National Referral Protocol

As clinicians we must focus on delivering better care by reducing interventions which are not considered helpful and may be harmful to the people we care for.

Reducing inappropriate interventions will also contribute to a more sustainable health and care system by reducing waste, and redirecting resources to higher-value care. Careful and kind care has Realistic Medicine as its foundation, and this is the care we must aspire to provide consistently across Scotland. By doing so, we can deliver better value care for both the people we care for and our healthcare system.

This National Referral Protocol (NRP) contains a series of procedures where evidence suggests that there is less clinical benefit and as such, they must not be routinely offered by NHS Scotland.

By practising Realistic Medicine we can deliver the best outcomes for the people we care for based on what matters to them and their capacity to benefit from their treatment and care options. Evidence based practice sits at the heart of Realistic Medicine and helps us to optimise resources and achieve outcomes that people value.

Under this umbrella of evidence-based practice, there are treatments where current evidence suggests that the majority of people are unlikely to benefit clinically, and good outcomes will be limited to a small number of people.

Inappropriate treatment and care use resources that could be used to deliver higher value care, namely interventions where the evidence shows they provide greater health benefits. We must focus on ensuring that all procedures are offered fairly and consistently, promoting evidence informed practice. This approach will help ensure more appropriate use of our healthcare resources and help to ensure equity of access for those who are likely to benefit from them.