87% of respondents thought it is very important that NHS Scotland makes better use of its resources and reduces waste and potential harm, 11% said it was somewhat important and 2% had a neutral opinion on this. All respondents were asked to explain the reason for their response to this question. In response to this open question 38% of respondents who commented said that making better use of resources and reducing waste will positively impact service delivery and allow money to be spent elsewhere. A further 31% commented more generally on saving through waste reduction and 28% spoke about reducing costs and saving money. This demonstrates the public’s understanding around the impact of poor use of resources in the NHS.

Just over 4 in 10 people said that the last time they used NHS Scotland services, they received most of their treatment or advice from a GP (44%), 23% said it was from a hospital doctor and 17% said it was from a nurse. Respondents were most likely to say that they most recently saw their health professional at a GP surgery (48%), 24% said it was in a hospital and 11% said they had contact with the health professional at home by telephone.

88% of respondents agreed that following a hospital appointment with a healthcare professional they would like them to write to them to explain their condition, summarise what they discussed and agreed, and potential next steps. They would like this to be done by letter and/or email.

Respondents were asked to think about the last healthcare professional they saw within NHS Scotland and how much they agreed or disagreed with various statements. Respondents were highly likely to agree that: they understood the information they received (94%), they were treated with compassion and understanding (84%), they were listened to, and the healthcare professional understood what mattered to them (83%). However, they were less likely to agree that: they were given the opportunity to involve the people that matter to them in their discussions about their care (62%), and they were involved in discussing what they can do to promote good health and prevent ill health in the future (63%).

Panel members were asked for their opinions on the BRAN questions. These are questions which can help people to make an informed decision about the treatment and care that is right for them. The BRAN questions are:

B – What are the Benefits of this test or procedure?

R – What are the Risks of this test or procedure?

A – Are there any Alternatives?

N – What if I do Nothing?

Only 12% of respondents said that before answering the survey they had heard of the BRAN questions (86% had not heard of these questions and 2% were unsure). Despite low levels of awareness, 80% of respondents said they would use the BRAN questions with health and care professionals in future. Of those who said they would use the BRAN questions just under 4 in 10 said the questions would make them feel better informed (37%) and a further 22% said the BRAN questions were straightforward and in a simple format. Where respondents said they would not use the question set, this tended to be where they felt it would depend on circumstances (38%) or where they felt they would forget them (20%). Just over 1 in 5 respondents (21%) were aware of the NHS campaign “It’s OK to ask”. 84% said including a reminder of the BRAN questions on appointment letters and in waiting rooms would encourage them to ask them during their appointment.

Respondents said the best ways of promoting the need to focus on delivering the care that matters to people and make best use of healthcare resources was via a social media campaign (51%). This was followed by a TV campaign (48%) and adverts in NHS premises (33%). Following on from this, respondents were asked how strongly they support or oppose doing each of a variety of things to help NHS Scotland make best use of its resources, reduce waste and deliver better value care. Almost all respondents (97%) supported or strongly supported getting involved in shared decision-making with their healthcare professionals. 9 in 10 respondents supported or strongly supported discussing the outcomes that matter to them with their healthcare team and have them written down or recorded, so they can focus on achieving their goals (90%).

When asked about what matters most to them about what NHS Scotland could do to reduce waste, 23% spoke about making best use of resources to ensure effective care and minimise waste, 20% mentioned the need to reduce waste and costs and 18% mentioned the need to tackle unnecessary prescriptions and overprescribing.

NHS Reform

The second section of the survey began by asking respondents for their opinions on NHS Reform:

Panel members were asked to choose 2 health services that are top priorities for them from a list provided. Over 8 in 10 respondents said that primary care services such as GPs, dentistry, pharmacy and nurses working in the community was their top or second priority (81%). This was followed by A&E and other urgent care (53%).

It was explained to Panel members that sometimes it is safer to provide services in a specialist unit to ensure a patient receives the highest quality care with the best outcomes. This could be, for example, cancer services, surgery, or dermatology. 84% of respondents strongly agreed or agreed they were willing to travel further for specialist services if it will result in better outcomes for them.

Sometimes it is safer to provide specialised services (such as cancer services, surgery or dermatology) regionally or nationally instead of locally, to ensure patients receive the highest quality care with the best outcomes. When planning for this, NHS Scotland will need to involve the public and listen to their views. An open question was included in the survey which asked Panel members how NHS Scotland should best involve the public in this. Over 1 in 4 respondents (26%) said that surveys or questionnaires should be used to involve the public, 24% suggested more public consultations or meetings and 15% suggested making sure everyone has the opportunity to participate by ensuring that meetings are arranged for various times and transport is available.

Panel members were asked how long they are prepared to travel to receive a range of services. Citizens’ Panel members were most likely to say they would be prepared to travel locally (45 minutes from home on public transport or in what they consider their local area) for primary care services (89%), A&E (82%) and to receive urgent care such as minor injuries or similar (81%). Respondents were most likely to be willing to travel regionally (within 1.5 hours from home) for rehabilitation inpatient hospital care (54%), routine impatient hospital care where a stay in hospital is needed for immediate care (55%) and to access outpatient hospital services (62%). With regards to specialised outpatient and inpatient hospital services, respondents were most likely to say they would be willing to travel regionally (43%), while 33% said they would be willing to travel nationally anywhere in Scotland and 24% said they would only be willing to travel locally to access this type of service.

Finally, respondents were asked about how they think access to services should be maintained when the NHS faces workforce shortages. Respondents were provided with a list of options and asked for their top two preferences. For 9 in 10 respondents (90%) expanding the range of NHS health and care professionals who provide services, while ensuring they have appropriate training and clinical support, was a top or second top priority. This was followed by providing services in the same locations but for reduced hours (60%) and reducing the number of locations at which services are provided.