Scotland must move away from ‘fix and treat’ NHS, says government delivery plan

e-health - Dombrowski

A "fundamental" cultural shift towards prevention is needed in Scotland if health and social care systems are to be sustainable, according to a new Scottish Government delivery plan.

This will require citizens to take more responsibility for their health and wellbeing by adopting more healthy behaviours to prevent getting ill in the first place.

 “People should be regularly involved in, and responsible for, their own health and wellbeing,” it said.

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The Health and Social Care delivery plan, published on Monday, also gives a specific timescale for when the Scottish Government expects services to be redesigned.

It follows on from the National Clinical Strategy and the Chief Medical Officer Catherine Calderwood’s Realistic Medicine vision, which outlined a need for a shift to more community care using less medicines.

By 2021, the majority of Scottish Government health spend should be spent in the community, according to the document, giving more people a personalised care and support plan, especially at the end of life.

Announcing the plan, Health Secretary Shona Robison said: “Over the nearly 70 years of our NHS, it has had to continually evolve with our society - and it must continue to do so.

“We have a wonderful challenge that, as a nation, our people are living longer lives than at any point in our history. That means our health and care services must change to aid increasingly more people living with multiple, complex conditions.”

Despite rumours there might be a restructuring or even merging of Scotland’s 14 territorial health boards, the plan instead suggests they should work more collaboratively on highly specialist care.

Robison added: “While delivering these changes will require reforms to how boards work, and work with each other in partnership across disciplines and boundaries, we do not currently envisage our patient-facing boards being reduced in number.

“Instead we see our 14 territorial health boards, and NHS 24 and the Scottish Ambulance Service, focusing on delivering better care and better health for local communities, and planning together for the most specialist care.”

Currently the health and social care system in Scotland is faced with spiralling demand while many patients lie in hospital beds waiting to be discharged.

Audit Scotland reported the NHS in Scotland is only meeting one of its eight waiting time targets and faces “unprecedented savings”.

“Where people need hospital care, our aim is for day surgery to be the norm, and when stays must be longer, our aim is for people to be discharged as swiftly as it is safe to do so,” the delivery plan said.

Social care and education services will be expected to take a bigger role in supporting people to live healthier lives, according to the document.

The aim is reduce unscheduled bed-days in hospital care by up to 10 percent by 2018.

The plan will be supported by £128 million of change funding in 2017-18.