NHS Delivery - a new national delivery organisation: consultation

Renewal of our Health and Social Care System

Our approach to the delivery of a sustainable and fit-for-purpose health and social care system is rooted in a commitment to the delivery of high-quality public services. These services represent an investment in our health, equality and prosperity and should be efficient, effective and targeted in a way which maximises their impact and delivers the greatest value and outcomes for the people of Scotland.

Through our Public Service Reform strategy, we have set out the way in which these services must evolve if they are to meet our future needs. Our Service Renewal Framework (SRF) describes how we will give effect to our public service reform ambitions through the transformation of the way we deliver health and social care services to people across the country.

Delivering a sustainable, high-quality health and social care system is central to Scotland’s ambitions for health, equality, and prosperity. Yet, as highlighted in both the SRF and the Population Health Framework (PHF), the scale of the challenges we face – rising demand, persistent inequalities, and rapid technological change – means that our system must evolve fundamentally, not incrementally. The SRF sets out a bold, ten-year roadmap for transformation, focused on ensuring that services are:

• Sustainable and efficient in the face of financial and workforce pressures,
• Accessible and equitable for all communities,
• Modern and person-centred, harnessing digital innovation and new models of care.

The SRF sets out 5 key principles for renewal which will guide our future approach:

• Prevention Principle: Prevention across the continuum of care.
• People Principle: Care designed around people rather than the ‘system’ or ‘services’.
• Community Principle: More care in the community rather than a hospital focused model.
• Population Principle: Population planning, rather than along boundaries.
• Digital Principle: Reflecting societal expectations and system needs.

Building on these principles, the Framework sets out major areas for change, including:

• Enhancing services that prevent disease, enable early detection and effectively manage long-term conditions.
• Delivering health and social care that is people-led and ‘Value Based’.
• Strengthening integration across the system.
• Improving access to services and treatments in the community.
• Redesigning our hospitals as we deliver more care within communities.
• Delivering services which are accessible through digital technologies, with people and our workforce able to access and make use of the right information.

Crucially, the SRF recognises that achieving these ambitions requires a new approach to national support services.

Fragmentation of key functions across multiple national bodies has led to duplication, variation, and slower progress. To address this, the SRF commits to bringing together NHS Education for Scotland (NES) and NHS National Services Scotland (NSS) into a single, unified delivery organisation. This new body, NHS Delivery, will provide the national leadership, capability, and accountability needed to drive transformation at scale and pace, supporting the “Once for Scotland” ethos of consistency and excellence, enhancing efficiency and productivity.

Renewal is not optional; it is essential if Scotland is to deliver on its vision of longer, healthier, and more fulfilling lives for all.