UK can learn from Scotland’s NHS

A new report by the Nuffield Trust has claimed that the UK could learn lessons from Scotland’s unique system for improving the quality and safety of patient care.

Learning from Scotland’s NHS, written by Mark Dayan and Nigel Edwards, is the first in a new series from the trust looking at each of the four health services of the UK in a detailed and qualitative way.

The report states that, whilst Scotland’s smaller size as a country has enabled it to develop a more personalised, less formal approach than in England, it also ‘uses a consistent, coherent method where better ways of working are tested on a small scale, quickly changed, and then rolled out’. When opposed to ‘chopping and changing’ policy in England, whereby ‘too many short-term, top-down initiatives often fail to reach the front line’, this benefits patients and the NHS workforce.

The report also claims ‘there are pioneering initiatives to address’ the problem of access of care in remote areas, and should be considered in other parts of the UK facing similar issues.

However, some problems are not so easily addressed. The Nuffield Trust finds that, like other UK countries, Scotland has struggled to move care out of hospital and that it faces a ‘serious financial predicament’. The Scottish NHS needs to make average savings this year of more than four per cent - higher than those in England and Wales. The trust’s report summary says that ‘while the strengths of the Scottish NHS could help it to save money, there is also a risk that they are undermined by the intense financial squeeze’.

Dayan found the same conclusion in saying that: “Scotland's well thought-through system of improving patient safety and quality of care works by engaging frontline staff in the process, and importantly the country has stuck with that approach rather than chopping and changing every couple of years.

"Scotland has also worked on getting its healthcare services to co-operate for longer than the other nations of the UK. So we're urging healthcare leaders from England, Wales and Northern Ireland to think about what elements they might want to import from Scotland. However, the dark cloud on the horizon threatening these strengths is potentially serious financial problems."