Value based health and care action plan: measurement framework

Action 2

The Scottish Government, professional bodies, NHS Boards and Health and Social Care Partnerships (HSCPs) will work together to increase professional awareness of Realistic Medicine and enable delivery of Value Based Health and Care.

Progress to date and future priorities

The Scottish Government has worked with a wide range of partners to raise professional awareness of Realistic Medicine and enable VBH&C delivery. VBH&C has been embedded as a key enabler of the Population Health Framework and the Service Renewal Framework, which set out how the Scottish health and care system will be transformed over the next ten years to become more outcomes focused and sustainable. Practising Realistic Medicine and delivering VBH&C are also essential requirements of NHS Boards’ Annual Delivery Plans (ADP) for 2025-26. ADP guidance makes it clear that NHS Boards must focus on practising RM. Boards are required to provide regular updates on progress with their ADPs including this action. From the Boards’ local Realistic Medicine Action Plan progress updates, we can see that the majority of boards are making good progress. Boards have established local leadership and governance structures to champion Realistic Medicine and foster a culture of stewardship, ensuring VBH&C is embedded across Boards and Health & Social Care Partnerships. Boards are making progress with promoting Realistic Medicine and Value Based Health and Care training and improving uptake. Some boards have set up Realistic Medicine champions networks that aim to promote and support people to practise Realistic Medicine.

The annual Realistic Medicine Conference, complemented by local symposia and learning events, promotes Realistic Medicine and enables sharing of good practice. Thematic analysis of qualitative feedback provided by 2025 conference attendees suggests that this conference achieved that aim.^[4]

The Scottish Government have worked with the many stakeholders including CfSD, HIS, NSS, NES, Scottish Intercollegiate Guidelines Network (SIGN), professional bodies and higher education institutions to promote and embed Realistic Medicine into clinical guidance and to influence practice. In June 2025, the Royal College of Physicians of Edinburgh hosted a national evening medical update webinar on Realistic Medicine. The Scottish Government Funding also requires Boards to demonstrate action on promoting training and improving uptake.

The main priorities moving forward, include 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 VBH&C. The Scottish Government will continue to:

• host an annual conference
• work with NES and other partners to strengthen our training offer and our community of practice
• promote RM and VBH&C at local, national and international events
• ensure that delivery of VBH&C is viewed as a key enabler of NHS Boards’ Annual Delivery Plans

Monitoring metrics

The monitoring metrics for Action 2 draw primarily on survey data and qualitative evidence from open‑text survey responses from health and care professionals. The data capture levels of awareness, understanding and confidence, as well as the perceived impact of applying Realistic Medicine and Value Based Health and Care.

Metric 2.1: A majority of health and care professionals surveyed reported feeling very (24%) or fairly (51%) confident in their understanding of the principles of Realistic Medicine.

Metric 2.2: A majority of health and care professionals surveyed reported that Realistic Medicine has had a strong (29%) or slight (41%) positive influence on their practice of healthcare in the previous year.

Metric 2.3: 66% of health and care professional surveyed described their understanding of the following statement as clear: ‘By practising Realistic Medicine we can deliver Value Based Health and Care’.

Metric 2.4: Qualitative Evidence from the Realistic Medicine Survey relating to awareness of Realistic Medicine and delivery of Value Based Health and Care:

Awareness of Realistic Medicine and VBH&C led many health and care professionals surveyed to report better communication and more collaborative, patient‑ centred decisions while others lacked awareness of these approaches.

“Learning about realistic medicine has improved the way I collaborate with patients.”

“Sounds great, but the concept [RM] has not been implemented or even discussed in my clinical area.”