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Route map: Health

This route map was last updated in December 2025 with all information that is known about work underway and still required. It is not yet fully populated and work continues to identify what still needs to happen. Route maps are shared planning tools to support delivery of the promise and as progress is made and the rest of the route becomes clearer, this route map will continue to be updated. 

Where is Scotland now?

The promise highlighted the significant impact of mental health challenges. Trauma, disrupted relationships and inconsistent access to support contribute to more complex needs, affecting wellbeing and life chances. Community-based mental health support has expanded, including school counselling and local provision, supported by the Community Mental Health and Wellbeing Framework, with some continuity into adulthood. However, access, quality and outcomes remain inconsistent. Early, accessible and non-stigmatising support delivered close to home and sustained over time is crucial. Priorities include consistency, embedding rights-based practice, strengthening the workforce, sustainable funding and improving transitions between children’s and adult services.

 

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Health

Where does Scotland need to be by 2030?

All of the promise's calls to action have been grouped into delivery-focused outcomes that make clear what Scotland must deliver to keep the promise. The route map then identifies who must take responsibility for action by when for each outcome. This means the outcomes are fully aligned to what children, young people, and care experienced adults said must happen and the actions required are in a format that supports delivery, accountability, and monitoring. 

The outcomes in Health are: 

  • All children, young people, families, and care experienced adults have equal, stigma-free access to physical, mental, dental, and sexual health support through caring, nurturing relationships.
  • Scotland delivers timely, trauma-informed mental health support that does not require diagnosis, avoids crisis and hospitalisation, and ensures sufficient inpatient capacity where needed.
  • Community-based and family-inclusive therapies are available to all, supporting lifelong mental wellbeing and integrated adult–child services.
  • Children, young people, and adults leaving hospital care receive continuous, planned, wraparound support to sustain recovery and reintegration into their communities.
Where does Scotland need to be by 2030?

The route map to get there

In 2024, The Promise Scotland began convening the NHS Promise Network: this brings together practitioners and commissioners from Health Boards across Scotland to share insights and learning on their work to keep the promise.

In 2025, The NHS Promise Network established a short life working group exploring approaches and learning around CEL 16 (2009).

NHS Reform Report (ALLIANCE) emphasises person-centred care, trauma-informed practice, and co-production. Highlights the need to remove stigma and barriers to access for care experienced individuals. Advocates for integration of services, continuity of care, and mental health support.

In 2025, Healthcare Improvement Scotland launched the Scottish Approach to Change in health and social care.

The Scottish Government provided just over £4.5 million over the last two years across the West, East and North of Scotland to support the planning and development of regional elements of the CAMHS Service Specification. This includes the development of Forensic CAMHS and CAMHS into Secure Care services and regional pathways.

In 2025, the Scottish Government also provided funding to the North of Scotland to establish a CAMHS into Rossie pathway in line with what has been achieved in the West of Scotland.

The development of the National Secure Adolescent Inpatient Service (NSAIS), known as “Foxgrove” commissioned by National Services Division, will initially provide four beds for children and young people aged 12-18 years who require psychiatric care in an inpatient setting with medium levels of security. Foxgrove is due to open early 2026.

Explore how the Scottish Approach to Change could be applied in the context of keeping the promise across the health and social care sectors.

There are no milestones identified for this year yet. Once progress is made in earlier years, the work required in this year will be clearer and milestones will be added here.

There are no milestones identified for this year yet. Once progress is made in earlier years, the work required in this year will be clearer and milestones will be added here.

There are no milestones identified for this year yet. Once progress is made in earlier years, the work required in this year will be clearer and milestones will be added here.

There are no milestones identified for this year yet. Once progress is made in earlier years, the work required in this year will be clearer and milestones will be added here.

Who needs to work on this:

The Promise Scotland, Scottish Government, Healthcare Improvement Scotland, Local Authorities, NHS Scotland, NHS Education for Scotland

Other route maps this links to:

Rights and restraint

Workforce support

Rules, processes and culture

Relationships

To see which calls to action from the promise sit under this outcome, click here.

Scotland’s Mental Health and Wellbeing Strategy sets out the Scottish Government’s and COSLA’s shared approach to improving mental health for everyone in Scotland, with a vision of a Scotland free from stigma and inequality where everyone can achieve the best possible mental health and wellbeing.

The National Trauma transformation programme developed a care experienced companion pack aimed at practitioners and organisations involved in supporting children and young people with care experience the report aims to support understanding of trauma, recognise its impact and support practitioners to adapt their practice accordingly.

The National Trauma transformation programme developed a Roadmap for Creating Trauma-Informed and Responsive Change: Guidance for Organisations, Systems and Workforces in Scotland.

The Curriculum Improvement Cycle (CIC) sets out Education Scotland’s approach to reviewing and evolving Curriculum for Excellence so it stays current and strengthens learning for children and young people. School staff can also draw on wellbeing resources such as Compassionate and Connected Classroom (upper primary), which builds confidence to support pupils’ mental wellbeing through understanding adversity/trauma and developing compassion and coping strategies, and Keeping Trauma in Mind, a professional learning programme to build trauma-informed knowledge and skills to support children, young people and colleagues affected by trauma.

Scottish Government committed to working alongside the Mental Health Partnership Delivery Group to consider developing a ‘safe spaces toolkit’ following the publication of the ‘safe spaces: scoping report’. Scottish Government to consider a cost benefit analysis.

The Scottish Government will publish a Framework for Supporting Children and Young People in Crisis. The Framework will set out what good looks like for crisis support across Scotland to support local areas to ensure they are providing effective support for their populations. This will be published early 2026. The Framework highlights the importance of ensuring that any crisis supports or services are accessible to high-risk groups, such as those on the edges of care, or those who are care experienced. 

The Scottish Government and COSLA will publish a new three-year Suicide Prevention Action Plan (2026-29) early in 2026, which will set out a series of high level actions we will deliver to make progress towards our long term vision of ensuring that anyone of any age, who has thoughts of suicide or who is affected by suicide gets the help they need and feels a sense of hope. Our new action plan sets out work we will take forward to support the development and delivery of tailored and targeted support to those most at risk of suicide and includes specific refence to care experienced children and young people, in line with our commitments in The Promise. 

Scottish Government to outline next steps to safe spaces feasibility work following the safe spaces: scoping report’ for people experiencing crisis and acute emotional distress. 

Scottish Government provided just under £3.4 million in 2024-25 across the West, East and North of Scotland to support the planning and development of regional elements of the Child and Adolescent Mental Health (CAMHS) Service Specification. This includes funding for the development of a four-bed Adolescent Intensive Psychiatric Care Unit in the West of Scotland and the development of Forensic CAMHS, CAMHS into Secure Care and Intensive Home Treatment CAMHS services and regional pathways.

The Scottish Government are providing funding to the North of Scotland to establish a CAMHS into Rossie pathway in line with what has been achieved in the West of Scotland.

The development of the National Secure Adolescent Inpatient Service (NSAIS), known as Foxgrove commissioned by National Services Division, will initially provide four beds for children and young people aged 12-18 years who require psychiatric care in an inpatient setting with medium levels of security. Foxgrove is due to open early 2026.

The Scottish Government provide funding of up to £308k to the Interventions for Vulnerable Youth (IVY) service based at Kibble. IVY is a specialist psychological and social work service offering therapeutic forensic mental health risk assessment and management support to children and young people up to age 19, who present a risk of harm to others. 

The Scottish Government and COSLA's Mental Health and Wellbeing Workforce Action Plan  will continue to be implemented (as outlined in the Update on Progress and Next Steps report published in June 2025), and further actions will be included within the new combined refreshed MH Delivery Plan. In particular progress will continue to ensure the workforce are equipped with the skills, capacity and resources to support the children, young people and families they work alongside.  This includes building on the training and implementation support offered by the National Trauma Transformation Programme and further developing NHS Education for Scotland’s learning starters resources that is available to anyone and offers signposting to education resources associated with mental health and wellbeing.

Sustained effort is needed across the implementation and resourcing of key frameworks and delivery plans, such as the Mental Health and Wellbeing Delivery Plan, the Mental Health – distress framework for collaboration, and the Population Health Framework to strengthen data and information sharing between services, local authorities, and health boards. This will help to ensure that care-experienced children and young people can fully access the wellbeing and physical health support they are entitled to, without being hindered by systems or processes.

Local Authorities, Health Boards and Health & Social Care Partnerships work in partnership to consistently deliver CAMHS that meets the needs of all children and young people, providing timely, trauma-informed support that is accessible and effective for care experienced children and young people.

There are no milestones identified for this year yet. Once progress is made in earlier years, the work required in this year will be clearer and milestones will be added here.

There are no milestones identified for this year yet. Once progress is made in earlier years, the work required in this year will be clearer and milestones will be added here.

Who needs to work on this:

Scottish Government, COSLA, Local Authorities, Health Boards, Health and Social Care Partnerships, NHS Scotland 

Other route maps this links to:

Intensive family support

Universal family support

Where children live

Education

Relationships

Poverty

To see which calls to action from the promise sit under this outcome, click here.

Scottish Government published the Public Service Reform strategy, setting out commitments to ensure public services were preventative, joined up and efficient.

Scottish Government and COSLA launched Scotland’s Population Health Framework (PHF). The joint Population Health Framework takes a preventative approach to population health over the next 10 years. It is focused on tackling the root causes of poor health and inequalities through action on the wider determinants of health, including social, economic and environmental factors. The Framework articulates that these determinants together bear a greater influence on population health outcomes than access to health and care services and sets out upstream action to improve access to, and quality of these determinants, including in areas such as housing, employability and early childhood development. The Framework outlines key commitments and focus areas:

  • Social & economic conditions, for examples: early years/education, work, income.
  • Healthy living: supporting healthier behaviours and environments.
  • Place & community: healthy places, strong communities.
  • Equitable health & social care: fair access and outcomes.
  • A prevention-focused system: shifting investment and decision-making toward prevention.
  • Some specific commitments as set out in the PHF include:
    • Develop new resource-allocation approaches that prioritise prevention across health and public services.
    • Implement a “health lens” impact-assessment process across policy and planning.
    • Strengthen place-based, community-focused working (e.g. through “place principle” and local planning).
    • Develop a National Social Prescribing Framework.

Scottish Government published a multi-agency partnership approach to distress: framework for collaboration (February 2025). The framework promotes a ‘no wrong door’ whole system approach to improving and responding to mental health distress.

Scottish Government launched the Wellbeing for Wee Ones Hub on the Parent Club website, which supports parents to gain an understanding of their infant’s emotional and mental wellbeing from an early stage.

Scottish Government published the Perinatal Mental Health Service Specification which emphasises that perinatal mental health services should be delivered in accessible, trauma-informed community settings, with strong cross-sector collaboration (health, social care, third sector). Enhancing the Delivery of the Health Visiting Service: Scotland’s Health Visiting Action Plan 2025–2035 is being implemented by the Scottish Government and delivery partners to support the universal health visiting service for all of Scotland’s pre-school children and their families, with a focus on consistent early support and early intervention (including during pregnancy and infancy. 

Key to sharing information safely across organisations will be a more streamlined, collaborative approach to information governance. The National Information Governance Programme aims to improve the management of information and related technologies across Scotland's health and social care sectors, creating a consistent, holistic approach to governance and assurance in line with Scottish Government and COSLA’s Health and Social Care Data Strategy and Health and Social Care Digital Strategy. This will support more efficient management of digital and data across health and social care.

Scottish Government and COSLA to provide a clear delivery plan on the key commitments for the next two years outlined in Scotland’s Population Health Framework. This includes:

  • Implement Fairer Funding principles
  • Develop a National Social Prescribing Framework for Scotland.
  • Embed health and wellbeing considerations into the development of Local Development Plans
  • Progress joint actions agreed by Scottish Government and COSLA on improving the provision of temporary accommodation and affordable housing.

The refreshed Mental Health and Wellbeing Delivery plan will be published following the election in May 2026.

As part of the multi-agency partnership approach to distress: framework for collaboration, the Mental Health Partnership Delivery Group will report on progress across the four collaborative commitments, this must include details on who is leading and timescales for delivery.

The 20th anniversary of GIRFEC provides an opportunity to reaffirm its relevance as a shared framework and approach to support children and young people’s wellbeing needs.

As part of the National Trauma Transformation Programme and in line with a commitment made in the Promise, work is ongoing with stakeholders to develop a parenting resource - ‘Thriving Futures’ - to support kinship, foster, supported lodging carers and adoptive parents to provide trauma-informed care for their children and young people.

Progress on the Population Health Framework will continue to be overseen and reported through its own governance arrangements, including updates on delivery of the commitment to support a greater shift towards preventative spend through development of a new resource allocation tool, with an initial focus on health and social care budgets. In parallel, progress on the Mental Health and Wellbeing Delivery Plan and the Collaborative Commitments plan will be reported to the Mental Health Leadership Board.

The Perinatal Mental Health Curricular Framework (funded by the government via NHS Education for Scotland) defines core competencies for staff working in maternity, health-visiting, neonatal, primary care and mental-health settings with a clear expectation that staff are equipped to recognise and respond to perinatal and infant mental health needs. 

There are no milestones identified for this year yet. Once progress is made in earlier years, the work required in this year will be clearer and milestones will be added here.

There are no milestones identified for this year yet. Once progress is made in earlier years, the work required in this year will be clearer and milestones will be added here.

There are no milestones identified for this year yet. Once progress is made in earlier years, the work required in this year will be clearer and milestones will be added here.

Who needs to work on this:

Scottish Government, COSLA, the Mental Health Partnership Delivery Group, Public Health Scotland, Local Authorities, NHS Education for Scotland

Other route maps this links to:

Universal family support

Education

Where children live

Poverty

To see which calls to action from the promise sit under this outcome, click here.

There are no milestones identified for this year yet. Once progress is made in earlier years, the work required in this year will be clearer and milestones will be added here.

There are no milestones identified for this year yet. Once progress is made in earlier years, the work required in this year will be clearer and milestones will be added here.

There are no milestones identified for this year yet. Once progress is made in earlier years, the work required in this year will be clearer and milestones will be added here.

There are no milestones identified for this year yet. Once progress is made in earlier years, the work required in this year will be clearer and milestones will be added here.

There are no milestones identified for this year yet. Once progress is made in earlier years, the work required in this year will be clearer and milestones will be added here.

There are no milestones identified for this year yet. Once progress is made in earlier years, the work required in this year will be clearer and milestones will be added here.

Who needs to work on this:

Other route maps this links to:

To see which calls to action from the promise sit under this outcome, click here.

What matters to children, families, and care experienced adults

My mental, emotional and physical wellbeing are being consistently cared for without it making me feel singled out or different.

I feel important and loved, and I have someone I trust to ask for help if I need it.

Find out more about what matters here

Foundations