Scottish national clinical strategy for health services revealed by Shona Robison

The Scottish Government has unveiled its plans to shift healthcare from hospitals into homes over the next decade, to cope with Scotland’s ageing population.

The National Clinical Strategy, revealed by Health Secretary Shona Robison in Dundee, outlines plans to shift care closer to communities using smaller and rural hospitals and primary care hubs, with more patients self-managing their own conditions.

The strategy has been cautiously welcomed by interest groups, although the Royal College of Nursing (RCN) said it lacked detail on how it would be delivered.

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The basis of the proposals is to treat people as close to home as possible.

“The aim of primary care must be to support people to maintain the maximum level of health they can achieve, but in a way that encourages independence and self-management and reduces dependence on the healthcare system,” it says.

Primary care will be delivered by multi-disciplinary teams in communities with strong links with local authority social services.

Advanced nurse practitioners, pharmacists and allied health professionals will be given extended professional roles as part of the health team.

Robison said she would continue to consult with stakeholders to deliver the plans.

“We want to make sure that the best possible care is available for everyone when they need it. This includes supporting patients to fully understand and manage their health needs, with a focus on rehabilitation and independence,” she said.

Hospital care will be focused on highly specialist treatments, while more recovery and rehabilitation will take place at home. Other specialists will work across more than one hospital so care can be delivered to remote and rural locations.

RCN Scotland director Theresa Fyffe said “bold changes” were implicit in the document, something the royal medical colleges have warned were necessary.

“What’s missing, however, is any explicit detail on how these changes could be delivered. The document published today states that the RCN, among other organisations, has been engaged in its development and has shown a high level of support for all aspects of the strategy.

“This overstates our position somewhat, but we look forward to engaging with all our members and working with Government and all other stakeholders involved to develop a ‘route map’ for implementation,” she said.

Services must be designed around patients, she added, and involve the public in how services change.

“Politicians also need to be honest with the public and take a long-term view on the need for change,” she said.

The Health and Social Care Alliance Scotland, which represents third sector organisations, welcomed the commitment to greater involvement of people in their own care.

Chief Executive Ian Welsh said the Alliance would demonstrate why the third sector should be “equal partners” in the process.

“These issues strongly reflect what our members tell us matter to them, and are areas in which the third sector undoubtedly has an important role to play,” he said.