Intended for healthcare professionals

Observations The Best Policy

England’s NHS could learn a lot from Scotland

BMJ 2017; 359 doi: (Published 08 December 2017) Cite this as: BMJ 2017;359:j5703
  1. Nigel Edwards, chief executive
  1. Nuffield Trust, London, UK
  1. nigel.edwards{at}

Quality improvement and professional engagement are areas where Scotland may be doing better

Last year England’s NHS was given high marks for trying to improve standards of care in a report by the Organisation for Economic Co-operation and Development on quality improvement in the UK’s health services.1 Yet the report also pointed to several persistent flaws in the way the NHS improves standards. A review by the think tank the Health Foundation made very similar points.2

Firstly, there are too many initiatives, ranging from highly specific ones such as investment in newer cancer equipment to big structural changes such as pooling NHS and local councils’ health and care budgets through the Better Care Fund. Between 2011 and 2015 the Health Foundation counted one initiative a week. …

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