Realistic Medicine: Survey Highlights

Foreword

In 2016, the six principles of Realistic Medicine emerged through conversations with health and care professionals about how they wanted to practise healthcare. Those conversations focused on how we and the people we care for can combine our expertise to share decisions that focus on achieving the outcomes that matter for people.

We explored how we can understand and further reduce the burden and harm that people experience from over- investigation and overtreatment, and how we can reduce unwarranted variation in clinical practice to achieve optimal outcomes. There was also a genuine desire to ensure value for public money and to reduce waste and harm. Many of you were keen to understand how we can manage risk and how we can become innovators to improve the way we deliver care.

Over the years, I have continued these vital conversations with you and received a wealth of feedback which has helped shape my own thinking on what it means to be a health and care professional – our purpose, how we should practise, and how we can achieve better outcomes for the people we care for.

You have contributed to the evolution of Realistic Medicine and Value Based Health and Care which form the foundation of my annual reports. They describe the challenges our system – and our planet is facing, how we as health and care professionals can optimise the use of our resources, provide better value care and showcase examples of how practising Realistic Medicine can create a more sustainable system. I am grateful to all of you for your contribution and support.

In 2016, we created a shared vision for Scotland – that “all health and care professionals would be supported to practise Realistic Medicine by 2025”. So how far have we come?

In January, we shared a survey that aimed to gauge precisely that. Over 1,800 health and care professionals responded – an excellent response given how busy you are. This makes the findings from this survey all the more powerful.

These findings tell me that despite the significant challenges we face, and while there is more to do, we have come along way. We have worked to create a network of local Realistic Medicine teams across Scotland. We have developed training resources and made Realistic Medicine an integral part of NHS Boards’ Delivery Plans. You can see the progress we are making, and the positive impact Realistic Medicine is having on the lives of the people we care for. You want to be supported to practise Realistic Medicine and for the barriers to practising it to be overcome.

The structural changes required to deliver the renewal of our health and care system are set out in the Operational Improvement Plan, Population Health Framework, and the Health & Social Care Services Reform Framework (expected June 2025). If we are to deliver these changes, we must do things differently, we need to practise differently.

Today, I remain convinced that by practising Realistic Medicine we will form the culture and foster the conditions required to create a fairer, more sustainable health and care system. I encourage us all, including system leaders to consider these findings and how we can continue to ensure that Realistic Medicine is firmly embedded as “the way we deliver care in Scotland”.

Professor Sir Gregor Smith

Chief Medical Officer for Scotland