Scotland: Partnership and collaboration as the hallmark of scottish healthcare improvement

Partnership and collaboration have been the dominant motif of strategic policy for NHSScotland since 1997. This chapter highlights vertical partnerships between service providers, or managed clinical networks (MCNs). It focuses on particular services or health conditions, such as diabetes. The chapter discusses the two service partnerships around staff governance and public involvement. Early evaluation of one MCN identified improvements in clinical outcomes between 1998 and 2005, significantly for type 2 diabetes and to a lesser degree among type 1 patients, which was largely due to enthusiastic leadership, shared vision, and commitment by primary care and specialist clinicians. Partnership structures—involving trade unions, managers, and, at the national level, government—have been put in place to involve staff in key decisions on strategic, workforce, and operational issues. In recognition of the need to work in partnership with people rather than doing things to them, a framework was developed for involving citizens in NHSScotland: Patient Focus and Public Involvement.