‘Scotland has a unique system of improving the quality of health care’ says the Nuffield Trust: Looking at the full report and not the Labour/BBC Scotland extracts in July


Those are some of the opening words of a report from the highly respected Nuffield Trust in a research report published by them in July of this year. For some reason I missed the full report at the time but it’s well worth a look. The BBC Scotland website gave it a reasonable airing but now that I’ve seen the whole thing, they were faint in their praise and then let Labour’s Anas Sarwar have the last words in their report with this appalling set of unrepresentative and nakedly political comments:

‘It includes suggestions that the SNP is avoiding taking the decisive action our NHS needs because of its obsession with independence – and it is not doing nearly enough to shift the balance of care from hospitals to the community. Given the SNP has cut £1.5bn from local budgets since 2011, that is just not going to happen.  The last thing Scotland’s NHS needs is another divisive referendum, and Nicola Sturgeon must now get back to the day job of delivering for our nurses, doctors, care staff and patients.’

I don’t know what Reporting Scotland did with it. Here are the opening four key points from page 3 of the report:


Scotland has a unique system of improving the quality of health care. It

focuses on engaging the altruistic professional motivations of frontline staff

to do better, and building their skills to improve. Success is defined based

on specific measurements of safety and effectiveness that make sense

to clinicians.


Scotland’s smaller size as a country supports a more personalised, less

formal approach than in England. The Scottish NHS has also benefited

from a continuous focus on quality improvement over many years. It uses

a consistent, coherent method where better ways of working are tested on

a small scale, quickly changed, and then rolled out. Unlike in the rest of the

UK, this is overseen by a single organisation that both monitors the quality

of care and also helps staff to improve it.


Scotland faces particular issues of unequal health outcomes, and very

remote areas. There are pioneering initiatives to address these, like the

Links worker programme and Early Years Collaborative to support

people in very deprived areas, and use of video links for outpatient care on

remote islands. These should be considered in other parts of the UK facing

similar issues.


There is much for the other countries of the UK to learn from this. While

comparing performance is very difficult, Scotland has had particular

success in some priority areas like reducing the numbers of stillbirths.

Scotland’s system provides possible alternatives for an English system

with a tendency towards too many short-term, top-down initiatives that

often fail to reach the front line. It also provides one possible model for

a Northern Irish NHS yet to have a pervasive commitment to quality

improvement, and a Welsh system described as needing better ways to

hold health boards to account while supporting them in improving care.

Scotland has a longer history of drives towards making different parts of

the health and social care system work together. It has used legislation

to get these efforts underway while recognising that ultimately local

relationships are the deciding factor. There is much for England and Wales

to learn from this.


The above statements positively glow with praise for NHS Scotland. It’s an A plus plus! Sarwar comes across, frankly as a dim-witted F grade dunce.


Research Report, July 2017, Learning from Scotland’s NHS at: https://www.nuffieldtrust.org.uk/files/2017-07/learning-from-scotland-s-nhs-final.pdf


15 thoughts on “‘Scotland has a unique system of improving the quality of health care’ says the Nuffield Trust: Looking at the full report and not the Labour/BBC Scotland extracts in July

  1. William Henderson October 30, 2017 / 7:44 pm


    From this I would say that the personnel of the ‘mainstream’ media world and the political opposition in Scotland are apparently suffering a psychiatric disease. Perhaps the Scottish NHS, in kindness, should offer them treatment.

    It’s a pity, in a way, that the old-fashioned electric shock stuff is no longer current. (pun intended).

    Liked by 1 person

  2. johnrobertson834 October 30, 2017 / 8:08 pm

    Good one. Ohm most impressed.

    They suffer from compulsive lying disorder


    • William Henderson October 30, 2017 / 8:22 pm

      Yes, I’m still enjoying the mental picture of their conversion from compulsive liars to convulsive liars.

      Liked by 1 person

  3. Ludo Thierry October 30, 2017 / 8:33 pm

    Watt was Anas thinking of – If he could only tell the truth faraday – a single day! – Particularly galling considering Anas is a qualified healthcare professional himself. Obsessive/compulsive Lying Disorder?



  4. Ludo Thierry October 30, 2017 / 9:27 pm

    Or maybe his volting ambition got the better of him?



  5. Ludo Thierry October 30, 2017 / 9:36 pm

    Hi John – apols for going slightly off topic – but noticed this headline on beeb website: ‘Seven Great Yarmouth UKIP councillors defect to Tories’ – clearly the Colonel’s council recruitment strategies are gaining a wider currency within the tory party.

    Ta, ludo


  6. Brian October 31, 2017 / 5:40 pm

    I’ve been there, it’s not that great.

    Liked by 1 person

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