Chamber and committees

On the 1 September, as part of the Programme for Government, the First Minister announced the Scottish Government’s intention to simplify the NHS by replacing the current 14 territorial Health Boards with two Strategic Health Boards and build on planned reforms to further reduce the number of special Health Boards.

This work will be done with the workforce, not to the workforce. We remain fully committed to partnership working and will work closely with trade unions throughout this process.

For NHS staff the principal change will, in due course, be the transfer of their employment from their current Board to one of the new NHS Boards.

Staff in NHS Scotland continue to receive the best reward package in the UK, and pay, terms and conditions will remain the same, all underpinned by the Scottish Government’s Fair Work principles, and our ongoing commitment to no compulsory redundancies.

Any future workforce changes will be done in full partnership with NHS Trade Unions in a structured and managed way, in line with existing NHS Scotland policies which have been agreed in partnership with trade unions.

While structural change will support long-term financial sustainability, the greatest benefits will come from service redesign, better planning and reducing variation in health care and outcomes across Scotland. The costs and benefits of reform will be set out through the programme's business case and developed in partnership with NHS Boards.

This work will complement existing plans to improve financial sustainability and support Boards in returning to financial balance. The programme will be supported by a clear benefits framework and ongoing monitoring to assess whether it delivers improved outcomes and value for money. Decisions on final service structure models and their locations will be worked through during this design phase.

This work will be done with the workforce, not to the workforce. We remain fully committed to partnership working and will work closely with trade unions throughout this process.

For NHS staff the principal change will, in due course, be the transfer of their employment from their current Board to one of the new NHS Boards.

Staff in NHS Scotland continue to receive the best reward package in the UK, and pay, terms and conditions will remain the same, all underpinned by the Scottish Government’s Fair Work principles, and our ongoing commitment to no compulsory redundancies.

Any future workforce changes will be done in full partnership with NHS Trade Unions in a structured and managed way, in line with existing NHS Scotland policies which have been agreed in partnership with trade unions.

On the 1 September, as part of the Programme for Government, the First Minister announced the Scottish Government’s intention to simplify the NHS by replacing the current 14 territorial Health Boards with two Strategic Health Boards and build on planned reforms to further reduce the number of special Health Boards.

We remain fully committed to partnership working and will work closely with trade unions throughout this process to ensure the voices of those who deliver our services are heard.

Robust local, regional and national governance arrangements will be established to support both the transition and the longer-term model. We will ensure detailed impact assessments will be undertaken as part of the programme's next phase. Equality, fairness and reducing health inequalities will be fundamental considerations in the design of the reforms. The intention is that structural reform will align organisational arrangements with the way many services, staff and patients are already working across East and West Scotland, as a result of the sub-national planning structures.

I refer the member to the answer to question S7W-03221 on 23 September 2026. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers.

The Programme for Government set out our commitment to a three month period of intensive dialogue with partners in local government, across Parliament, and with stakeholders including representatives from local communities, to agree a clear and shared direction for the future of local governance in Scotland. As part of this process, Ministers are keen to engage with a wide range of stakeholders who may wish to come forward with proposals that deliver on our public service reform ambitions.

This period of dialogue began with the publication of the Programme for Government on 1 September. It will build on discussions already undertaken on the need for reform and will help ensure real and lasting improvements to public services. As part of this process, the First Minister, Deputy First Minister and I attended a special meeting of COSLA Leaders on 11 September 2026 to discuss the Programme for Government's commitments on reform to our public services.

As part of this process Ministers are keen to engage with a wide range of stakeholders who may wish to come forward with proposals that deliver on our Public Service Reform ambitions.

We recognise that demand for neurodevelopmental support, including autism diagnostic assessments, is exceeding current capacity in many areas. This reflects wider challenges across health and social care, which is why the Population Health and Service Renewal Frameworks sets out the need to shift towards earlier intervention, prevention and support that is centred on people’s needs.

Within this wider programme of reform, we are working with NHS Boards, local authorities and other partners to improve access to neurodevelopmental support for children, young people and adults. Our focus is on ensuring that people can access appropriate support when they need it, based on their needs rather than requiring a diagnosis before support is available.

For children and young people, this includes delivering the actions arising from the implementation review of the National Neurodevelopmental Specification for Children and Young People, working with COSLA and the Children and Young People’s Neurodevelopmental Taskforce.

For adults, we are working to improve access to neurodevelopmental support through implementation of the Royal College of Psychiatrists in Scotland's four-tier national pathway. This work will help health boards to develop approaches that provide support on the basis of need, whether or not a person has a formal diagnosis.

In delivering our 100-day commitment, we have worked with key stakeholders and people with lived experience to develop a route-map for adoption and integration of this approach, which we expect to publish this Autumn.

Integration arrangements will be reviewed as part of wider health, social care and public service reform. Over the next three months, we will undertake an intensive programme of engagement with local government and partners to consider how health, social care and wider public services can work more effectively together, make best use of public investment and improve outcomes for people and communities. Detailed arrangements will be developed as part of wider public service reform. In doing so, we will also draw on the intelligence from extensive civic engagement and co-design with lived experience as part of the National Care Service development and Independent Review of Adult Social Care.

While structural change will support long-term financial sustainability, the greatest benefits will come from service redesign, better planning and reducing variation in health care and outcomes across Scotland. The costs and benefits of reform will be set out through the programme's business case and developed in partnership with NHS Boards.

This work will complement existing plans to improve financial sustainability and support Boards in returning to financial balance. The programme will be supported by a clear benefits framework and ongoing monitoring to assess whether it delivers improved outcomes and value for money. Decisions on final service structure models and their locations will be worked through during this design phase.

On the 1 September, as part of the Programme for Government, the First Minister announced the Scottish Government’s intention to simplify the NHS by replacing the current 14 territorial Health Boards with two Strategic Health Boards and build on planned reforms to further reduce the number of special Health Boards.

The Scottish Government will engage first and foremost with the workforce and we will set out and agree a process with trade unions to ensure the workforce is able to help to shape these plans. We are currently in the design phase of the work, which includes developing the business case. The work will be developed in partnership with staff, staff representatives, trade unions, stakeholders and the public, with a strong focus on the needs of rural and island communities.

We will be using the next three months to reach agreement on reform of social care which makes best use of the funding in the system, delivers fairer and more efficient services and achieves economies of scale, while maintaining a focus on community need. Making integration work is vital because the experience of services is too often fragmented and we know social and healthcare depend on each other.

On the 1 September, as part of the Programme for Government, the First Minister announced the Scottish Government’s intention to simplify the NHS by replacing the current 14 territorial Health Boards with two Strategic Health Boards and build on planned reforms to further reduce the number of special Health Boards.

The Scottish Government will engage first and foremost with the workforce and we will set out and agree a process with trade unions to ensure the workforce is able to help to shape these plans. We are currently in the design phase of the work, which includes developing the business case. The work will be developed in partnership with staff, staff representatives, trade unions, stakeholders and the public, with a strong focus on the needs of rural and island communities.