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Health and social care: a year of progress 2025-2026

Neil Gray, former Cabinet Secretary for Health and Social Care, Scottish Government

This has been a pivotal year for Scotland’s Health and Social Care system, as our focus has shifted from recovery to reform and renewal. Our NHS is turning a corner, and the work delivered in the Health and Social Care Service Renewal Framework and the Population Health Framework set out a coherent and ambitious vision to shift our thinking and action, both to address the immediate pressures we face and lay the groundwork for sustainable improvement and reform.

Through the NHS Recovery Plan and the relentless efforts of our hard-working NHS staff, the NHS has emerged from the acute phase of the pandemic. We have seen the restoration of services, recovery of lost capacity and enhancement of access to treatment and earlier intervention. That work has been delivered in the context of significant ongoing pressure, including rising demand, demographic changes, a difficult flu season for two winters in a row and financial challenges. These achievements are a testament to the dedication of our workforce and their sustained commitment to delivering high-quality care for the people of Scotland.

The Operational Improvement Plan marks the first concrete steps towards our future vision. The OIP set out ambitious targets to reduce waiting times, improve hospital flow and use digital innovation to improve journeys and outcomes for people. While some people do continue to wait longer than we would want for some procedures, the latest data is showing activity is up and long waits are down in 2025/26 compared to 2024/25. New Outpatient waits of more than a year have more than halved since July 2025, and waits of over a year have reduced by almost 30% for inpatient/day-case procedures in the same period. We cannot underestimate the impact this has had on thousands of patients and their families, and it is clear evidence of the NHS pivoting to respond to the significant challenge of reducing a backlog that has developed post-pandemic.

Whilst there has been progress in some areas, we are clear that delays in Accident and Emergency (A&E) and performance must be improved. We know the sustained pressures facing A&Es are not unique to Scotland, but we also know we have the building blocks for improvement now in place. Every Health Board now has specialist frailty services at the hospital front door, and Hospital at Home continues to expand in both the overall number of beds, as well as in the specialities that use this service. We remain committed to working towards our target of achieving 2,000 Hospital at Home beds by the end of this year. Significant investment has been made to enhance the Scottish Ambulance Service’s specialist practitioner workforce and community-based roles, particularly in remote and rural areas. These expanded roles support home visits to acute, chronic and palliative care patients, improving outcomes and experience. SAS’s continued development and optimisation of the Integrated Clinical Hub (ICH) remains a key priority within its annual and medium-term plans. During the past year, a further 22 clinical advisors and advanced practitioners, including GPs, joined the ICH. Additionally, the NHS 24’s Digital Transformation Programme was launched in October 2025, modernising urgent care pathways, improving access, and streamlining digital services.

These important milestones will reduce occupancy and improve flow within our acute hospitals, making sure people can access the care they need in the right place, at the right time.

The achievements set out in this report mark the start of a journey and represent real, tangible improvements for people receiving health and social care and the staff who care for them.

Neil Gray, Cabinet Secretary for Health and Social Care, Scottish Government

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