Scottish Spending Review 2026

Chapter 4 Health & Social Care

The Health and Social Care portfolio is committed to bold reform to meet the challenges facing health and social care now and in the future. Our vision is clear: a Scotland where people live longer, healthier, more fulfilling lives and experience care that is accessible, high-quality, and person-centred.

We aim to strengthen prevention, resilience, and efficiency within the Health and Social Care system. We will improve the health of our population and improve access to health and social care by delivering on the principles and actions set out in the Health and Social Care Service Renewal Framework (SRF) and the Population Health Framework (PHF).

Health and social care services contribute to the First Minister’s priority of eradicating child poverty through integrated, preventative, family focused approaches. Key actions include strengthening mental health support for children and young people, such as working with health boards to ensure they continue to meet the Child and Adolescent Mental Health Services (CAMHS) waiting times, providing quality sporting opportunities through the Active Schools programme, and ensuring we have a skilled, sustainable workforce that is clearly linked to the child poverty agenda through NHS Anchor Plans.

In alignment with Scotland’s broader environmental commitments, we remain focused on embedding climate resilience and sustainability as core priorities within our reform agenda. This includes actions set out in the PHF to maximise efforts to tackle the climate and nature emergencies, recognising the close links between environmental and human health. We will also make better use of digital technology to transform how people interact with services and manage their wellbeing, delivering modern, joined up and efficient services, including investing in our new app MyCare and the development of Digital Prescribing.

The portfolio also contributes significantly to ensuring high quality, sustainable public services. Over the medium term, building on our SRF, we will strengthen planning and delivery structures by establishing Sub-National Planning Committees and create a new national delivery organisation to lead reform on a Once for Scotland basis. We will work in partnership to ensure effective workforce planning.

Prevention initiatives such as Hospital at Home and Frailty services will reduce long term demand, while substantial added investment of £531 million over three years in GP practices will increase primary care capacity.

Capital investment will maintain critical infrastructure and support continued development of our major acute capital projects, including University Hospital Monklands, Princess Alexandra Eye Pavilion, Belford Hospital replacements, and St Brendan’s Hospital on Barra. We will also embark on a programme of primary and community care infrastructure investment with an expected capital value in excess of £500 million.

In the year Glasgow hosts the Commonwealth Games and the men’s national football team competes in the FIFA World Cup, we will continue to invest in a healthier Scotland by committing significant additional funding to sport.

*Note: Following the UK Autumn budget, the rate of growth in health over the UK Spending Review period has reduced, with negative consequentials applied in 2027-28 and 2028-29.

*Note: NHS Education for Scotland and NHS National Services Scotland will merge to create a new national delivery body from 1 April 2026, provisionally called NHS Delivery.

**Note: Includes £271 million of non-cash budget.

An estimate of NHS Scotland Board’s funding for the next three years is set out above based on high level assumptions available at the time of writing. Actual funding could significantly change with the release of new information and subject to the annual budget process, therefore the outlined funding is highly provisional. Actual funding could change for the following reasons:

• Settlements for NHS Scotland Health Boards are highly subject to fiscal environments and budget cycles, which are not known at this stage. This could significantly impact the overall settlement for NHS Scotland.
• Territorial Health Boards receive a share of the Health and Social Care portfolio budget based on the formula set out by the National Resource Allocation Committee (NRAC). This is refreshed each year and could materially impact the split of the overall total across NHS Scotland’s Health Boards from year to year.
• NHS Scotland is entering a period of reform through the ambitions set out in the Service Renewal and Population Health Frameworks, and through increased collaboration through sub-national structures. The forecasts provided above are projected on the current cost base, but we anticipate the cost base to shift and reduce as NHS Scotland progresses through its reform agenda.