Scottish Approach to Change Launch Event (21 November 2025)

Building the Scottish Approach to Change

Clare Morrison, Director of Engagement and Change, Healthcare Improvement Scotland

Diana Hekerem, Associate Director of Transformational Change, Healthcare Improvement Scotland

Jo Matthews, Associate Director of Improvement and Safety, Healthcare Improvement Scotland

• We set a simple, universal aim for the Scottish Approach to Change: to provide a clear pathway and coherent method that empowers everyone – not just specialists – to do change well across health and social care.
• We prioritised creating a universal language for change by bringing proven methods (quality improvement, service design, engagement, and strategic planning) together as equals rather than inventing a new methodology.
• We insisted the approach be accessible, familiar, and meaningful focused on strategic priorities, making a real difference for people, and normalising high-quality change at pace and scale.

• The Scottish Approach to Change has been built with people, through relationships, and rigorous curiosity – emphasising that understanding why change works matters as much as what was changed.
• We have learned and adapted continuously, integrating the Quality Management System approach fully into the Scottish Approach to Change.
• The Scottish Approach to Change has been co-designed with a broad range of stakeholders (pathfinder sites, expert groups, colleagues delivering change, and people affected by change) to ensure the language and tools are practical and accessible for everyone involved.

• The Scottish Approach to Change is based on evidence showing that success is greatest when there is a shared vision and common goals. Many systems, however, struggle with competing priorities and change fatigue.
• Spreading and sustaining improvement is not linear but dynamic and iterative. Sporadic, fixed-term programme structures often hinder progress.
• It is critical to invest in people. A supportive culture and practical tools are essential to delivering NHS reform.

Stepping into Health and Social Care Renewal: why a new approach is needed

Caroline Lamb, Chief Executive of NHS Scotland and Director-General Health and Social Care, Scottish Government

• The Scottish Approach to Change aims to deliver rapid, sustainable improvement across health and care, grounded in government reform plans (the public service reform strategy, population health and service renewal frameworks, and the operational improvement plan) and tested at pathfinder sites across Scotland.
• It builds on existing successes (quality improvement and the Scottish Patient Safety Programme) and brings multiple improvement methods into a single, common-language framework to deliver person-centred, high-quality, effective, and safe change.
• While the 2025 budget delivers a record 21.7 billion investment in the health and social care portfolio, the emphasis is on deploying resources differently – empowering teams, aligning with community priorities, creating clearer channels for change, and collaborating as a learning community.

Stepping into Health and Social Care Renewal: why a new approach is needed

John Harden, National Clinical Lead for Quality and Safety, Scottish Government

• The Scottish Approach to Change provides a single, practical “how” for improvement bringing together methods like quality improvement and service design, alongside the enablers to remove barriers – so change is simpler and more accessible across the system.
• Developed through true co-design and guided by an External Reference Group, the Scottish Approach to Change is intended for health, social care, and wider public services. Early pathfinder sites are already demonstrating strong, owned, local improvement.
• With a Quality Management System at its core, the Scottish Approach to Change aims to drive better quality, safety, and outcomes in complex, adaptive systems – giving busy frontline teams a clear go-to route for making change happen without creating an “elite club” of trained insiders.

Stepping into Health and Social Care Renewal: why a new approach is needed

Joanna Macdonald, National Chief Social Work Adviser and Chief Executive of the National Social Work Agency, Scottish Government

• The Scottish Approach to Change strengthens integrated health and social care by giving teams clarity, confidence and a shared purpose – so support is seamless, personal and truly person-centred, helping people live their best lives.
• Using simple, practical, and inclusive common language, the Scottish Approach to Change creates a shared way forward, where hope and a shared vision motivate action, boost engagement, and turn belief in improvement into real change.
• Hope and empowerment drive action – when staff and communities believe improvement is possible, engagement rises, resilience grows through tough times, and care focuses on dignity, rights and what matters to people.

The Scottish Approach to Change in Practice: Dumfries and Galloway

Gareth Marr, Chief Officer, Dumfries and Galloway Health and Social Care Partnership (HSCP)

• Dumfries and Galloway HSCP is deliberately moving away from post-Covid command-and-control approaches and is treating the Scottish Approach to Change as a long-term way of working – with celebrated milestones rather than a single ‘end point.’
• The HSCP is rethinking unscheduled care by tackling real drivers – frailty, palliative and long-term conditions, and multiple disadvantage – shifting efforts toward community solutions and alliance commissioning with the third and independent sectors around what communities need.
• Key challenges include demographic pressure, short-term funding, and a heavy reporting burden. In response the HSCP is investing in enablers (empowering governance, using data for insight, and investing in leadership time) and articulating a people-centred vision (“Don’t waste Agnes’s time”).

The Scottish Approach to Change in Practice: NHS Forth Valley

Jennifer Champion, Director of Public Health, NHS Forth Valley

Wendy Nimmo, Interim Head of Efficiency, Improvement and Innovation, NHS Forth Valley

• NHS Forth Valley is being reframed as a population health organisation – collaborative, prevention-focused, and delivering sustainable, value-based care.
• NHS Forth Valley is using the Scottish Approach to Change to embed Value-Based Health and Care (VBHC) to reduce waste and unwanted variation across services and pathways.
• There is a clear north-star vision, leadership at all levels, a staff-valuing culture, a learning system with horizontal and vertical data flows, and process rigour via a steering group, programme board, and strong programme management.

Wendy Nimmo, Interim Head of Efficiency, Improvement and Innovation, NHS Forth Valley

• NHS Forth Valley is launching a Value-Based Health and Care Collaborative as the practical framework to equip professionals by 2028.
• The Collaborative will use the Scottish Approach to Change steps to prototype outcome and experience measures and costing models.
• The Scottish Approach to Change has encouraged teams to own their change ideas – promoting innovation, curiosity, and continuous learning.

The Scottish Approach to Change in Practice: North Lanarkshire HSCP

Morag Dendy, Head of Planning, Performance and Quality Assurance, North Lanarkshire Council (UHSCP)

• The Scottish Approach to Change in North Lanarkshire emphasised whole-system, sustainable change by breaking down silos and focusing on relationships, trust, and collaborative leadership across all levels of health and social care.
• A shift to a principles-based, people-led model “getting it right for everyone” allowed staff to be empowered, adapt, and focus on outcomes for individuals and communities, resulting in a more flexible and responsive system.
• Concrete changes included new governance aligned with local priorities, and a culture that values curiosity, learning, and continuous improvement.