Value based health and care action plan: measurement framework

Conclusion and next steps

The Value Based Health and Care Action Plan: Measurement Framework provides the first comprehensive overview of Scotland’s progress in embedding Realistic Medicine and Value Based Health & Care (VBH&C) across the health and social care system. It outlines progress with 13 actions supported by 89 metrics, drawing on survey data, usage statistics, national datasets and supplementary case studies in three Actions to benchmark implementation and their impact.

Significant work is underway across Scotland that is grounded in Realistic Medicine but not yet reflected in metrics within this report, largely because evidence to assess progress and impact of such work is still in development. Future iterations of this Measurement Framework will reflect on the progress on both ongoing and future work, aiming to include additional monitoring metrics to offer a more comprehensive view over time.

The framework assesses levels of professional engagement with VBH&C principles, uptake of education and digital tools, and activity related to person‑centred care, shared decision making, sustainable prescribing and reducing unwarranted variation. It highlights progress in areas such as digital innovation, prescribing, community of practice development and implementation of decision support tools, while also identifying gaps where data or infrastructure remain in development.

This initial assessment has also helped to inform next steps, including continuing to:

• engage with professional bodies, senior leaders and health and care professional colleagues to promote and support the practise of Realistic Medicine and delivery of Value Based Health and Care;
• roll out of the MyCare.scot service across Scotland;
• develop a national approach to the digital capture and use of PROMS and PREMs to learn from those with lived experience to improve services and deliver the outcomes that matter to the people we care for;
• support professionals to identify and tackle unwarranted variation to help reduce waste and potential harm;
• support people and communities to access preventative and proactive approaches to improve healthy life expectancy and reduce health inequalities, through our approach to Health and Social Care Reform; and
• develop and support effective prescribing practices.

This initial benchmark indicates that further work is needed to support the practice of Realistic Medicine and the delivery of value‑based, sustainable care, while also showing areas where progress has been made. The measurement framework will be updated every two years to strengthen system‑wide understanding of what is developing effectively and to support more equitable, sustainable and outcomes‑focused care for people and communities across Scotland.