Long term conditions framework: consultation analysis

1. Introduction

This report

This report presents the independent analysis of responses received to the Scottish Government consultation on the Long Term Conditions Framework. The analysis was undertaken by EKOS Ltd on behalf of the Scottish Government.

Section 1 sets out:

• background to the consultation
• what the consultation sought views on
• next steps
• structure of this consultation analysis report

Background to the consultation

Until now, the Scottish Government’s policy approach to long term conditions has focused primarily on individual conditions and there are a number of strategies and policies in place to improve care and support for a range of long term conditions and condition groups. These do not join up actions or prioritise according to burden of disease or impact. Whilst much has been achieved, in terms of clinical guidelines, patient and clinician information and education and service delivery, resources are not allocated as impactfully as they could be. Conditions that are major contributors to the burden of disease, but which happen not to have a strategy, receive less resource than conditions which have a framework or action plan.

Continuing to add to the list of conditions with dedicated strategies and/or action plans is not a viable way forward due to finite resources and places an additional burden on NHS boards and other delivery partners. The Scottish Government recognises that it needs to more efficiently and impactfully allocate finite resources on long term conditions.

Some condition-specific Scottish Government policies are approaching the end of their planned duration. This has provided an opportunity for the Scottish Government to review its current approach to policy for the care and support of people with long term conditions to ensure it evolves and responds to the changing context, builds on progress achieved to date, and considers if and how policy support for other long term conditions can also be provided. The review also supports the vision for reform by exploring how the Scottish Government and its partners can improve the approach to healthcare quality, care, support, and inequalities in long term conditions. As the Scottish Government reassesses how best to focus policy work for long term conditions, it is recognised there will be a need to prioritise areas for improvement, and that improvement priorities may sometimes cut across all conditions, and other times be more condition-specific.

What the consultation sought views on

The Scottish Government consultation has sought views on the development of a national Long Term Conditions Framework – a unified policy approach – to improve the prevention, identification, management, and experience of living with long term conditions in Scotland. For this consultation ‘long term conditions’ means any physical illness or mental illness expected to last a year or more.

The role of the consultation is intended to help the Scottish Government identify improvement priorities for long term conditions at a national level. It is also intended to support the delivery of the NHS reform and renewal work which is underway to make people’s experience of the NHS in Scotland better than it is today, and to ensure the national framework is prepared in a way that meaningfully reflects the needs of those living with long term conditions and the organisations that support them.

To inform topics and questions for this consultation, the Scottish Government spoke to a small number of people with lived experience across a range of long term conditions, to understand what is and isn’t working well with their care and support. The same questions were asked of a number of third sector organisations, as well as clinicians via the Scottish Government’s Professional Advisory Group, again to help inform consultation topics and questions.

The consultation asked a range of questions around what is working well in long term conditions, what could be better, and how the Scottish Government could prioritise work. The consultation has sought to gather the views of a wide range of individuals and organisations on what matters when it comes to prevention, care, support, and equalities in long term conditions.

Next steps

The consultation analysis report will form part of the evidence base that will be used by the Scottish Government to help develop and finalise the Long Term Conditions Framework which will set out principles, priorities, and themes to then guide action across health and social care. Insights from work delivered through the existing condition-specific Scottish Government policies will also help to inform an integrated approach. It is expected that the finalised Long Term Conditions Framework will be published by the Scottish Government before the end of December 2025, with the first in a series of action plans published by March 2026.

Structure of this consultation analysis report

The remainder of this report is structured in line with the 19 questions asked within the consultation paper. It also provides an overview of the consultation methodology, responses, analysis, and limitations. A summary of feedback captured at the focus group sessions has also been provided.