Delivering value based health and care: a vision for Scotland

Sets out the challenges our system is facing and how practising Realistic Medicine can deliver a more sustainable system. It includes six commitments on what we’ll do to support health and care professionals deliver care that people value.

7. Commitments

1. Our health and care system will continue to promote Realistic Medicine as the way to deliver Value Based Health & Care.

By doing so, we will increase understanding of the challenges our health and care system is facing and how acting on the principles of Realistic Medicine can help us deliver a more equitable and sustainable health and care system.

2. Our health and care system will promote the measurement of outcomes that matter to the people we care for, and explore how we can ensure a coordinated approach to their development and implementation.

By measuring the outcomes and experiences that matter, we will be able to provide treatment and care that people really value, capture the data we need to identify low value care and redirect resources in order to provide high value care. This knowledge will allow health and care colleagues to make informed decisions about how we deliver care in the future, focusing on what matters to the people we care for.

3. Our health and care system will continue to support the development of tools that enable health and care colleagues to seek out and eliminate unwarranted variation in access to healthcare, treatment and outcomes.

By being transparent about our decisions we will promote equity of access to care and utilise a whole system approach that puts people's needs at its heart. This is a vital step in reducing health inequalities.

By supporting the development and use of the Demand Optimisation Atlas, we can increase transparency around demand for primary care testing, and focus our efforts to ensure all tests are appropriate. This reduces the risk of the people we care for being exposed to inappropriate testing or interventions, and reducing waste, ensuring we use our available resources in the best way.

We will also seek to understand the reasons behind underutilisation of treatment and tests by some groups of the population and will seek to remove barriers to ensure equitable and timely treatment for all.

We will continue to work with PHS, CfSD and NHS Boards to develop the Scottish Atlas of Healthcare Variation to allow health and care colleagues to ensure that we identify unwarranted variation across Scotland, reduce inappropriate interventions and improve equity of access to service for people who will benefit most.

We will address disparities in health outcomes for specific population groups including communities affected by systemic racism by working, for example, with the Racialised Health Inequalities Steering Group in implementing VBH&C approaches.

4. Our health and care system will continue to build a community of practice and a culture of stewardship across Scotland.

We will support sharing best practice and support health and care colleagues to implement their own VBH&C approaches, as well as understanding the impact on the people they care for. A culture of stewardship means everyone feels a responsibility to look after the resources we have, use them wisely and support each other to do so.

By doing so we will support health and care colleagues to practise Realistic Medicine, deliver VBH&C and create a health and care system where resources are utilised appropriately and more sustainably.

5. Our health and care system will support the delivery of sustainable care in line with the NHS Scotland climate emergency and sustainability strategy by reducing waste and harm.

By supporting more sustainable practice and approaches, we will deliver better societal value by helping to address the climate emergency.

6. Our health and care system will engage with the public to promote understanding of Realistic Medicine and VBH&C and its benefits for Scotland. We will also work to empower people to be equal partners in their care, through shared decision making enabling self-management, and promoting health literacy and healthy lifestyle choices.

Consulting with patient organisations and supporting patient education will allow us to better understand what matters to people, the benefits and risks of their treatment options and the alternatives, as well as helping them to feel that they are at the centre of their care. This will support them to make an informed choice about the treatment and care that is right for them.



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