This guidance provides NHS boards, and their communities, with a framework that will help them to identify potentially major service changes. It will help boards to carry out a conversation with key stakeholders in order to agree a consensus view. Our Service Change Team can advise on using this guidance.

The following issues should be considered when identifying whether a proposed service change should be regarded as major. They are not ranked in order of importance. Some issues may appear to overlap, but each should be considered. Any evaluation as to what extent these issues apply will involve a level of subjectivity.

NHS boards and other stakeholders (such as Scottish Government, community representatives and elected members) should consider each issue along with local circumstances. As a general rule, the more issues that apply, the more likely it is that a service change should be considered as major. The prompts under each heading are not intended to be exhaustive. NHS boards should consider what evidence they have from their engagement to date and whether they are at the right stage in the process to complete the major service change template.