Value based health and care action plan: measurement framework

Annex 1: Measurement framework metrics and their data sources

This annex provides a comprehensive overview of the metrics included in the measurement framework and their corresponding data sources. More detail on previously unpublished data sources is provided in Annex 2.

Metric(s) 1.1, 1.2, 1.4 and 1.6 - Metric detail

NHS NES Realistic Medicine learning resource usage:

1.1 Value Based Health and Care TURAS e-modules learner completions

1.2 SWAY resources access

1.4 NHS NES animations access

1.6 TURAS Learning Page views

Metric(s) 1.1, 1.2, 1.4 and 1.6 - Data source

Management information provided by NHS NES. First published in this Measurement Framework

Metric(s) 1.3, 1.5 and 1.7 - Metric detail

The proportion of health and care professionals surveyed who report using the following resources to support the care they provide:

1.3 Realistic Medicine Sways

1.5 Realistic Medicine Animations

1.7 Realistic Medicine TURAS learning pages

Metric(s) 1.3, 1.5 and 1.7 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 1.8 - 1.10 - Metric detail

1.8 Percentage of health and care professionals who had completed some Realistic Medicine and/or Value-Based Health & Care training

1.9 E‑learning modules most frequently completed by health professionals

1.10 Percentage of health professionals who felt confident practising Realistic Medicine after completing training

Metric(s) 1.8 - 1.10 - Data source

Practising Realistic Medicine Survey. Scottish Government. (2025). Published at: Realistic Medicine: Survey Highlights

Metric(s) Action 1 Supplementary case study - Metric detail

Case studies illustrating the impact and progress relating to Action 1

Metric(s) Action 1 Supplementary case study - Data source

Data collated by NES in collaboration with Higher Education Institutions. First published in this Measurement Framework.

Metric(s) 2.1 and 2.2 - Metric detail

2.1 Confidence among health professionals in their understanding of the principles of Realistic Medicine.

2.2 Influence of Realistic Medicine on health professionals’ practice

Metric(s) 2.1 and 2.2 - Data source

Practising Realistic Medicine Survey. Scottish Government. (2025). Published at:

Realistic Medicine: Survey Highlights

Metric(s) 2.3 - Metric detail

Health professionals’ understanding of how Realistic Medicine supports VBH&C

Metric(s) 2.3 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 2.4 - Metric detail

Examples of awareness of Realistic Medicine and delivery of VBH&C among healthcare professionals

Metric(s) 2.4 - Data source

Scottish Government. (2025). Practising Realistic Medicine Survey. Available at: Realistic Medicine: Survey Highlights

Metric(s) 3.1 - Metric detail

Number of Near Me consultations carried out in 2025

Metric(s) 3.1 - Data source

Near Me: Review of Usage Jan – Dec 25. Digital Health and Care Scotland. Published at:

Near Me – Digital Services and Innovation (Accessed: 12^th February 2026).

Metric(s) 3.2 - Metric detail

Estimated patient travel miles avoided through Near Me in 2025

Metric(s) 3.2 - Data source

Near Me: Review of Usage Jan – Dec 25. Digital Health and Care Scotland. Published at:

Near Me – Digital Services and Innovation (Accessed: 12^th February 2026).

Metric(s) 3.3 - Metric detail

The proportion of healthcare professionals who reported using Near Me to support the care they provide.

Metric(s) 3.3 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 3.4 - Metric detail

Number of individuals enrolled in Connect Me in 2025

Metric(s) 3.4 - Data source

Management information provided by the National Virtual Consultation Service.

Metric(s) 3.5 - Metric detail

Barriers identified by Healthcare professionals to using digital technology in delivering VBH&C

Metric(s) 3.5 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 4.1 - 4.5 - Metric detail

Healthcare professionals’ use of feedback from the following sources to inform the delivery of person-centred care:

4.1 PREMs

4.2 Shared decision-making tools

4.3 Patient experience surveys

4.4 Care Opinion

4.5 Near Me end of consultation

Metric(s) 4.1 - 4.5 - Data source

Value Based Health and Care Survey. Scottish Government. (2025).

First published in this Measurement Framework.

Metric(s) 5.1 - Metric detail

Healthcare professionals’ use of PROMs feedback to inform the delivery of person-centred care

Metric(s) 5.1 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) Action 5 Supplementary case study - Metric detail

Case study showcasing the integration of PROMs as a part of Polypharmacy Management project

Metric(s) Action 5 Supplementary case study - Data source

iSIMPATHY (2023) iSIMPATHY Evaluation Report. Special EU Programmes Body (SEUPB). Available at:

ISIMPATHY evaluation report

Metric(s) 6.1, 6.2 and 6.4 - Metric detail

6.1 Healthcare professionals’ use of the Scottish Atlas of Healthcare Variation to identify unwarranted Variation in access, treatment and outcomes

6.2 Barriers identified by healthcare professionals in using the Scottish Atlas of Healthcare Variation to identify unwarranted variation

6.3

6.4 Qualitative Evidence on Health and Care Professionals’ Views of the Atlas

Metric(s) 6.1, 6.2 and 6.4 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 6.3 - Metric detail

Orthopaedics, Ophthalmology, and Dentistry healthcare professionals’ use of the recently updated paediatric dental extraction and hip, knee and cataract surgery maps in the Scottish Atlas of Healthcare Variation.

Metric(s) 6.3 - Data source

Scottish Atlas of Variation Surgical Procedures Dashboard: Survey Insights on the latest Atlas maps. Scottish Government (2026).

Available at: Scottish Atlas of Variation Surgical Procedures dashboard: survey report

Metric(s) 7.1 - Metric detail

Interaction (total page views) with Demand Optimisation webpage.

Metric(s) 7.1 - Data source

Management information provided by Public Health Scotland

Metric(s) 8.1 and 8.2 - Metric detail

8.1 Healthcare professionals’ level of agreement that their organisation promotes a culture of prevention in health and care.

8.2 Healthcare professionals’ level of agreement that their organisation actively works to address racialised inequalities in health and care

Metric(s) 8.1 and 8.2 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 8.3 - Metric detail

Citizen’s Panel 14 respondents’ agreement that they were involved in discussions on promoting good health and preventing ill health.

Metric(s) 8.3 - Data source

Healthcare Improvement Scotland (2024) Fourteenth Citizens’ Panel Report: Realistic Medicine, Value Based Health and Care, and NHS Reform. Available at:

Fourteenth Citizens' Panel report

Metric(s) 8.4 - Metric detail

Scottish Life Expectancy at Birth by Sex

Metric(s) 8.4 - Data source

National Records of Scotland (2024) Life Expectancy in Scotland 2022–2024. Available at:

https://www.nrscotland.gov.uk/publications/life-expectancy-in-scotland-2022-2024/

(Accessed: 12^th February 2026).

Metric(s) 9.1 – 9.4 - Metric detail

Healthcare professionals’ engagement with the following:

9.1 Community of Practice

9.2 Realistic Medicine Network

9.3 Their Realistic Medicine Team

9.4 Local or national events related to Realistic Medicine

Metric(s) 9.1 – 9.4 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) Action 9 Supplementary case study - Metric detail

Case studies showcasing integration of shared decision making and person-centred practice enabled by Community of Practice engagement.

Metric(s) Action 9 Supplementary case study - Data source

Data collated by Scottish Government in collaboration with NHS Lothian and NHS Fife. First published in this Measurement Framework.

Metric(s) 10.1 – 10.3 - Metric detail

Healthcare professionals’ use of the following resources to support the care they provide:

10.1 SIGN

10.2 NHS Inform

10.3 Right Decision Service tools for professionals

Metric(s) 10.1 – 10.3 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 10.4 – 10.5 - Metric detail

10.4 Percentage of Content Reviewed on NHS Inform

10.5 Percentage of NHS Inform Content Governed by Subject Matter Experts

Metric(s) 10.4 – 10.5 - Data source

Management information provided by NHS Inform

Metric(s) 10.6 - Metric detail

10.6 Total user visits to NHS Inform webpages

Metric(s) 10.6 - Data source

Management information provided by NHS Inform: NHS inform (2026) NHS inform annual status update report [Google Analytics dataset]. Extracted from: Google Analytics (Accessed: 9th January 2026).

Metric(s) 10.7 – 10.9 - Metric detail

10.7 Total user visits to Right Decision Service webpages

10.8 Total user visits to Professional-facing Realistic Medicine website and mobile App

10.9 Total user visits to Citizen-facing Realistic Medicine website and mobile App

Metric(s) 10.7 – 10.9 - Data source

Management information provided by HIS. First published in this Measurement Framework.

Metric(s) 11.1 – 11.3 - Metric detail

Consultants and Resident Doctors’ use of the following resources to support them to reduce or stop lower-value interventions and care:

11

11.1 Active Clinical Referral Triage

11.2 Opt-in Pathways

11.3 Discharge PIR (Patient Initiated Review)

Metric(s) 11.1 – 11.3 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 11.4 – 11.5 - Metric detail

Health and care professionals’ use of the following resources to support them to reduce or stop lower-value interventions and care:

11.4 CfSD Clinical Pathways

11.5 NHS Scotland Discovery data

Metric(s) 11.4 – 11.5 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 11.6 - Metric detail

Total number of low clinical value Interventions in 2024/25, including Benign skin lesions, Breast surgery, Ganglion, Rhinoplasty and Varicose veins procedures

Metric(s) 11.6 - Data source

Data source: Public Health Scotland Database - Scottish Morbidity Records - SMR01 dataset (inpatients and day cases)

Date of Analysis: 14/01/2026 (SMR01)

Data source: Public Health Scotland Database - Scottish Morbidity Records - SMR00 dataset (outpatients)

Date of Analysis: 07/01/2026 (SMR00)

Metric(s) 11.7 – 11.14 - Metric detail

10

11.6

11.7 Total appointments released through Active Clinical Referral Triage in 2024/25

11.8 Total patient travel miles avoided through Active Clinical Referral Triage in 2024/25

11.9 Cost avoidance achieved through Active Clinical Referral Triage in 2024/25

11.10 Total appointments released through Discharge PIR (Patient Initiated Review) in 2024/25

11.11 Total patient travel miles avoided through Discharge PIR in 2024/25

11.12 Cost avoidance achieved through PIR in 2024/25

11.13 Total number of appointments avoided as a result of National Elective Coordination Unit

11.14 Cost avoidance achieved through National Elective Coordination Unit in 2024/25

Metric(s) 11.7 – 11.14 - Data source

NHS Centre for Sustainable Delivery Annual Report 2024–25.

Published at: Centre for Sustainable DeliveryAnnual Report

Metric(s) 12.1 – 12.5 - Metric detail

The impact of the following resources on healthcare professionals’ use of medicines of low and limited clinical value and ability to deliver safer, more effective, and person-centred care:

11

12

12.1 7-Step Person-Centred Reviews

12.2 National Therapeutic Indicators

12.3 Polypharmacy prescribing guidance and implementation toolkits

12.4 High risk prescribing toolkit for Vision and EMIS

12.5 Scottish Therapeutics Utility

Metric(s) 12.1 – 12.5 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 12.6 - Metric detail

The impact of the Scottish Government Quality Prescribing Resources on healthcare professionals’ ability to deliver safer, more effective, and person-centred care

Metric(s) 12.6 - Data source

Value Based Health and Care Survey. Scottish Government. (2025).

First published in this Measurement Framework.

Metric(s) 12.7 – 12.10 - Metric detail

12.6

12.7 Per capita prescription of 10 or More Medicines Including a High‑Risk Medicine

12.8 Per capita co-prescription of three or more of the following medicine classes: benzodiazepines/Z‑drugs, opioids (including tramadol), gabapentinoids, antidepressants, and antipsychotics (excluding depots).

12.9 Per capita co-prescription of an ACE inhibitor or angiotensin receptor blocker, a diuretic and a Nonsteroidal Anti-Inflammatory Drug

12.10 Per capita prescription of 3 or more short-acting beta-agonist inhalers (SABA)

Metric(s) 12.7 – 12.10 - Data source

Public Health Scotland (2025). National therapeutic indicators data visualisation: Data to September 2025.

Available at: National therapeutic indicators data visualisation (Accessed: 2^nd March 2026).

Metric(s) 12.11 - Metric detail

Interaction with effective prescribing resources (total views between Apr 24 to Mar 25):

11

12

12.1

12.2

12.3

12.4

12.5

12.6

12.7

12.8

12.9

Quality Prescribing Strategy for Type 2 Diabetes Mellitus guide

Respiratory conditions - quality prescribing strategy guide

Quality prescribing for antidepressants guide

Quality prescribing for Benzodiazepines and z-drugs guide

Medicines - achieving value and sustainability in prescribing

Right Decision Service Diabetes toolkit

Right Decision Service Respiratory toolkit

Right Decision Service Polypharmacy toolkit

Right Decision Service ‘Manage My Meds’ toolkit

Metric(s) 12.11 - Data source

Management information provided by the Scottish Government

Extracted from: Google Analytics (Accessed: June/July, 2025).

Metric(s) 13.1 - Metric detail

Healthcare professionals’ view on their organisation’s promotion for the ‘It’s OK to Ask’ campaign

Metric(s) 13.1 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 13.2 - Metric detail

Healthcare professionals’ use of BRAN questions

Metric(s) 13.2 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 13.3 - Metric detail

Healthcare professionals’ view on the effectiveness of BRAN questions in helping people make an informed choice about their treatment and care.

Metric(s) 13.3 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 13.4 - Metric detail

Healthcare professionals’ view on their organisation’s support for them to promote and use BRAN questions.

Metric(s) 13.4 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 13.5 - Metric detail

Citizen Panel 14 respondents’ prior awareness of the need for improved outcomes and effective use of healthcare resources.

Metric(s) 13.5 - Data source

Healthcare Improvement Scotland (2024)

Fourteenth Citizens’ Panel Report: Realistic Medicine, Value Based Health and Care, and NHS Reform. Available at: Fourteenth Citizens' Panel report

Metric(s) 13.6 – 13.8 - Metric detail

Whether Citizen Panel 14 respondents had heard of the following prior to their involvement in the research:

13

13.1

13.2

13.3

13.4

13.5

13.6 Realistic medicine

13.7 BRAN questions

13.8 the NHS “It’s OK to Ask” campaign

Metric(s) 13.6 – 13.8 - Data source

Healthcare Improvement Scotland (2024)

Fourteenth Citizens’ Panel Report: Realistic Medicine, Value Based Health and Care, and NHS Reform. Available at: Fourteenth Citizens' Panel report

Metric(s) 13.9 - Metric detail

Health and Care Experience Survey 2023/24 respondents’ agreement that they ‘had a chance to ask about the benefits and risks of the treatment’ the last time they received treatment or advice at their General Practice.

Metric(s) 13.9 - Data source

Scottish Government, Health and Care Experience Survey 2023/24. Available at:

Health and Care Experience Survey 2023/24: National Results

Metric(s) 13.10 - Metric detail

Health and Care Experience Survey 2023/24 respondents’ agreement that they were ‘involved in decisions about [their] treatment and care’ the last time they received treatment or advice at their General Practice.

Metric(s) 13.10 - Data source

Scottish Government, Health and Care Experience Survey 2023/24. Available at:

Health and Care Experience Survey 2023/24: National Results

Metric(s) 13.11 - Metric detail

Health and Care Experience Survey 2023/24 respondents’ agreement that ‘staff helped [them] to feel in control of [their] treatment and care’ the last time they received treatment or advice from Out of Hours Healthcare

Metric(s) 13.11 - Data source

Scottish Government, Health and Care Experience Survey 2023/24. Available at:

Health and Care Experience Survey 2023/24: National Results

Metric(s) 14.1 - Metric detail

Healthcare professionals’ view on their organisation’s promotion for Realistic Medicine and Value-Based Health & Care.

Metric(s) 14.1 - Data source

Practising Realistic Medicine Survey. Scottish Government. (2025). Published at:

Realistic Medicine: Survey Highlights

Metric(s) 14.2 - Metric detail

Healthcare professionals’ view on their professional body’s promotion for Realistic Medicine and Value-Based Health & Care.

Metric(s) 14.2 - Data source

Practising Realistic Medicine Survey. Scottish Government. (2025). Published at:

Realistic Medicine: Survey Highlights

Metric(s) 14.3 - Metric detail

Healthcare professionals’ view on the level of support received from peers and leaders across the Health and Care system to practice Realistic Medicine and Value-Based Health & Care.

Metric(s) 14.3 - Data source

Practising Realistic Medicine Survey. Scottish Government. (2025). Published at:

Realistic Medicine: Survey Highlights

Metric(s) 14.4 - Metric detail

Healthcare professionals’ agreement that they are ‘able to take the time to get to know the people [they] care for and what is important to them’.

Metric(s) 14.4 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 14.5 - Metric detail

Healthcare professionals’ agreement that they are ‘able to involve the people [they] care for in decisions about their care’.

Metric(s) 14.5 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 14.6 - Metric detail

Healthcare professionals’ agreement that they are ‘able to listen to the people [they] care for and understand the outcomes that matter to them’.

Metric(s) 14.6 - Data source

Value Based Health and Care Survey. Scottish Government. (2025). First published in this Measurement Framework.

Metric(s) 14.7 - Metric detail

Examples of survey respondents’ experiences of person‑centred care and shared decision‑making in General Practice and Out‑of‑Hours Healthcare

Metric(s) 14.7 - Data source

Secondary analysis – published here for the first time - of data captured as part of Scottish Government, Health and Care Experience Survey 2023/24.