The voluntary health sector must be equal partners in shaping Scotland’s landmark framework to improve health, public health leaders have heard as community organisations share that they are experts in early intervention and tackling health inequalities.

Over the course of two meetings with voluntary health sector staff and Public Health Scotland (PHS), leaders discussed the Scottish government’s population health framework – and the importance of working across portfolios to deliver on these.

The framework has been led by PHS and the government and details a decade of plans to address health inequalities and improve health and wellbeing across Scotland.

It aims to bring together leaders in a ‘whole system’ approach to health, where housing, education and employment are considered alongside the promotion of positive healthy behaviour.

Alongside effectively funding and resourcing public services, the framework aims to shift Scotland’s focus to preventing ill health and inequalities by addressing the social, environmental and economic factors which influence health inequalities.

With Scots dying younger than in any other Western European country, spending more of their lives in ill health and widening inequalities, PHS said it is ‘key to reversing those trends’.

Th government’s Chief Social Policy Advisor Professor Linda Bauld told the Voluntary Health Scotland (VHS) conference of the extensive engagement taken to develop the framework.

However, a mismatch between the hopes of cross-sectoral working and the reality became clear after attendees at a solutions for a sector in crisis session were asked:

‘Who felt extensively engaged with on this population health framework?’

Only one hand rose – VHS Chief Executive, Tejesh Mistry’s.

As a result, VHS has now delivered two engagement events within a matter of weeks to ensure third sector voices are heard in the development of the framework.

Mr Mistry explained early conversations with the third sector in developing the national priorities and action plans to accompany the framework are essential:

“It’s not new or groundbreaking that the third sector are experts in prevention. What works is person-centred approaches to the multifaceted and complex reasons that bring about poor health outcomes.

“Third sector organisations are also a really valuable asset with great insight on emerging issues and causes of inequalities.

“Every aspect of the NHS and social care is vital to improve health but the third sector are a vital part of the system, too.”

Mr Mistry added that PHS made it clear that this is just the start of engagement process and further conversations will be scheduled for in the future, including to align the two organisations’ strategies to support ongoing collaboration.

Prevention focus for “a return on investment”

Public Health Scotland Chief Executive Paul Johnston said the framework is only in its beginning stages.

He told healthandcare.scot that Scotland’s health challenges require “collective focus and resolve”.

He acknowledged that the while public health body has “long recognised” the third sector’s contribution to tackling population health challenges, more is needed to work in partnership:

“We know supporting prevention delivers a direct return on investment – yet third sector funding remains challenging, with many organisations experiencing genuine financial insecurity, putting at risk the vital work the sector is delivering to improve health in communities across Scotland.

“If the framework is to have the impact we hope for, it needs to provide a catalyst for partners to work collaboratively.”

Mr Johnston explained that engaging the third sector must extend beyond areas of focus for the framework to question of ‘how’ it will be delivered to drive transformation and improvements in people’s health.

He added that hearing from people across the sector reinforced the importance of community-based expertise and the potential of partnership-working, and they “know what needs to change”.

“There is a great deal of willingness and ambition in the sector to have real and impactful delivery as equal partners.”

Siloed working no more

When asked about shifting from a state of crisis to perspective, Mr Johnston agreed leaders must be held accountable to long-term outcomes like life expectancy and levels of happiness.

He said there are signs of this shift from within the government, where concerns over silos and barriers to long-term working are shared, adding that community groups can help challenge these silos.

Voluntary Health Scotland’s Mr Mistry highlighted that it was positive to hear everyone is “on the same page” that prevention is not only essential for decreasing inequalities, but also reducing the long-term health and social care spend.

Mr Mistry said that a growing understanding such isolated working is not the way forward brought hope, and the sense of collaboration needed to make a real difference, adding that giving more agency to community organisations to input into future decision-making is critical:

“It was really refreshing to hear Paul Johnston also commit to advocating for funding that extends beyond traditional health services, stressing the necessity of holistic support and prevention services that save money in the long run.

“Paul also reiterated that kind of investment is not just beneficial — it’s essential. This is a message this third sector has been championing for years and there is now very real and tangible support.”

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