NHS Scotland operational improvement plan

Improving access to health and social care services through digital and technological innovation

The deployment of digital technologies will help to modernise services and improve efficiency, as noted in the Programme for Government 2024-25. A stronger ‘digital first’ approach will support the provision of tools that enable personalised patient experiences, tailored health recommendations, and proactive health and care management. Implementation of, for example, remote monitoring of long-term conditions, digital mental health treatments and enhanced use of video access to care and support, alongside existing national digital services such as NHS inform and Care Information Scotland, will allow us to accelerate our ‘digital first’ approach. Fundamentally, we want it to be easier for people to navigate their way around the health and care system and, for example, manage their appointments in a more flexible, person-centred way. It is about accessing the right care and support, in the right way, and at the right time.

Digital access for your health and social care

Working with NHS Education for Scotland (NES), we will accelerate delivery of our ‘Digital Front Door’ service to commence roll-out of an app for health and social care by the end of 2025. This is part of our Programme for Government commitment to launch a new national personalised digital health and care service, which will be developed and enhanced over the next five years.

This app will mean people can securely access their hospital appointments online, receive communications, find local services and access and update their personal information. We will start with an initial release (known as a ‘Minimum Viable Product’) in December 2025 for a limited cohort of people in Lanarkshire, in partnership with NHS Lanarkshire. This will be supported by a plan for roll-out to the whole country. Over time the functionality of the app will be extended to include social care and community health and will be continuously developed, enhanced and extended in scope and scale.

To help with this, and in conjunction with COSLA, the Digital Office for Local Government and Public Health Scotland, we will start the work required to use the Community Health Index (CHI) within local government, beginning with social work and social care. This is to allow the matching of people’s records across health and social care and to make it easier to access information and local social care services through the national ‘Digital Front Door’ service and its associated app.

Longer term, the use of the CHI in local government will support the appropriate sharing of information across health, social work and social care settings by expanding the use of a common identifier for verification and data matching. In practice, for people in Scotland this means a better integrated health and social care system that will streamline citizen access to systems, reduce the need to repeat information multiple times and deliver better outcomes by creating much needed capacity in the health and care system.

Digital Dermatology Pathway

We will roll out a new Digital Dermatology Pathway to all General Practitioners across Scotland and to all NHS health boards by the end of spring 2025.

The procurement of a new digital service has been completed which enables GPs to take photographs of a patient’s skin issues and attach those images to a dermatology referral. This was launched in December 2024 and is already available in six territorial health boards and to over 400 GP practices.

For patients, evidence suggests that this will allow around 50% to be returned to the GP, with advice or reassurance, without having an in-person appointment with a consultant. Some patients are also likely to be fast-tracked to further diagnostics or treatment based on assessment at this digital triage stage.

Impact will be tracked by measuring the number of territorial health boards and GP practices using this pathway, the number of referrals containing an image and outcomes from the digital triage process.

National digital type 2 diabetes remission programme

A new national digital intensive weight management programme will be used to support 3,000 people newly diagnosed with type 2 diabetes over the next three years, with the first patients recruited in January 2026.

We anticipate that around 35 to 40% will achieve remission from type 2 diabetes at the end of their first year on the programme, with a majority of patients benefiting from a clinically significant average weight loss of 10% and reductions in blood pressure, all contributing to reduced cardiovascular disease risk and reduction in polypharmacy.

We will measure impact by the number of patients recruited into this programme, their NHS health board, the number who achieve remission and the number with clinically significant weight loss.

Genetic testing to deliver improved clinical outcomes and target medications

Pharmacogenetics is concerned with how an individual’s genetic variation affects their response to specific drugs. Identifying these genetic variations allows healthcare providers to choose the most appropriate drug treatment and dose for a patient to improve their treatment outcomes, minimise side effects and reduce adverse drug reactions.

We will start using genetic testing to target medications and deliver improved clinical outcomes for recent stroke patients and newborn babies with bacterial infections. The aim will be to prevent debilitating recurrent strokes and severe adverse reactions to antibiotics.

Genetic testing for recent stroke patients

There will be a pathway established across Scotland for new stroke patients to receive a lab-based genetic test to inform what drug they are given to reduce the risk of a secondary stroke. This programme will begin in October 2025 and be rolled out to all territorial health boards within 12 months.

Once fully implemented, we anticipate over the first year that around 20,000 recent stroke patients would be tested and around 30% moved to a drug that will be more effective in preventing a secondary stroke.

We will measure impact by the number of NHS health boards applying this pathway, the number of patients tested, and the number moved to an alternative drug.

Genetic testing for newborn babies with bacterial infections

A pathway will be established across Scotland for newborn babies to receive a genetic test via a point-of-care device to inform what drug they are given to manage an infection. This programme will begin in October 2025 and be rolled out to all territorial health boards within 18 months.

Once fully implemented, we anticipate over the first year that around 3,000 newborn babies would be tested and those with the relevant genetic variation moved onto an alternative antibiotic as appropriate.

We will measure impact by the number of NHS health boards applying this pathway, the number of patients tested, and the number moved to an alternative drug.

An operating theatre scheduling tool

We are rolling out a theatre scheduling tool that has been shown to increase operating theatre productivity by up to 20% for some specialties. The tool supports health boards to optimise the use of available theatre slots and find patients or procedures that best fill gaps, based on waiting list priority. Improving scheduling will mean better use of our facilities and will make it easier for people to get their treatment quicker. All territorial health boards will have been scheduled into the rollout plan for the theatre scheduling tool by the end of June 2025.