Value based health and care action plan: measurement framework
This report is the first iteration of the Value Based Health and Care measurement framework. It presents updates and monitoring metrics which aim to provide an assessment of the progress with and impact of work aligned to each of the 13 actions from the value based health and care action plan.
Footnotes
1 The Full Story – Realistic Medicine.
2 Defining Value-based Healthcare in the NHS.
3 The National Realistic Medicine Network includes NHS Board Clinical Leads and Programme Managers, funded by Scottish Government, tasked with helping to promote and supporting people to practice Realistic Medicine and deliver VBH&C within their NHS Boards.
4 Attendees to either of two “World Café Sessions” at the Realistic Medicine Annual Conference 2025 were invited to share their views via an open text question hosted on Slido: “After participating in the World Café session, what key insights, reflections, or takeaways stood out to you, and how might they influence your thinking or approach going forward?”. A total of 107 responses were provided.
5 A consultation is a call which lasts 2 minutes or more.
6 Figure is based on responses to the Near Me end of call feedback survey (approx. 17,600 responses in 2025).
7 Domains of person-centred care were identified through a literature review and synthesis undertaken by Healthcare Improvement Scotland and subsequently tested using a modified Delphi review. This work built on previous work delivered by The Health Foundation: Person-centred care made simple | The Health Foundation.
8 This is not the Care Opinion hosted PREM which was launched in Dec 2025, after the Value Based Health and Care Survey.
9 This is standard pre-existing Care Opinion data, not the PREM addition mentioned prior. The PREM element was launched in Dec 2025, after the Value Based Health and Care Survey.
10 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
11 See Action 11 metrics.
12 At the time of reporting, the CoP had 39 core members representing a range of Health Boards, specialisms and Scottish Government policy areas. These are the members who attend most regularly. Membership is fluid and continues to grow. Participation is open to any Health and Care staff who wish to join.
13 Content on NHS inform is reviewed on a three‑year cycle, meaning around one‑third 33% of total content is expected to be reviewed each year.
14 Wherever possible, NHS inform looks to engage external subject matter experts (SME) to support the development and assurance of NHS inform content. This support helps ensure NHS inform reflects the current evidence base for treatment and best clinical practice.
16 Adherence is defined as “the extent to which a person’s behaviour – taking medication, following a diet, and/or executing lifestyle changes corresponds with agreed recommendations from a health care provider”. Among patients with chronic illness, approximately 50% do not take medications as prescribed. Non-adherence may limit the benefits of medicines, resulting in lack of improvement, or deterioration in health.
17 Health and care professionals referenced in Action 12 metrics refer only to those in a role which involves prescribing.
18 This metric identifies the number of people prescribed three or more high‑risk mental‑health‑related medicines, which can greatly increase the chance of serious harm such as heavy sedation, falls and dangerous breathing problems.
19 The Health and Care Experience Survey asks respondents about their experiences accessing and using their General Practice and other local healthcare services. In the ‘Out of Hours Healthcare’ section, respondents were asked to think about the last time they tried to get treatment when their General Practice was closed.
20 Secondary analysis of free text comments in the Health and Care Experience Survey 2023/24 was carried out by government research analysts to inform the Value Based Health and Care Measurement Framework. Further methodological and background information is provided in Annex 2.4.
21 Response options which received fewer than 10 responses are omitted from Table 1 to mitigate disclosure risk. These include: Dentistry, Finance professional, Resident Doctor, Social Care Provider. Responses for these options are included in the response total.
22 Response options which received fewer than 10 responses are omitted from Table 2 to mitigate disclosure risk. These include: Scottish Ambulance Service, NHS Education for Scotland, National Services Scotland, GP practice, Local Authority, NHS Golden Jubilee (National Waiting Times Centre Board), NHS 24, Healthcare Improvement Scotland, Public Health Scotland, Private Health / Private Care Provider, Regulator (e.g. Care Inspectorate), Third Sector, Other. Responses for these options are included in the response total.
23 The case study presented under Action 5 is based on the evaluation report of the iSIMPATHY project.
24 Health+and+Care+Experience+Survey+2023+to+2024+-+survey+sample.pdf
25 A keyword framework was developed as the initial method for analysing the open-ended responses from the HACE survey. This framework was subsequently reviewed and commented on by key stakeholders, including members of the Realistic Medicine team and key action leads from the Value Based Health and Care Action Plan, ensuring alignment with strategic priorities and expert perspectives.
Contact
Email: realisticmedicine@gov.scot