A Mutual NHS

In 1948, every household in Scotland received a booklet setting out what the new NHS would mean for them. It was called simply Your Health Service because the NHS now belonged to the people of Scotland.

Sixty years on, the public’s role as owners as well as users of the NHS is being emphasised more strongly than ever before.

A programme of work is underway in Scotland to develop the NHS as a mutual organisation where patients and the public are active partners and not just passive recipients of care. It will strengthen the influence and involvement of both the public and staff in the running of the NHS.

Mutual organisations are designed to serve their members and gather people around a common sense of purpose. It will take time for a mutual NHS to develop fully but some of the key elements are already being put in place.

These include:

  • Better Together – this is a programme that seeks to learn from the experiences of people who use the service. It will be used to design improvements.
  • A Patients’ Rights Bill – this will clarify the rights people have in using the NHS as well as the responsibilities they share as co-owners.
  • An annual ownership report will be delivered to every household in Scotland setting out information on their local service, their rights and responsibilities and how to make their voice heard.
  • There will be independent scrutiny of plans for major service changes including ensuring that the views of local people have been taken fully into account.
  • A participation standard will be developed for NHS Boards to ensure that they fully involve the public, patients and staff in the decision making process.
  • Consideration will be given to having direct elections for members of NHS Boards.

Difficult decisions will still have to be taken in the NHS, such as deciding on the closure or changes in local services. A mutual NHS will ensure that that the public is centrally involved as co-owners of the NHS in these decisions. It will be a system that is open, transparent and accountable and one that can command public trust and confidence.

It will ensure that people are treated as equals, with dignity and respect. If they need care, they can expect to be given options and be actively involved in taking decisions about their care. All of this is based on the key values of the NHS in Scotland of equity, fairness, co-operation and collaboration.

In 1948, the NHS was established as a public service. A mutual NHS will involve the public to a greater degree than ever before in how the service is managed and delivered. The NHS of the future will be paid for and owned by the public, for the benefit of the public, and designed and developed in partnership with the public. It will help the people of Scotland sustain and improve their own health and allow them to have a greater say in decisions to improve the quality of health care services.

Derek Feeley
Director of Healthcare Policy and Strategy

Nurse and patient. 
Credit: NHS Photo Library

Better Together: Scotland's Patient Experience Programme

This is a new programme to gather patient experiences and use them to improve NHS Services in Scotland. The programme will support NHS Boards and frontline staff in working with patients and service users to drive forward service improvement.