Long term conditions - framework: consultation paper

Ministerial foreword

Over a third of people in Scotland now live with at least one long term health condition. As Minister for Public Health and Women’s Health, I hear first-hand from people living with these conditions about the challenges not just to their physical health but for all aspects of their life, such as mental health, relationships, money and work.

Until now, our policy approach to long term conditions has focused primarily on individual diseases. Through the sustained efforts of healthcare staff, the third sector, people with lived experience and the wider public sector, this approach has achieved tangible improvements in care and support for heart disease, neurological conditions, chronic pain, stroke, long Covid, respiratory conditions and out-of-hospital cardiac arrest amongst others. But, with one in four of us now living with more than one health condition and our burden of disease increasing, the way we make policy needs to adapt to our changing context.

We have already set out a new a vision for health and social care services in Scotland. This vision is to ‘enable people to live longer, healthier and more fulfilling lives’ and is supported by four key areas of work: improving population health; a focus on prevention and early intervention; providing quality services; and maximising access, all underpinned by a person-centred approach.

We recognise that many people living with long term conditions will require access to the same types of care and support. We want to ensure equitable and sustainable access to those services whilst also providing services specific to conditions when required. While there are areas that will always benefit from a condition-specific focus, we also know there are opportunities to integrate common themes from our existing policies and frameworks to form a cross-cutting policy framework for long term conditions. This cross-cutting approach could also benefit people with long term conditions who additionally live with other conditions such as rare diseases, cancer, mental health conditions and congenital disorders. People affected by these conditions are also invited to contribute to the consultation so their interests are represented in consideration of cross-cutting themes for the framework from which they may benefit. We want to empower NHS boards and other partner organisations to deliver improvements that benefit as many people as possible, including those living with multiple conditions. We know this approach can work: we already approach our policymaking on other issues, such as prevention and population health, in a cross-cutting way that focuses first and foremost on people’s needs as individuals rather than being segmented by condition.

It is for these reasons that we are reviewing our approach to policy for the care and support of people with long term conditions.

This consultation supports our vision for reform by exploring how we can improve our approach to healthcare quality, care, support and inequalities in long term conditions. Your views and experiences are important in helping us to ensure that Scottish Government policymaking on long term conditions is fit for the future. I hope you will take this opportunity to let us know what matters to you.