NHS must be reformed to remain affordable and sustainable, watchdog says

The governance of NHS Scotland must improve if the Scottish Government is to deliver the scale of reform needed across the health service, Audit Scotland has found.

A new report by the watchdog found there were weaknesses in how the Scottish Government scrutinises the NHS.

It said the nation’s health system must be reformed to remain affordable and sustainable, with better governance key to achieving this.

It urged the Government to make better use of non-executive directors to provide more challenge to the system.

It warned that the planning and governance of healthcare in Scotland is becoming increasingly complex, limiting the ability of NHS boards to drive reform.

NHS Scotland consists of 22 boards, with oversight lying with the Scottish Government.

Audit Scotland said the mix of local, regional and national partners in the system made decision-making and accountability difficult.

The Scottish Government has introduced a new planning framework, while a fresh national strategy is due this year.

The watchdog’s report said this will provide clarity for the NHS, while helping boards to work better together to deliver reform. But it warned it will also be challenging to implement.

It said that the blueprint for good governance created with the Scottish Government had been well-received, but that there was scope for it to be strengthened in a way that more clearly set out how governance would be adapted to deliver reform.

Stephen Boyle, Auditor General for Scotland, said: “The delivery of NHS services must be reformed for Scotland’s health service to remain affordable and sustainable.

“NHS Scotland’s governance arrangements are key to delivering that reform, but they need to be strengthened.

“The planning of healthcare in Scotland is becoming more complex and the Scottish Government needs to ensure lines of accountability and decision-making are clear.”

The Scottish Government has been approached for comment.