The Scottish government is to change the way it plans and delivers NHS services, moving to a system where ministers agree with NHS boards what services they will – and will not – be expected to deliver, and making it harder for any board to go it alone to set up a service or buy new kit.

In a letter to NHS board leaders, NHS Scotland’s Chief Operating Officer John Burns says there will now be a significant change to the way services are planned, organised, delivered and funded – adding that the lack of a joined-up Once for Scotland approach by NHS decisionmakers has potentially led to public money being ‘misspent’.

A long established network of three regional planning groups has brought together NHS boards into three regions, North, West and East, to work across boundaries to integrate some services – most notably in cancer – ensuring people in less populated areas do not lose out.

Earlier today, the Auditor General for Scotland published a report calling on the Scottish government to publish its promised plan for NHS reform, and make ‘difficult decisions’ about what services to invest in and which to stop.

The letter to NHS leaders says ministers want to address the failure to have an overarching strategy for commissioning NHS services, technologies or medicines, that has led to a ‘disjointed approach with little transparency or governance, creating the opportunity for duplication with unclear prioritisation and strategic direction, and potentially leading to mis-spent public monies’.

Mr Burns says the Scottish government will review and update its commissioning processes to move to ‘a more coherent and consistent approach for assessing proposals for acute services’.

Better strategic alignment is also promised between government and NHS boards in their financial planning, and a new ‘prioritisation tool’ to allow evidence-based decisions on what new services to commission and what to stop spending on.

Ultimately, the government will agree a list with each board of the services it is expected to deliver.

Mr Burns says the more collaborative approach will enable more equity in patient access and outcomes, while ensuring NHS services are financially sustainable in the future.

Under the changes, a Scottish government National Planning Executive Group is being created to act as a ‘key lever’ to deliver transformation at a national level.

NHS Western Isles – previously part of the North region alongside Grampian, Highland, Orkney, Shetland and Tayside – has been moved into the, largest, West region which already brings together Ayrshire & Arran, Dumfries & Galloway, Forth Valley, Greater Glasgow & Clyde, Lanarkshire and the Golden Jubilee Hospital.

Read more: Watchdog: action needed now on NHS reform; NHS Scotland: waiting lists and beyond; NHS Greater Glasgow and Clyde welcomes new chief; Health boards given deadline to cut agency nurses

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