The National Clinical Strategy and the Chief Medical Officer’s report on Realistic Medicine identify a number of key challenges facing healthcare including the need for a continuous drive to deliver services of the highest quality and value. It also highlights the significant variation in care and considerable evidence of inappropriate clinical interventions which, at best, adds little or no value and, at worst, may cause harm.

These reports call for a new clinical approach that ensures healthcare delivery is proportionate, relevant to individual patient’s needs and uses the least disruptive interventions wherever possible.

The Effective Care Pathways Programme responds to this call.

Service Description

The Effective Care Programme is a clinically led quality improvement programme to reduce waste, harm and unwarranted variation in healthcare. Specifically, the programme will identify:

  • Opportunities to identify common pathways where there are significant opportunities to improve outcomes and reduce costs Scotland wide.
  • Facilitate clinical leaders to agree clinically meaningful measures for those pathways.
  • Support the setting up of systems to capture, record and report data for benchmarking over time.
  • Provide learning networks, guidance and resources to support improvement.
  • Encourage active patient and public involvement from the outset, both nationally and locally.


The initial scoping work of the Effective Care Pathways Programme is expected to be complete in spring 2016 and timelines for implementation will be confirmed after scoping is complete.


NHS boards

Benefits of programme

It is anticipated that this work will deliver

  • Improved clinical outcomes including reduction in harm.
  • Reduction in variation against agreed best practice standards thereby contributing to reduced inequalities.
  • Reduction in costs and/or delivery of productivity gains.

Evaluation of similar programme of work in North West of England highlighted

  • 5,227 Quality adjusted life year (QALYs) gained.
  • £105 million estimated health gains (8 fold return on investment).
  • Length of stay reduced by 22,802 bed days (£4.4 million).


Monica Merson