There is no clear plan for NHS reform in Scotland, a new report by Audit Scotland has found.
The auditor general has said the Scottish Government needs a delivery plan that clearly sets out to the public how it will reform the health service and address the existing pressures.
The independent auditor described the Scottish Government’s vision for health and social care as "not clear” on how operational pressures on the NHS will be addressed or how reform will be prioritised.
It said it must work with NHS staff, partners and the public to set out a clear delivery plan and make difficult decisions about how it may reform or potentially end some services.
Audit Scotland said that commitments to reducing waiting lists have not been met, while the number of people remaining in hospital because their discharge has been delayed is the highest on record.
The report has also concluded that NHS initiatives to improve productivity and patient outcomes have yet to have an impact and lack clear progress reporting.
Health accounts for around 40 per cent of the Scottish Budget, and although the NHS in Scotland has benefited from increased staffing and funding it is still seeing fewer patients than before the pandemic.
Most of the extra funding has been spent on covering pay commitments and inflation, while costs are forecast to continue to rise.
Stephen Boyle, Auditor General for Scotland, said: “To safeguard the NHS, a fundamental change in how services are provided remains urgent. The Scottish Government needs to set out clearly to the public and the health service how it will deliver reform, including how progress will be measured and monitored.
“Difficult decisions are needed about making services more efficient or, potentially, withdrawing those services with more limited clinical value to allow funding to be re-directed. Taking those steps will require greater leadership from Scottish Government and NHS leaders than we’ve seen to date.”
Ruaraidh Gilmour is a journalist at CSW's sister publication Holyrood Magazine, where a longer version of this story first appeared.