Our Path Ahead: Chief Medical Officer for Scotland Annual Report 2025–2026

Chapter 4: Doing what Matters

The Power of Everyday Actions

Working in health and care services can, at times, feel overwhelming. Pressure is relentless, population needs are rising and the pace and complexity of work can make compassionate practice feel harder than it should. And yet, even in challenging conditions, each of us retains agency.

The choices we make in clinics, wards, homes and communities may seem small, but they carry weight. Every interaction, sometimes brief, always consequential, has the power to shape a person’s health, their trust in care and their experience of being heard. When thousands of such moments align with our professional values, they create collective momentum: a shared expectation of dignity, respect and humanity in care. Momentum alone cannot transform systems, but it strengthens the culture that enables careful and kind care. We must treat the privilege of caring with humility and continue to advocate for and design systems that allow us to practise in ways consistent with our values.

Tackling today’s challenges will take systems that serve by enabling careful, kind care, disruptive innovation harnessed to create equity and stronger foundations for health in people’s everyday lives. Each of us can help make that future real. Realistic Medicine is our method. It asks us to keep people’s outcomes and experiences at the centre, to deliver careful and kind care and to steward resources and trust wisely. These themes have shaped my recent reports and must remain the compass for the years ahead.

Realistic Medicine comes to life in ordinary moments: the consultation that slows down enough to understand what matters; the ward round that makes space for questions; the home visit that notices the context behind the symptoms; the handover that protects continuity and prevents avoidable harm. Realistic Medicine is not an add-on alongside everything else. It is a way of working that helps us meet complexity with clarity, practise with humility and use our finite resources well.

Individual actions matter, and collective engagement helps those actions add up to real change. This is the steady work of improvement. It means working in partnership with people, colleagues and communities; advocating for the conditions that enable careful and kind care; participating in civic life with professionalism; and using whatever influence we have, however modest, to move our culture toward trust, openness and careful and kind care. Collective engagement is not about doing everything, but about contributing what we can, where we are, in ways that align with our values and purpose.

Optimism Is Not Naïve

Connection and continuity improve outcomes; careful and kind care is compatible with sustainability; and prevention and equity are essential for a resilient system. This is not wishful thinking. It is grounded in evidence and lived experience across Scotland.

We cannot change everything at once. But every shared decision, every avoided low value intervention, every conversation that restores dignity, every improvement to a pathway, every act of advocacy- all of these small actions contribute to momentum that sustains hope, strengthens culture and builds a better future.

The way we care matters. And together, our everyday actions help shape a system worthy of the people we serve. Creative disruption does not spark from comfort – it ignites when people collectively refuse to uphold systems that clash with their values, choosing instead to challenge, reshape and rebuild them.