The Scottish government has published its public sector reform plans, calling them a ‘blueprint for enhancing lives and communities’, through preventative, integrated and efficient working.

Ministers say they can save £1bn in five years by better joined up partnership working – including with the third and private sectors.

While Scotland’s largest health charity has welcomed the “promising vision” but said implementation is what matters most, the Scottish Trade Union Congress described the plans as “cuts disguised as reforms”.

Scotland’s Public Service Reform Strategy: Delivering for Scotland, is supported by improvement plans, including the NHS Operational Improvement Plan and the two ten-year frameworks for health and care.

In the strategy the government commits to lead cultural change that fosters trust and collaboration across sectors while focusing on the bigger picture by strategically planning for the long-term.

Among the strategy’s actions are plans to reduce the number of public bodies and deliver spending cuts to ‘corporate functions’ which will bring £1bn savings in five years.

It states that integration of services and approaches will bring ‘significant benefits’ from closer working across services and avoiding duplication.

The merging of two national NHS bodies, NHS National Services Scotland and NHS Education for Scotland was included in the frameworks published on Tuesday while the 14 territorial NHS boards remains unchanged.

Launching the new strategy, Public Finance Minister Ivan McKee said the government must be “bold and brave” to deliver long-lasting, meaningful change:

“This strategy is grounded in the shared belief that Scotland’s public services are an investment — in people, places and our collective future. It builds on the work we’ve done since the Christie Commission which outlined the need for public services focused on prevention, place, partnership, people and performance.

“The strategy sets out a bold, system-wide approach to change centred around three key priorities: prevention, joined-up services and efficiency.

“The aim is to do things better, not do less. Public services are an asset and investment in our collective future. They reflect the society we are, and who we aspire to be.

“We are determined to unlock the full potential of Scotland’s public services — making them more efficient, joined-up, and preventative in approach, so that they work better for the people of Scotland.

“It demonstrates that this government is ready to go further and faster than we ever have to reform our public services.”

However, it comes after criticism that the government ‘lacks urgency’ on delivery of long-awaited care reforms, and has meanwhile failed to deliver its 2018 promises to GPs amid rising need.

Key areas for system-wide preventative focus set out in the strategy are poverty, smoking and obesity, which the government has identified as large drivers public spending across health and care.

It also details plans to ‘embrace automation’ and publish a new Digital Strategy which to help accelerate the digitisation of government.

More communication will become digital, including through the NHS Digital Front Door, using the government’s new secure Mailbox service, will be piloted from December of this year.

By 2030, 25% of all government, agency and NDPB correspondence will be digital, saving at least £100m a year according to the government.

People, places and communities

The strategy also commits to support decisions to be made as close

as possible to the places they will impact, to empower and include voices of experience, regional and local partners in policymaking and implementation.

Responding to the strategy, Chest Heart & Stroke Scotland said it sets a positive direction and welcomed the recognition of the third sector in delivering key services.

Chief Executive Jane-Clare Judson said the charity is encouraged by the call for greater integration of work across sectors which has been underutilised in service planning “for too long”.

She added that “true partnership-working” is needed to deliver the strategy’s ambitions:

“Investing in prevention is not only more cost-effective in the long term, but it also leads to better outcomes for people living with long-term conditions.

“While the vision is promising, the real test lies in its implementation. Integration must go beyond policy ambition.

“It requires meaningful and prioritised investment, structural and cultural reform, and a genuine shift in how public services value and collaborate with third sector organisations. 

“We urge the Scottish government to ensure that the commitments made in this strategy are translated into action. The third sector must be fully respected and included to help deliver a more person-centred, preventative, and equitable public service landscape.” 

Alongside the reform strategy, the government has published its key learnings from 25 years of Preventative Interventions in Scotland.

These detail case studies including Scotland becoming the world’s first national naloxone programme and minimum unit pricing for alcohol, and the first in the UK to ban smoking in enclosed spaces and enshrine the right to breastfeed in public.

Jobs fears

While the government says will take concrete steps ‘particularly with trade unions’ to ensure investment is focused on frontline delivery, the Scottish Trade Union Congress is concerned frontline roles will be cut.

General Secretary Roz Foyer said the reforms “miss the mark” and could see staff stretched past breaking point:

“Whenever government ministers speak of public sector ‘efficiencies’, workers anxiously hold their breath. These cuts, prepacked as reforms, miss the mark entirely.

“Simply put: you can’t fix public services by cutting the very people who keep them running. Talk of reducing headcount while NHS waiting times spiral, A&E departments are overwhelmed and social care is in crisis is as reckless as it is illogical.

“Scotland deserves public services that are properly funded. That requires investment in people, not an overreliance on technology to plug staffing shortages.

“Instead of chasing cuts disguised as reform, ministers should be adopting progressive tax policies that can raise the revenue we need.”

Read more: Partnership working for Scotland’s population health; Watchdog criticises homelessness service cuts; Call for public funding to conditional on Carer Positive employment; Chief Medic: ‘Critical connections' priority; Urgent workforce reforms needed for Scotland’s NHS  NHS Scotland: waiting lists and beyond; Minister urges council transparency over carer funding

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