Public Health Scotland welcomes bold new Frameworks to tackle health inequality

In our latest blog, Paul Johnston, Chief Executive of Public Health Scotland (PHS) reflects on the publication of the Population Health and Service Renewal Frameworks by the Scottish Government and the Convention of Scottish Local Authorities (COSLA), which aim to improve health and wellbeing in Scotland by addressing social and economic factors. View his short video and read the blog below.

At Public Health Scotland, we’re delighted to see the publication of the new Population Health and Service Renewal Frameworks. We have contributed extensively to the Population Health Framework and strongly support the long-term and ambitious approach it takes to improving population health.

Scotland faces significant health challenges. We have the lowest life expectancy in Western Europe, and people in our most deprived communities die more than a decade earlier than those in the wealthiest areas.

A shift towards shared responsibility and prevention

The Population Health Framework marks a crucial shift in our approach. It makes clear that responsibility for health extends far beyond the NHS. It sets out vital, evidence-based actions for every sector across Scotland to transform health outcomes and tackle health inequalities at their root.

PHS, alongside Directors of Public Health in Scotland, has worked closely with the Scottish Government and COSLA to ensure the prevention of ill health sits firmly at the heart of the Population Health Framework. This will allow us to create lasting positive change across Scotland and ensure our public services are sustainable for the long term.

From past successes to new priorities

Scotland has already taken bold action to improve health - including banning smoking in public places and the introduction of Minimum Pricing for Alcohol.  Further innovative action is urgently needed to address the most pressing challenges we face. 

The Framework identifies the need to tackle obesity as an early priority. Two-thirds of adults in Scotland carry excess weight that threatens their health and wellbeing. This isn't simply about individual choices – it reflects environments where healthy options are often less accessible and more expensive than unhealthy ones. We strongly support the Framework's commitment to making it easier and more affordable to maintain a healthy weight as an early priority for action.

Building on evidence and partnerships

PHS plays a unique role in supporting the NHS and wider public sector with data, analysis and forecasting to predict disease prevalence and their impact.

Today, we published new research projecting future health and care demand in Scotland, assuming no substantial changes are made to the current dietary, exercise and other lifestyle habits of the population. It concludes that by 2034, the NHS in Scotland could face around 1,300 additional unplanned hospital admissions - instances where patients are admitted to the hospital urgently and unexpectedly - each week.

This builds on previous work from the Scottish Burden of Disease study which has highlighted the potential future population health challenges across a wide range of health conditions. These findings underline the critical importance of delivering on the Population Health Framework’s commitments. These predictions aren't inevitable, but the priorities outlined must be delivered to prevent them becoming reality.

We have also provided evidence-based advice and research to inform the Framework’s development and this technical report has been published alongside today’s announcements.   

We're particularly pleased to see a commitment to roll out "Marmot places" in Scotland – a key step towards a prevention-focused system. PHS is leading this initiative through our partnership with the Institute of Health Equity, led by Professor Sir Michael Marmot, alongside Community Planning Partnerships, local authorities and NHS boards in Aberdeen City, North Ayrshire and South Lanarkshire. The Collaboration for Health Equity in Scotland aims to address the wider determinants of health, accelerate action and drive forward major improvements in health equity.

A call to action

Scotland’s health challenges facing Scotland have been decades in the making, but with ambitious, coordinated action, we can reverse these trends. We urge partners across Scotland – local authorities, NHS boards, community organisations and businesses – to work together in this vital mission.

As we develop our new 10-year strategy, due later in 2025, we will ensure it aligns with and actively delivers against the ambitions of these Frameworks, supporting progress across the five key prevention drivers and system-wide reform.

By working together to implement the Population Health Framework, alongside the Service Renewal Framework's focus on strengthening health and care services, we can build a healthier, more equitable Scotland for generations to come.

View the Scottish Government's Population Health and Service Renewal Frameworks

Find out more about the Scottish Burden of Disease study

Find out more about the Future Demand for Health and Care Services in Scotland report

Find out more about the Collaboration for Health Equity in Scotland