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Realistic medicine - Working together to provide the care that's right for you. 


Realistic Medicine is an approach to healthcare that aims to put the patient at the centre of decisions made about their care. Shared decision making and a personalised approach to care are key elements of practising Realistic Medicine. It also aims to reduce harm, waste and unwarranted variation, whilst acknowledging and managing the inherent risks associated with all healthcare, and championing innovation and improvement.

Realistic Medicine is relevant to all health and social care professionals, and a multi-disciplinary approach is vital to ensure that Realistic Medicine becomes standard care for people in Scotland.

Our aim is to provide you with access to learning and practice support tools to help you embed Realistic Medicine into your daily practice.

Personalised approach to care
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Person-centred care is delivered when health and social care professionals work together with people who use services, tailoring them to the needs of the individual and what matters to them. The person-centred approach supports people to develop the knowledge, skills and confidence they need to more effectively make informed decisions and be involved in their own health and care.

The Healthcare Improvement Scotland Person-Centred Health and Care Knowledge Network hosted by NES contains tools, templates and guidance on how to implement person-centred care and has examples of good practice.

Caring Conversations, developed by Professor Belinda Dewar, are at the heart of compassionate relationship-centred care. Caring Conversations are proven to have positive effects for both patients and health professionals. This evidence informed learning resource will equip you to put Caring Conversations into practice.

Shared decision making
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Practicing shared decision-making is a central component of Realistic Medicine. Patients and the public have identified training and education for staff in shared decision-making  as a priority.

This online course SDM is and how you can implement it in practice immediately. This interactive and reflective module provides practical hints and tips on communication and a how to talk about risks and statistics in ways that are meaningful to people

Having realistic conversations about what matters to a person and options we have available is important for shared decision making discussions and other situations such anticipatory care planning. We can use proven conversation models and language to help us with these discussions.

Effective Communication for Healthcare (EC4H) is Scotland’s leading NHS communication education programme. EC4H provides workshops supporting staff training in shared decision-making.

Scotland’s House of Care programme is a proven approach that supports and enables people to articulate their own needs and to decide on their own priorities, through a process of joint decision making, goal setting and action planning.

Reducing unwarranted variation
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Variation in healthcare exists because health systems are complex and the population has differing needs. However, some variation cannot be explained by the characteristics of the people being treated, or their geographical setting.  This is called unwarranted variation.

ISD produce the Scottish Atlas of Healthcare Variation which highlights geographical variation in healthcare services and associated outcomes. The Atlas is a tool to facilitate discussion and promote quality improvement. This website includes a user guide to the Atlas and access to the interactive atlas maps. 

Reduce harm and waste
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The Scottish Patient Safety programme is a national initiative that aims to improve the safety and reliability of healthcare and reduce harm, whenever care is delivered. This website contains tools and resources to help improve health and social care delivery in Scotland.

Manage risk better
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Discussing risk with patients is a central skill required for shared decision making. This online module hosted by e-Learning for Health covers how to discuss the concept of risk with patients in a way they will understand. Access to this module requires registration with the e-Learning for Health platform.

Primary Care

Secondary Care

Become improvers and innovators
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The NES Quality Improvement Zone supports staff at all levels to develop the skills to improve their services.  The QI zone has tools, resources and learning programmes to develop their knowledge to improve and innovate Scottish public service.