Chamber and committees

NHS boards are responsible for planning, providing and securing the provision of NHS services for its population and for ensuring the quality of that care.

Where NHS boards contract with the independent healthcare sector to provide NHS services these contracts need to specify the same quality standards that would apply in the NHS. This means that suitable governance arrangements need to be in place so that the Chair, Chief Executive and other board members have the necessary assurances in place to ensure that risks are identified and managed and planned outcomes are delivered.

Healthcare Improvement Scotland is responsible for supporting, ensuring and monitoring the quality of healthcare provided or secured by the health services. They have the power to scrutinise any NHS service and this can be carried out in a number of ways including peer review, evaluation panels, clinical case review and the inspection model used by the Healthcare Environment Inspectorate. Any planned inspection of NHS services undertaken by Healthcare Improvement Scotland must be in accordance with their Inspection Plan which they are required to agree with Scottish Ministers.

In addition, the Public Services Reform (Scotland) Act 2010 requires Healthcare Improvement Scotland and the Care Inspectorate to co-operate and co-ordinate their activities for the purpose of improving the exercise of their scrutiny functions. The current development work on the new Standards of Care for Dementia is a good example of how this collaborate approach could support service monitoring and improvement.

Personal assistants (PAs) are not a regulated service under the Public Service Reform (Scotland) Act 2010. There are currently no plans to regulate PAs through the Care Inspectorate. The Scottish Government considers that the route to adequate protection of personal employers should be through effective inspection of social work services to ensure they are prepared to meet their duty of care.

In 2009-10, 30 Improvement Notices were not complied with and in 2010-11, six were not complied with. Statistics on the number re-issued are not routinely collected.

Yes. The PVG scheme strikes a balance between proportionate protection and robust regulation and makes it easier for individual employers to determine who they might safely employ.

Statistics on average or maximum length of time between the Care Inspectorate issuing an improvement notice and carrying out a follow-up inspection are not collected as each notice is unique to the service it is served on.

Each improvement has a time specified within the notice that should be a reasonable time to allow the improvement to be made. The Care Inspectorate inspects at the earliest date possible after the time period specified in the Improvement Notice has passed. There may be a number of inspections arising from an Improvement Notice and public reports made available following these. The Care inspectorate would expect an action plan in response to the Improvement Notice and this would be taken into account when planning any inspection to validate compliance.

The Care Inspectorate can also make application to the sheriff for cancellation of the registration of a care service on the basis that unless the order is made “there will be a serious risk to the life, health or wellbeing of persons”. The sheriff has the power to make an interim order, which may include an order suspending registration pending a full hearing. If necessary, the Care Inspectorate can also impose an emergency condition of registration, which becomes effective immediately and remains in place until removed or successfully challenged on appeal.

The Care Inspectorate does not collect data on emergency hospital admissions from care homes.

The Care Inspectorate can cancel registration of a care service in a number of scenarios. It has the power to withdraw registration from care homes where it has served an Improvement Notice and this has not been complied with within the period specified in the notice. It can also cancel registration of a service where the person providing the registered care service ceases to provide the service.

The Care Inspectorate also has expedited powers, to apply to the sheriff (under s65 of the Public Sector Reform (Scotland) Act 2010) for cancellation of the registration of a care service (including care homes) on the basis that unless the order is made “there will be a serious risk to the life, health or wellbeing of persons”. The sheriff has the power to make an interim order, which may include an order suspending registration pending a full hearing.

If necessary, the Care Inspectorate can also impose an emergency condition of registration, which becomes effective immediately and remains in place until removed or successfully challenged on appeal.

There are no plans at this time.

The Scottish Government is responsible for the development of national procurement policy and guidance in Scotland. NHS National Services Scotland’s National Procurement Division (NHS National Procurement) sits on the National Policy Forum providing input to the development of policy and guidance.

NHS National Procurement support the dissemination of that policy and guidance across NHS health boards.

NHS National Procurement provide advice and contract solutions to all NHSScotland organisations. NHS National Procurement has responsibility for identifying collaborative procurement opportunities across all NHS boards and works collaboratively with the Scottish Government in the development and roll out of cross public sector contracts to all NHS Scotland organisations.

Work on expanding collaborative procurement is ongoing, however, it is not possible to confirm at this time, given procurements have not yet concluded, the extent of potential savings or the timescales for achieving them.

In the field of construction there are a number of collaborative procurement initiatives underway which include the roll out of the hub initiative which will deliver a flexible financing and procurement route for community healthcare projects for NHSScotland and other public sector bodies. The benefits statement produced by the Scottish Future Trust identifies savings of £1.46 million in bid costs for the procurement of the five hub territories with further savings of £4.4 million achieved through reduced procurement times and reduced private sector returns. Frameworks Scotland is a strategic and flexible partnering or collaborative approach to the procurement of publicly funded construction work. Evidence collated on the first 10 completed projects indicates a saving in construction costs alone of £400 per square metre or £5.8 million when compared to traditional capital procurement approaches. These cost reductions increase the impact of the capital budget allocated to support NHSScotland.

On equipment, the national approach to the procurement of radiotherapy and imaging equipment will maximise value for money for the purchase of that equipment through national procurement exercises. Work has also commenced on “Accelerated procurement” which delivers value for money by extending the benefits of national procurement to good and services not already included in national contracts.

Although held in the name of Scottish Ministers, day-to-day management of NHSScotland property, including rationalisation and disposal of surplus assets is the responsibility of NHS boards. Boards are required to produce Property and Asset Management Strategies annually which set out their objectives with regard to the management of their assets including the rationalisation of estate and disposal of surplus assets.

The capital budget for NHSScotland as outlined in the Scottish Spending Review 2011 identifies the potential to generate up to £60 million of capital receipts from the disposal of surplus assets which would then be available for reinvestment in NHSScotland infrastructure.