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    The National Health Service has served the people of Scotland well for over 50 years. It still provides a universal service based on need.

    But people today expect more. They want the right care at the right time and in the right place. They want to be involved in decisions about what is best for them. They want safe and consistent healthcare in modern premises.

    Funding for healthcare in Scotland will rise, from 6.7 billion to 9.3 billion over the life of the next Parliament. Taxpayers and patients want to see a real improvement in services for this extra money.

    The vast majority of patients are happy with the way the health service has helped them. But most people also think the NHS can do better. In any case, the NHS must adapt as it treats increasing numbers of older people and tackles new diseases.

    That is why we are publishing this White Paper - to promote a culture of continuous improvement in NHSScotland. The White Paper describes how services can be modernised to deliver the high quality care we all want.

    This White Paper aims to devolve power to those best placed to make a difference, and to involve people better in promoting the right changes for our healthcare.

    Improving health

    We need a radical change to improve our health in Scotland. We have some of the highest death rates in the world for cancer and heart disease. Mental ill health is increasing. There are unacceptable health inequalities within our society.

    Tackling these problems will not be easy. We need to work together to change our own unhealthy lifestyles and the unhealthy circumstances in which too many people live.

    We will encourage people to care about their own health - helping them understand how they can improve their own health. We will work to create a national movement for health improvement.

    Higher standards of healthcare

    Scotland has an international reputation for assessing the quality of healthcare. In recent years we have set national clinical and service standards and are monitoring how well NHSScotland is performing against these standards of care. The public will be involved at every stage. This process will help to drive forward change.

    We are tackling waiting times and delayed discharges. We will strengthen the system of targets for waiting times with a new guarantee of treatment on time, with new clinical targets for conditions like hip operations, and
    local targets, set by NHS Boards, to drive performance ahead of the national targets.

    Listening to patients and the public

    A huge investment is being made to modernise healthcare services across Scotland with the largest hospital building programme ever and many new and modernised healthcare facilities at local level. We need now to release the energy and talent in NHSScotland to deliver better services for patients.

    The health service exists for patients. It has to become more responsive to their needs. Most people want to be involved in decisions about their own health. They expect the health service to work in partnership with their families and carers.

    We will produce a new statement of a patient's rights and responsibilities. A Patient Information Initiative will provide better information and make it more widely available. A new complaints procedure will emphasise service improvement. We will improve the training for NHS staff to help them communicate more effectively with patients.

    A new Integrated Care Record for each patient will enable health professionals to work better as a team in partnership with the patient.

    People also expect to be properly consulted about changes in their local health services. We will set up a new Scottish Health Council to promote public involvement in decisions about the NHS.

    We will require new Community Health Partnerships, which bring together health professionals at a local level, to work with Community Planning partners to promote good health.

    What the White Paper means for patients:

    • More local health care - a wider range of services (diagnostic, treatment, rehabilitation) delivered locally in communities.

    • Safe and high quality health care - in modernised hospitals for acute health services.

    • Shorter waiting times - as services are redesigned to meet national clinical standards of care and to treat patients more quickly. A new guarantee of treatment on time, new clinical targets for specific conditions and new local targets.

    • Better health information and advice - national roll out of NHS 24. A Patient Information Initiative to provide reliable information on healthcare.

    • Better public involvement in planning services - a new Scottish Health Council and local Public Partnership Forums so that people can be heard inside the NHS.

    • Patients as partners in decision making - plans for an Integrated Care Record, owned jointly by patients and their health professionals. A new statement of patients' rights and responsibilities.

    What the White Paper means for NHS staff:

    • A new opportunity - to play an active part in modernising health services for the benefit of patients and for your own job satisfaction.

    • New reward systems - to recognise those who contribute most to the NHS; by acquiring new skills, developing new roles and modernising services.

    • Partnership working - a fresh commitment to the Scottish Partnership Forum by NHSScotland and its workforce.

    • Support for professional development - to make NHSScotland a learning organisation, dedicated to continual improvement.

    • Support for local leadership - by devolving authority within NHS Boards to encourage local initiative.

    • New approach on workforce planning - to increase the capacity of NHSScotland and to match skills to the needs of the NHS.

    Empowering and equipping staff

    It is the frontline staff of NHSScotland who are the key to improving health services. We will invest in NHS staff - to provide them with what they need to do their best for patients.

    We will improve workforce planning and invest in training and education. Patients are already benefiting from more flexible working within NHSScotland as key staff, such as nurses and pharmacists, make better use of their skills.

    We will continue to reform the pay and working conditions of NHSScotland staff, to link the rewards they deserve with the delivery of modernised
    health services that patients need.

    Delivering change

    The public is concerned about quality of service, not the body that provides it. They expect the NHS at local level to be a unified organisation.

    NHS Boards will bring forward plans to dissolve NHS Trusts. New operational units, including new Community Health Partnerships, will
    allow authority to be devolved as far as possible and will enable health professionals to improve patient care. They will be supported by the Centre for Change and Innovation. We will establish a Change and Innovation Fund.

    Patients want simple, streamlined services. So we emphasise the integration of services within NHSScotland and between NHSScotland
    and the social work services of Local Authorities.

    In summary, the White Paper proposes:

    • Unified NHS Boards, abolition of NHS Trusts, and new requirements to devolve authority to frontline staff and to involve professionals.

    • New Community Health Partnerships, more accountable to local communities, better matched with social work services and better able to represent local interests within the NHS Boards.

    • A new Scottish Health Council to involve the public in NHSScotland.

    • A Change and Innovation Fund to help NHS Boards improve services for patients.

    • A new guarantee of treatment on time, initially for certain heart surgery, but to be extended to services with national waiting time targets. New clinical and local service targets.

    • A Patient Information Initiative and a new complaints procedure, to give patients and carers better information and a stronger voice.

    • A radical approach to improve our health - a Health Improvement Challenge focused on four groups; children in early years, teenagers, people at work and communities.

    Legislation will be needed to implement some of these changes.


    The White Paper sets out a clear direction for NHSScotland - decentralising power, involving patients, staff and the public - to improve services, and a new approach to improve Scotland's health. It includes measures to encourage a redesign of services, better integration and partnership, so that the patient experiences a better, quicker service. Some of these measures will require new legislation.

    Innovation and service improvement must be led by people in the NHS, with support from the centre. Increasing resources, on both staff and premises, will increase the capacity of the service to respond to the changing needs of patients. This is the framework for a modernised NHSScotland fit for the 21st century.

    If you would like a copy of the Health White Paper "Partnership for Care" or have comments or questions, please write to:

    White Paper Team
    Scottish Executive Health Department
    St Andrew's House
    Regent Road
    EH1 3DG

    Or e-mail Health.Whitepaper@scotland.gsi.gov.uk

    The White Paper can also be viewed on the Scottish Executive website at: www.scotland.gov.uk