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

Preventative Investment - Develop new approaches to resource allocation that support prevention across health and other public services.

PHF

Prevention Focused System

PHF Programme Board

A prevention budget tagging pilot has been undertaken with participating NHS Boards, and the final report was published in June 2026. A similar pilot is now taking place with participating local authorities and other public sector bodies. Work is ongoing, led by the Scottish Government Prevention Unit, to refine and expand the approach across the full Scottish Budget in the coming months.

Accountability – Improve whole‑system accountability for primary prevention.

PHF

Prevention Focused System

PHF Programme Board

The guidance and a maturity matrix to support NHS Boards to become Population Health Organisations (PHOs) were launched on 2 July 2026 by NHS Board Chairs. Boards are currently completing their self-assessments and will produce PHO action plans by the end of 2026.

Health in All Policies – Develop and implement a health lens approach to impact assessment

PHF

Prevention Focused System

PHF Programme Board

A pilot of the Health Lens Approach, designed to embed health considerations across all areas of public policy, has been undertaken and new guidance has been developed. This is being used to inform a wider rollout across other areas of public policy, including housing.

Community Planning – Strengthen collective leadership and shared accountability to improve local outcomes and address inequalities through a refreshed focus on the role of Community Planning Partnerships (CPPs)

PHF

Prevention Focused System

PHF Programme Board

A series of Deep Dives has been underway since spring 2026 with three Community Planning Partnerships (Angus, East Lothian & South Lanarkshire) to explore barriers to meeting their statutory duties, with Third Sector Interfaces undertaking focus groups with community organisations to explore their engagement with CPPs.

Collaboration for Health Equity in Scotland (CHES): Introduce Marmot Places in Scotland, a place-based model of cross-agency working that seeks to reduce the social determinants of ill-health within specific localities

PHF

Prevention Focused System

PHF Programme Board/ CHES Oversight Board

A national learning event of CHES partners held in May 2026 identified that the collaboration is progressing well across the 3 local pilot places (Aberdeen City, North Ayrshire and South Lanarkshire) that were established in autumn 2025, with a collective agreement that there is a need to continue to develop mechanisms to work across the local-national system to strengthen action on reducing inequalities, prevention and achieving long-term impact.

Digital Population Health – Ensure digital opportunities are maximised to ensure the prevention of poor mental and physical health

PHF

Prevention Focused System

COSLA-SG, Strategic Leadership Board

A broad portfolio of work is underway including the rollout of the MyCare.scot service, which was made available to the whole population in April 2026, the My Diabetes, My Way Platform, the transition to Digital Telecare for 142,000 users by January 2027 and the adoption and expansion of Hospital@Home over this winter (2026-27) and the discovery phase of the CHI in Local Government programme.

Early Years and Child Development – Take action to reduce the proportion of children with developmental concerns at 27-30 months, including reducing inequalities

PHF

Social & Economic Factors

PHF Programme Board

A portfolio of actions is underway including: ongoing delivery of continuity pathway, the full antenatal continuity pathway of midwifery care was delivered in June 2026 and the publication of early speech, language and communication action plan. This includes early implementation support, including rollout of Chatting Together messaging, workforce capability tools, and local authority practicum model from January to June 2026.

Education - Develop and Deliver a Public Health Approach to Learning

PHF

Social & Economic Factors

PHF Programme Board

The project is making strong progress, with active development underway in North Ayrshire and South Edinburgh moving into action planning in summer 2026. Additional resource has strengthened the collaborative Knowledge into Action approach, supported by extensive stakeholder engagement. Key delivery foundations are advancing, including the evidence toolkit and options for the most effective technical architecture to enable the dashboard to be taken to scale.

Community Wealth Building – Advance community wealth building in Scotland to address economic and wealth inequality by supporting the generation, circulation and retention of more wealth in local economies

PHF

Social & Economic Factors

PHF Programme Board

The Community Wealth Building (Scotland) Bill 2026 was passed on 25 March 2026, that will now act as a statutory means to support and require public bodies authorities to develop locally owned Action Plans to retain more wealth in local economies.

Planning – Embed health and well-being considerations into the development and delivery of Local Development Plans (LDPs)

PHF

Places & Communities

PHF Programme Board

As a result of this action, all Local Authorities will have to comply with the NPF 4, launched in 2023 and work is ongoing across the planning system to transition to the NPF4 (by 2028) which contains various health outcomes to be delivered through LDPs.

Housing – support the contribution of better housing to health

PHF

Places & Communities

Housing to 2040 Strategic Advisory Board

Presentation of a Health Lens approach to Scottish Government Housing Teams has been undertaken. Agreement has been reached to embed health considerations into key Housing policies, including within the impact assessments being carried out for the new housing agency that will be established: “More Homes Scotland”.

Climate Change and Nature – Maximise efforts to tackle the climate and nature emergencies given the close links between environmental and human health

PHF

Places & Communities

PHF Programme Board

Scotland’s Environment Strategy and Climate Change Plan published in March 2026.

Work has also commenced to develop a successor to the Cleaner Air for Scotland 2 Strategy that will seek to tighten objectives to tackle the main pollutants impacting upon population health in partnership with local authorities.

In addition, work has focused on strengthening preparedness and resilience to climate-related health risks. This included issuing national and social media communications to support the public during periods of hot weather, joining the Scottish Wildfire Forum to enhance cross-sector collaboration, establishing work on Adverse Weather and Health Surveillance and supporting NHS Assure’s climate change risk assessment work for the health sector.

Food Environment and Nutrition - Publish a 2-year Implementation Plan of preventative action to improve the Food Environment, diet and healthy weight

PHF

Enabling Healthy Living

PHF Programme Board

Regulations that restrict the promotion of food and drink products high in fat, sugar and salt (HFSS) were approved by Scottish Parliament in Autumn 2025, with aligned activity on track for implementation of these regulations in October 2026. Work has also been progressing on developing a new Diet and Healthy Weight Implementation Plan for publication later in 2026.

Physical Activity - Implement the evidence-based physical activity policy actions in the National Physical Activity for Health Framework

PHF

Enabling Healthy Living

National Leadership Group for Sport and Physical Activity

The National Leadership Group for Physical Activity and Sport oversees the delivery of the Framework, including the commitment to achieve a relative reduction in the adult inactivity level by 15% by 2030. In addition, progress is being made to ensure sport and physical activity opportunities target the people and communities where the need is greatest through the "Summer of Sport" Funding. This is through provision of activities delivered by local organisations across Scotland - including through the World Cup, Scottish Golf Events and The Commonwealth Games. As a result, the work has reached children and young people, especially those living in areas of high deprivation and those least active in society.

We continue to measure progress through the data produced by the Scottish Health and Household Surveys, analysed and summarised in our annual ‘State of the Nation’ report.

Tobacco Free Generation Deliver the initial 2-year Tobacco and Vapes Implementation Plan, including legislation to create a tobacco free generation.

PHF

Enabling Healthy Living

Tobacco and Vaping Framework Oversight Group

Work continues on implementation of the Tobacco and Vapes Act (April 2026), which includes the introduction of legislation to expand the retail register from October 2026 and the introduction of the rising age of sale of tobacco from 1 January 2027. Work is also on-going around improvements on the retail registrations on the ePass platform, which includes regular engagement with retailers to support the upcoming legislative changes.

Work also includes the launch of a 4 nation consultation on the display, packaging and appearance of nicotine and vaping products, which closes in October 2026.

This work progresses the three pillars of People, Product and Place within the Tobacco and Vapes Framework and its current implementation plan.

Alcohol and Drugs - Publish an Alcohol and Drugs Plan, building on progress made by the National Mission on Drugs, to reduce alcohol and drug related harms and deaths

PHF

Enabling Healthy Living

PHF Programme Board

In March 2026, the Alcohol and Drugs Strategic Plan was published as a joint COSLA and SG endeavour. In June 2026, a PHS-led Summit on the recent increase in drugs-related deaths brought together system leaders, people with lived experience and family members to identify priority actions.

Healthy Digital Use - Develop a robust approach to reducing health harms associated with the digital environment

PHF

Enabling Healthy Living

PHF Programme Board

The Online Safety Task Force Action Plan (2026-27) was published in March 2026, which has a wide range of actions that will now be delivered to boost prevention, equip parents, carers and practitioners, strengthen the law, improve mechanisms to identify and deal with perpetrators of online harms and provide holistic recovery support for children and young people.

On 14 June 2026 the UK Government announced that social media companies will no longer be able to offer their services to under-16s in the UK, which complements our work on this action.

Gambling Harm Reduction Progress interventions to reduce gambling harms as the Gambling Levy comes into operation

PHF

Enabling Healthy Living

PHF Programme Board

This work has seen the allocation of £7.9 million of funding in 2026-27 secured from the Gambling Levy for 31 projects to address gambling harm across Scotland, including to community and voluntary sector organisations. Work is on-going to support these organisations, who are, in some cases, receiving funding for the first time.

Economic Activity – Publish a Health and Work Action Plan

PHF

Social & Economic Factors

PHF Programme Board

Health and Work Action Plan is in development, including integration with Economy led activity on economic inactivity.

Income Maximisation – Improve opportunities to ensure that all individuals who require income assistance can access support

PHF

Social & Economic Factors

PHF Programme Board

An implementation partnership has been established, involving Public Health Scotland, the Scottish Government, and Public Services Delivery Scotland. Their joint plan focuses on coordinating actions to enhance income maximisation support for families via maternity and health visiting services. This initiative follows the publication of a report on income maximisation through health settings in February 2026. To facilitate local community implementation, priority health boards have been engaged to develop improvement plans.

Health inequalities - Develop a Healthcare Inequalities Action Plan

PHF

Equitable Health & Care

PHF Programme Board

Set up to deliver this work, the Public Health Action group has completed its initial evidence review and shared the findings in May 2026. These will inform the next stages of plan development by answering the key question of "what can make the biggest impact in reducing healthcare inequalities". The evidence review leads us to conclude that this work has to be better and more widely understood across major change programmes, as well as within specific policy areas and services.

Vaccination and immunisation – Deliver the actions of the Scottish Vaccination and Immunisation Programme (SVIP) 5-year Framework and Delivery Plan (2025-2030).

PHF

Equitable Health & Care

PHF Programme Board

This action involves delivering the actions of the Vaccination and Immunisation Programme 5-year Framework and Delivery Plan (2025-30):

• publication of the annual vaccination and immunisation report - June 2026
• vaccination action plan on false health information strategy approved by Scottish Vaccination and Immunisation Programme (SVIP) Citizen Engagement Group - August 2026
• introduction of 2 expansions to the Respiratory Syncytial Virus (RSV) programme (starting April 2026) and time-limited targeted MenB programme (July 2026 - March 2027)

Screening – Innovate and improve screening and early detection of disease

PHF

Equitable Health & Care

PHF Programme Board

This work has led to the publication of Cervical Cancer Elimination Action Plan in March 2026. Public Services Delivery Scotland formally agreed to provide programme support starting with preparatory work June – August 2026 and Breast and Lung Screening programmes will begin September 2026.

Sexual Health and Blood Borne Virus – Progress delivery of improvements to sexual health and wellbeing

PHF

Equitable Health & Care

PHF Programme Board

Scotland is well on the way towards the target to eliminate HIV Transmission within Scotland by 2030, with the first-time diagnosis figure falling by nearly 50% since 2017. In addition, we have made significant progress towards the elimination of hepatitis as a public health concern by 2030. Some achievements towards that goal include:

• commencing opt out testing of Blood Borne Virus (BBV) in A&E departments in Greater Glasgow & Clyde, Lothian and Grampian.
• funding development of HIV Informed, a package of materials to upskill health and social workers to provide relevant non-stigmatising information about HIV.
• introducing targets for the number of people tested for BBV in prison and drug & alcohol services which has seen a rise in testing.
• piloting an e-Prep clinic to explore the expansion of access to HIV Pre-exposure prophylaxis

We are now in the process of developing the next stage of the sexual health and BBV action plan.

Agree a joint programme of ongoing population planning

SRF

Integration

SRF Programme Board

As part of the Year 1 commitment on strategic planning, Public Health Scotland (PHS) and partners have made strong progress in developing new national guidance for Joint Strategic Needs Assessment (JSNA). Recognising the complexity of establishing a consistent national approach that meets diverse local needs, PHS is coordinating this work to strengthen population-based health and care planning across Scotland.

This includes developing a national minimum dataset, hosted by PHS, to support easier and more seamless access to shared data for planning and decision-making. Further consultation on the developing guidance and data set will continue in the coming months to ensure they are practical, robust and responsive to local and national priorities.

Publish Primary Care Route Map, to enhance core front door health services and wider community health improvement

SRF

Access

SRF Programme Board

The Primary Care and Community Route Map has been drafted and is currently being aligned with the Improving Flow Plan and the Community-First work. Extensive engagement has taken place with both internal and external stakeholders to support the adoption and development of proposed actions. Publication is expected in Autumn 2026.

Set out a new approach to how national organisations will support local health and social care systems to deliver digital transformation.

SRF

Digital & Innovation

SRF Programme Board

Public Services Delivery Scotland (PSD Scotland) was successfully established on 1 April 2026, bringing together NHS Education for Scotland (NES) and NHS National Services Scotland (NSS) into a single national organisation. PSD Scotland strengthens national capability across workforce, digital, infrastructure and improvement functions, supporting delivery of a more coordinated Once for Scotland approach to health and social care reform.

As of September 2026, Public Service Delivery Scotland and Local Government Digital Office have accepted a formal commission to develop a programme around the Digital Health and Care Record. £3.6 million will be invested this financial year to begin the necessary initial technology testing and business case work needed to set out the path to delivery and estimated delivery cost. Given the scale and complexity of the health and social care landscape, it is expected that full delivery of a future record will be major multi-year programme that will be delivered in phases.

MyCare.scot was launched nationally in April 2026, providing the first iteration of a digital front door for health and social care. It was launched as a free downloadable app in June 2026. Users can access information relating to medications, vaccinations, allergies and local services through a single digital platform.

Community and Voluntary Sector – build a resilient and sustainable community and voluntary sector that support the creation of healthy communities

PHF

Places & Communities

PHF Programme Board

Commitment made, and work commenced, to co-design Scotland’s first ever third sector partnership agreement which will further strengthen the role and place of the sector in Scotland. This will build on progress made through the £130 million Fairer Funding Pilot (2025-27). Work is also underway to develop a new investment decision toolkit with partners.

Social Prescribing – Develop a National Social Prescribing Framework for Scotland

PHF

Places & Communities

PHF Programme Board

Work underway to develop Scotland’s Social Prescribing Framework, including meetings of SG (cross-policy) Working Group; the establishment and meeting of an External Advisory Group (26 August 2026); launch of a public consultation using the new Comhairle platform (13 August 2026) and wider engagement with stakeholders in autumn 2026.

Preconception and Pregnancy - Reduce Health-Harming Risks during preconception and in pregnancy

PHF

Enabling Healthy Living

PHF Programme Board

Work continuing with Ready, Steady, Baby! (RSB!), a guide to pregnancy, labour, birth and early parenthood up to 8 weeks and a copy is given to all pregnant women in Scotland. Information in RSB! is also available online on the NHS Inform website and includes information about smoking cessation and signposts links to support.

PHS are leading a short-life working group as part of the Public Health Action Team on Smoking Cessation. The Public Health Action Team are responsible for implementing the Review of Smoking Cessation Services in Scotland.

A multi-agency tobacco dependence in pregnancy (TDiP) group met to agree action to improve the quality of treatment in pregnancy. The group included representation from the Chief Midwifery Office, treatment services, the Royal College of Midwives. The first report of the group, with recommendations for feasible service improvement actions, will be published in Autumn 2026.

Progress the work of the Adult Social Care Ethical Commissioning Group, ensuring the care and support we commission is high quality, person-led, and achieves best value

SRF

Person-led

SRF Programme Board

Development of statutory Ethical Commissioning Guidance is in progress, with draft guidance reviewed internally and shared with key stakeholders. Public consultation is planned between October 2026 and January 2027, with publication of final guidance expected in Spring 2027.

Task NHS Boards and Integration Authorities to actively involve communities in improving accessibility to services

SRF

Hospital Redesign

SRF Programme Board

The Health and Care Improving Flow Plan outlines whole system reform to deliver improved hospital flow. This plan explicitly outlines how improved navigation, home care and community care will deliver easier access to services.

Actively involve the workforce and their representatives in designing and implementing the changes we need to see locally and nationally

SRF

Person-led

SRF Programme Board

Workforce planning and engagement activity is progressing across reform programmes. A national forum for engaging with health trade unions exists where full engagement on reform takes place.

Research and Innovation – Support research and innovation that improves the prevention of ill health

PHF

Prevention Focused System

PHF Programme Board/ Reform Executive

The Chief Scientist’s Office, the Scottish Prevention Hub and SG came together as a partnership in June 2026 to begin to ensure prevention becomes a national research priority to inform action more effectively and develop a connected national learning system.

Evaluation and Learning – Develop a comprehensive evaluation and monitoring approach to measure the impact and value of the PHF

PHF

Prevention Focused System

PHF Programme Board/ Reform Executive

Progress on this action has seen the development of an Analytical Framework that was approved in November 2025 with provision for a biannual update and review. A draft Monitoring and Evaluation Plan was approved in September 2026 by the PHF Programme Board to act as the means of measuring the impact and value of PHF. It has been developed collaboratively by the Scottish Government and PHS and is being informed by engagement with NHS Boards (Public Health Intelligence Leads), COSLA, Scottish Government policy teams and topic experts.

Health Protection – Support better health protection in Scotland

PHF

Equitable Health & Care

PHF Programme Board

Scottish Pandemic Sciences Partnership Oversight Board

Surveillance has a mix of governance structures including; PHM Oversight Group, PAGOG

As part of this action, Scotland’s Pandemic Sciences Partnership was launched in January 2026. Hosted by PHS and co-chaired by Professor Emma Thompson from the University of Glasgow and Professor Deborah Williamson from the University of St Andrews, the Partnership will improve Scotland’s preparedness and resilience for future pandemics and infectious disease outbreaks.

In addition, a proposal to strengthen High Consequence Infectious Disease (HCID) pathways across all health boards was taken to the BCEs and agreement was reached to set up a task and finish group co-chaired by Brian Chittick, Chief Executive NHS Shetland and Scott Davidson, Medical Director NHS Greater Glasgow and Clyde. PHS are also developing a proposal on vector borne disease surveillance incorporating a one health approach and linking with climate change activities

Collaboration across SG, NHS Boards & Integration Authorities to develop population-level strategic needs assessments

SRF

Integration

SRF Programme Board

As part of the Year 1 commitment on strategic planning, Public Health Scotland (PHS) and partners have made strong progress in developing new national guidance for Joint Strategic Needs Assessment (JSNA). Recognising the complexity of establishing a consistent national approach that meets diverse local needs, PHS is coordinating this work to strengthen population-based health and care planning across Scotland.

This includes developing a national minimum dataset, hosted by PHS, to support easier and more seamless access to shared data for planning and decision-making. Further consultation on the developing guidance and data set will continue in the coming months to ensure they are practical, robust and responsive to local and national priorities.

Develop collaborative multi‑year service change plans at national, sub‑national, local levels

SRF

Integration

SRF Programme Board

Scotland East and Scotland West Strategic Planning and Delivery Committees are now leading on planning and delivery for orthopaedic planned care, emergency healthcare services and Once for Scotland business systems. This represents a significant milestone in implementing population-based planning and collaborative service redesign at scale.

Support social care sector, including HSCPs & third sector & independent care providers to draw upon evidence base of the population level Strategic Needs Assessments to inform workforce planning at a local or employer level.

SRF

Integration

SRF Programme Board

Work is progressing through wider strategic planning and population needs assessment activity to strengthen the use of evidence in local service, workforce and commission planning. Further development remains linked to Strategic Needs Assessment implementation.

Develop a shared outcomes framework to support implementation.

SRF

Integration

SRF Programme Board/ Reform Executive

A Health and Social Care Reform Monitoring Framework has been developed and is being socialised with partners. This will support a shared approach to monitoring reform outcomes and implementation progress across the SRF.

Initiate comprehensive review of existing NHS accountability mechanisms, strengthening performance oversight and foster collaboration, continuous improvement and public trust.

SRF

Hospital Redesign

SRF Programme Board

The NHS Accountability Review has concluded. As a result, Scotland East and Scotland West Strategic Planning and Delivery Committees are now operational, strengthening accountability, collaborative planning and coordinated service delivery across NHS Boards.

Introduce a forward-looking approach to identifying new and promising medicines earlier

SRF

Prevention, Digital and Innovation

SRF Programme Board

The Chief Pharmaceutical Officer for Scotland has established an Access to New Medicines Horizon Scanning Advisory Board (HSAB), to identify and consider new medicines, or new indications, to support advanced operational planning for their managed introduction in Scotland. In addition, proposals are being developed for a national approach to service readiness for innovative medicines, building on existing horizon-scanning arrangements and supporting timely and equitable implementation of innovative treatments across Scotland.