Royal College of Podiatry response to the Scottish Government's Programme for Government 2026

These priorities recognise the need to support people to remain healthy, active and independent for longer, while reducing pressure on health and care services. The commitment to shifting care closer to home and preventing ill health before it escalates aligns closely with the contribution podiatrists make across Scotland every day.

The ambitions set out in the Health and Care Improving Flow Plan, particularly the commitment to provide more care within communities and expand community based diagnostic and screening services, present an important opportunity to make fuller use of the skills already available within the allied health professions. Podiatrists are already delivering preventative care across Scotland, helping people manage diabetes, peripheral arterial disease, cardiovascular disease, arthritis, musculoskeletal conditions and mobility issues before they result in serious complications. Early identification and intervention can prevent avoidable deterioration, reduce demand on acute services and improve long term outcomes for patients.

As Scotland seeks to deliver more care closer to home, podiatrists should be recognised as part of the multidisciplinary workforce capable of identifying and managing risk factors associated with long term conditions. Community based podiatry services contribute directly to the early detection and management of diabetes related foot disease, peripheral arterial disease and other long term conditions that can lead to avoidable hospital admissions if left undetected and untreated. Making better use of existing professional expertise will be essential if Scotland is to deliver sustainable reform while improving patient access to care.

The benefits of prevention are particularly important in communities experiencing the greatest health inequalities. Conditions such as diabetes and peripheral arterial disease are closely associated with deprivation, and those living in the most deprived communities are more likely to experience serious lower limb complications and avoidable amputations. Improving access to podiatry services can help address these inequalities, supporting the Scottish Government's wider ambition to improve population health while reducing demand on more costly acute interventions.

The proposed reform of Scotland's health boards is also a significant development. A reduction in organisational structures has the potential to release resources currently used for administrative functions and redirect them towards frontline patient care. However, structural reform must be about more than reducing the number of organisations. It should deliver meaningful service improvement, strengthen prevention, improve integration across services and ensure that rural and island communities continue to have an effective voice in decision making and service design.

Investment in preventative podiatry services should not be viewed solely as a clinical intervention. It is also a practical example of public service reform in action. Preventing avoidable foot complications, hospital admissions and amputations reduces demand across the wider health and care system and helps ensure that finite public resources are directed towards those with the greatest need. At a time when government is focused on improving productivity, efficiency and outcomes, preventative foot health services offer a clear example of how relatively small interventions can deliver significant benefits for patients and the public purse.

The legislative changes likely to accompany health board reform also present an opportunity to address a longstanding gap in health system leadership. Effective reform requires the voices of those delivering care within communities to be present where strategic decisions are made. Allied Health Professionals (AHP) are central to prevention, rehabilitation, long term condition management, and supporting independent living, yet their contribution is not always reflected within senior governance structures. As new arrangements are developed, the Scottish Government should ensure that AHP representation is embedded within future health board governance. Doing so would better reflect the multidisciplinary nature of modern healthcare and support delivery of the prevention agenda at the heart of the Programme for Government.

If Scotland is to realise its ambitions for prevention, reducing demand on acute services and supporting people to live independently for longer, allied health professionals, including podiatrists, must be recognised as essential partners in designing and delivering that change. The success of Scotland's reform agenda will ultimately be measured not by organisational restructuring alone, but by whether more people are able to remain healthy, avoid preventable ill health and access the support they need within their own communities. Podiatrists are already contributing to these outcomes and stand ready to play an even greater role in delivering Scotland's prevention ambitions.

1 September 2026