Health and social care reform - year 1 progress report: population health and service renewal frameworks

6. Monitoring and evaluation

Monitoring and evaluation are central to understanding whether health and social care reform is delivering meaningful change over the long term. Given the scale and complexity of reform, no single measure can capture progress. Instead, we are putting in place a layered approach to monitoring and evaluation, bringing together national outcomes, portfolio-level indicators, programme evaluation, and local intelligence and learning. This approach, illustrated in Figure 2, will help track progress, learning, impact and accountability over the ten-year lifespan of the PHF and SRF.

The National Performance Framework (NPF) provides the overarching framework for assessing progress towards Scotland's long-term outcomes.

The Health and Social Care Reform Portfolio sits beneath this and uses a focused set of indicators to support oversight of progress towards the Health and Social Care Vision. As the PHF and SRF were only published in 2025, it is too early to expect measurable change in many of these high-level population outcomes. However further details of monitoring are set out in Annex B. The indicator set will be developed over time if required, for instance if new data becomes available.

The Health and Social Care Reform Portfolio indicators sit within a wider monitoring and intelligence architecture, providing a clear line of sight between national outcomes set out in the NPF, reform priorities set out in the PHF and SRF, and local delivery. While the portfolio indicators provide an overview of progress towards the Health and Social Care Vision, they are complemented by monitoring and intelligence from national and local partners, including NHS Boards, Integration Joint Boards, Community Planning Partnerships, local government, the third sector and wider partners.

Alongside the development of the overall portfolio indicators, programme-specific monitoring and evaluation arrangements are being developed for the both the PHF and SRF which reflect the differing nature of these frameworks.

The SRF brings together programmes of work intended to improve access, quality and sustainability across health and social care support services. Given the breadth and diversity of these programmes, evaluation frameworks and outcomes have been prioritised for individual programmes, where outcomes, measures and causal pathways can be more clearly defined.

Spotlight: Population Health Framework – Monitoring and Evaluation

A plan for monitoring and evaluation of the PHF has been developed. A set of focused PHF indicators will be tracked over time to monitor progress, supported by the Population Health Dashboard. Developed as part of the ScotPHO online profiles tool, the Dashboard brings together key indicators to help inform and support decision-making at national and local levels.

The evaluation will explore both process (how the PHF is implemented) and impact (what difference it has made).

It will take place in stages across the lifetime of the PHF, recognising that improving population health is complex and takes time.

In the early years (years 1–2) of the PHF, evaluation will support learning and early implementation. This will include further developing clear Theories of Change to explain how PHF actions are expected to lead to improved outcomes, and to test key assumptions.

From years 3–6, evaluation will focus on how well the PHF is being put into practice and whether early changes are emerging, using this learning to support ongoing improvement.

In the final phase (years 7–10), evaluation will place greater emphasis on longer‑term outcomes, using trend data and accumulated evidence to assess progress towards the PHF’s overall goals.