'Bold' changes needed to overhaul Scottish NHS, health bosses warn

GPs and other health professionals are not being used to their full potential because of fragmented NHS structures, heavy workload and outdated ways of working, Scottish health leaders have warned.

Scottish NHS: bold reform needed
Scottish NHS: bold reform needed

The NHS needs its health professionals to ‘step forward and take a leading role’ in driving changes for the future, and they should work with the public, media and politicians to do so, the Building a More Sustainable NHS in Scotland paper says.

Devised following a February meeting in Edinburgh of BMA Scotland, the Academy of Royal Colleges and Faculties in Scotland and the Royal College of Nursing Scotland, the paper marks the first time the professions have ‘spoken with a single voice’.

It declares that hospitals should no longer be ‘the mainstay of the health service’, and new models of care must be developed to allow healthcare services to better support patients in the home.

This makes one of four key areas of activity which they believe must be ‘pursued effectively and collectively’ to bring about the greatest improvements to the NHS.

The others include opening up debate with the public, moving away from a target-driven approach to healthcare – Scotland has already committed to scrapping the QOF in 2017 – and improving inter-professional working.

'Bold and visionary'

The groups warned that the health problems facing Scotland could not be fixed through ‘marginal change and improvement’ – and it was time to be ‘bold and visionary’.

The rousing call comes as the Scottish NHS faces mounting problems such as an increasingly ageing population, inflationary pressures from expensive new drugs and technologies and persistent health inequalities.

Dr Peter Bennie, chairman of the BMA in Scotland, said the paper represented a ‘significant first step’ towards opening up an ‘honest debate’ about the future of the NHS in Scotland.

‘There is no doubt that the service is struggling to cope with rising demand and the complex health needs of the aging population will further add to the pressure,’ he said.

‘It is vital that change is informed by those who work in the service and those who can see where the real pressure points are.  We need to develop a more mature, evidence-based approach to driving quality by changing how we measure and set targets so that we do not skew clinical judgement and allow the flexibility to prioritise patients with the greatest clinical need.’

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