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

7. Reflections and next steps

This report marks the first year of delivery of both the PHF and the SRF, highlighting the progress achieved through collaboration across national and local government, the NHS, the third sector, communities and wider partners. Significant foundations have been established and we are making progress in starting to embed preventative approaches, access is improving through community based and digital approaches, planning is becoming more evidence‑led, planning and delivery are becoming further coordinated and person‑led care is being placed at the centre of reform.

Whilst these foundations have been established, many of the ambitions set out in both frameworks are inherently medium to long term and will require sustained commitment, partnership working and continuous adaptation to achieve lasting improvements in population health, wellbeing and health and social care outcomes.

Looking ahead to Year 2 and beyond, the policy and delivery landscape has evolved since publication of the PHF and SRF. The Scottish Government's 2026 Programme for Government, alongside the wider range of manifesto commitments, has reinforced the focus on prevention, public service reform and improving outcomes for people and communities. This includes a number of immediate Scottish Government reform priorities, such as the simplification of NHS structures, development of a Community First approach and development of GP walk in centres. These priorities are now being incorporated within wider reform portfolio arrangements in Scottish Government, while ongoing joint working between Scottish Government and COSLA is considering alignment with the PHF and SRF.

The SRF already sets out an extensive programme of reform activity and longer-term deliverables, many of which continue to be refined through ongoing collaboration with delivery partners, local systems, professional groups and communities. As this work progresses, that partnership approach will remain critical to ensuring reform is informed by emerging evidence, responds to changing needs and capitalises on opportunities arising from the wider reform agenda.

The PHF was designed around an initial two-year action cycle, and work is now beginning to refresh its actions for the period from summer 2027 onwards. This process will be informed by learning from the first phase of implementation, evolving public health challenges, engagement with stakeholders and communities, and new cross-government commitments set out in the Programme for Government. The next phase of implementation will continue to work towards our shared aim of increasing life expectancy, reducing inequalities in outcomes, and working together to support people to live longer, healthier and more fulfilling lives.

Together, the first year of PHF and SRF implementation provide us with strong foundations. The next phase will build on the progress and partnerships established during Year 1 and will be characterised not only by the continued delivery of existing commitments, but also by the consideration of new reform priorities and deliverables. In doing so, we will maintain momentum towards our shared ambitions, ensuring Scotland's health, social care and wider public services are equipped to meet the challenges and opportunities of the years ahead, while continuing to drive improvements in population health, tackle inequalities, and deliver high-quality, sustainable services for the people of Scotland.