Realistic Medicine and Value Based Health and Care Casebook

Foreword

The First Minister has set out the Scottish Government’s ambition for renewing our NHS. To deliver this ambition and ensure a more accessible, more personalised NHS, we must reduce the immediate pressures across the NHS, shift the balance of care from acute services to the community, and use digital and technological innovation to improve access to care. Alongside this, we must also strengthen our long-term focus on prevention.

The structural changes required to deliver these priorities 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 achieve these ambitions and create a carbon-neutral, climate-resilient, equitable and sustainable health and care system, we must to do things differently. And we need also to practise with acumen, understanding and discernment if we’re to consistently provide careful and kind care. By practising Realistic Medicine we will establish the culture and foster the conditions required to create a fairer, more sustainable health and care system.

Enabling careful and kind care

• Focus on understanding and supporting people to achieve their goals
• Balance biography and biology when applying evidenceinformed practise
• Collaboration is key to providing care that people value and greater job satisfaction
• Use resources wisely to provide sustainable care for our service and our planet
• Measure the right things including outcomes that matter to people
• Kindness and compassion sit at the heart of the way we deliver care

Realistic Medicine: Taking Care - Chief Medical Officer for Scotland Annual Report 2023–2024

In a recent survey, you identified the need for detail on how Realistic Medicine can be applied to specific areas of healthcare as a future priority to achieve better outcomes. This compendium of case studies contains a variety of excellent examples that demonstrate how teams across Scotland are achieving the outcomes that matter to people. My thanks go to all teams who were willing to share the positive impact that practising Realistic Medicine is making to the people we care for and how this in turn is contributing to a more sustainable health and care system. We should celebrate their success.

Practising Realistic Medicine, in my view, clearly has huge benefits; to people, to our health and care system and to our planet. I very much hope that these excellent examples of good practice inspire you to innovate, adopt these approaches and deliver careful, kind, better value care and ensure that Realistic Medicine is firmly embedded as “the way we deliver care in Scotland”.

Professor Sir Gregor Smith

Chief Medical Officer for Scotland