Health and Social Care Service Renewal Framework

5. Delivering Change and Conclusion

Delivering Change

This Framework outlines the important changes needed to improve health and social care for people across Scotland. It creates a clear and supportive environment that encourages collaboration and strong, accountable leadership – so that all partners can deliver better outcomes for individuals and communities.

We will actively support accountable and collective leadership through NHS Board Chairs and Chief Executives, alongside the NCS Advisory Board. Working in partnership with Local Government, Integration Authorities and other partners, this leadership will be central to drive meaningful, system-wide change.

We have already set out our expectations for collaboration across NHS Board boundaries. Building on this, we will undertake a comprehensive NHS Accountability Review to ensure clarity in relation to national priorities, strengthening of performance oversight, and enable leaders to act with confidence. This review will help create an environment that encourages innovation, responsible risk-taking, better information and data sharing, and cross-organisational working. This will foster a culture where collaboration, testing, learning and continuous improvement are the norm, and ensure alignment with national priorities and measurable impact on health outcomes.

Overall, this Framework indicates a shift in how change is led and delivered. Leaders across the health and social care system will directly shape and implement the next phase of transformation, focusing planning at the population level and delivering modern digitally enabled and community focused services.

Conclusion

The Service Renewal Framework sets out a bold and necessary vision for the future of health and social care in Scotland—one that is person-led, prevention-focused, digitally enabled, and rooted in the needs of our communities and population. It provides a clear and actionable roadmap for transformation, grounded in five core principles: Prevention, People, Community, Population, and Digital.

This transformation will be underpinned by strengthened governance and accountability arrangements across NHS Scotland. The SRF reinforces the importance of clear accountability, robust oversight, and empowered leadership. We are clarifying decision-making structures and ensuring our governance structures guarantee that the NHS in Scotland is equipped to lead and deliver reform effectively.

These principles will:

• underpin population-level planning at both national and sub-national levels, such as supporting local areas with local planning, including Strategic Commissioning Plans, ensuring Scotland’s care and support services can meet the changing needs of our communities. This will be driven by high-quality data, robust evidence, and our collective analytical capabilities, enabling more informed and responsive decision-making.
• be applied and informed by clinical and professional advice, data, and evidence to support the redefinition of existing clinical pathways. This work will be clinically led, with strong engagement from the Chief Medical Officer and senior clinical leaders.
• address and support our existing work on health inequalities and underpin service design to reduce disparities in access, experience, and outcomes across the population of Scotland.
• build on existing work in areas such as oncology and vascular care to inform the redesign of hospital-based services, improving sustainability, reducing unwarranted variation and waste, and supporting a population approach to planning. This will contribute to the development of a leaner, more modern hospital estate across Scotland.
• prioritise investment in and support to our core first point of contact primary care services – such as general practice and community pharmacy – to provide a resilient foundation for a community-oriented model of health care.
• enhance community services so that they are person-led and embed the wider intentions of the SRF, in particular effective prevention and early intervention.
• guide the design of enablers such as education, training, digital and physical infrastructure so they support the changes we want to see, ensuring our plans are both realistic and deliverable.

This will be a collective endeavour. The success of the SRF will depend on shared leadership, clear accountability for delivery, sustained collaboration, and a relentless focus on what matters most: improving the health and wellbeing of the people of Scotland. Together, we can build a health and social care system that is fit for the future—one that delivers longer, healthier, and more fulfilling lives for all.

Summary: A Health and Care System for the Future

Scotland’s health and social care system is changing to better meet the needs of people today and in the future. This Health and Social Care Service Renewal Framework is a long-term plan to make care more local, more personal, and more effective. It is designed to complement the Operational Improvement Plan, which focuses on reducing long waits for planned care and improving access across the system and sits alongside the Population Health Framework (PHF), which prioritises primary prevention. While the PHF aims to prevent illness before it starts, the Service Renewal Framework focuses on secondary and tertiary prevention – ensuring timely diagnosis, treatment and ongoing care. The vision is simple: to help everyone in Scotland live longer, healthier, and more fulfilling lives.

What is Changing?

• More care in communities: You will have easier access to care in your community, and have access to more types of treatment and support closer to home, not just in hospitals.
• Focus on prevention: Services will help you stay well, and keep you from getting sicker, not just treat you when you are at your most unwell.
• Better use of technology: You will have easier access to your health information and services online.
• Joined-up care: Health and social care services will work more closely together, so you do not have to repeat your story.
• Person-centred, quality care: Services will be designed around your needs and what evidence tells us works best, and you’ll have more choice and control over your treatment.
• Support for staff: The people who care for you will be supported to work in new, different ways.

This is a big change, and it won’t happen overnight. But over the next 10 years, the aim is to build a health and care system that works better for everyone—wherever you live in Scotland.