Nationally determined service changes
Guidance for NHS boards and partnerships about national and local engagement responsibilities for nationally determined service changes
Planning with People sets out the responsibilities of NHS boards, local authorities and Integration Joint Boards for community engagement on service changes and the assurance responsibilities for Healthcare Improvement Scotland. Engagement responsibilities for Scottish Government are defined in the Participation Handbook and are assured by Scottish Ministers.
“Nationally determined service changes” are services that are defined by Scottish Government (including those that Scottish Government commissions via the NHS Scotland Planning and Delivery Board) and are delivered by NHS boards and Integration Joint Boards (hereafter referred to as “affected boards”).
The pdf document describes in more detail the recommended community engagement for nationally determined service changes.
The steps below summarise the roles and responsibilities whenever service changes are nationally determined.
National engagement stage
- Responsibility for engagement activities is held nationally by Scottish Government. Engagement includes commissioned activities across Scotland (including by us) in a coherent nationally co-ordinated plan.
- Assurance of all engagement activities within this stage is by Scottish Ministers via the Scottish Government's Participation Framework.
- We provide support and advice but have no assurance role.
Hand over point
- Scottish Government provides written notice to all affected boards explaining the national decision and engagement undertaken.
- This is the delineation point at which: (1) responsibility for engagement activities moves from national to local level and (2) assurance responsibility moves from Scottish Ministers to us.
- We provide advice to boards about the local engagement now required.
Local engagement stage
- Responsibility for engagement activities is held by boards. Engagement includes local activities undertaken by boards.
- Assurance of engagement is by us, in line with Planning With People. We cannot participate in engagement activities when we have an assurance role.
- If engagement does not meet Planning With People, We have the option to escalate to Scottish Ministers.
Temporary service changes
Sometimes there is a need to make immediate short-term, temporary service changes in response to specific pressures such as infection control or staffing shortages. It is recognised this situation may apply to service decisions being made at a national level, with temporary arrangements being put in place while a new long-term service operating model is developed.
Planning with People describes the engagement requirements for temporary service change. This includes the need to:
- Understand the impact of the temporary service change on people who use the service. This includes engaging with them to ask about the impact and potential mitigations.
- Clearly communicate with people what the temporary arrangement is, an indicative timescale for how long temporary arrangements will be in place, how services can be accessed and the support available.
- Seek ongoing feedback from people and communities on the temporary arrangements to inform current and future service design.
The guidance states that temporary service changes are for a short period of time and that at the end of this time, the service provider should contact us to discuss how it will be followed by engagement that meets Planning with People. It notes that the period of temporary change may have enabled the collection of evidence to support a case for a permanent service change. Therefore, for temporary service changes at a national level, the expectation would be:
- Complete the actions stated in Planning with People for temporary service change (understand the impact, communicate clearly and seek ongoing feedback).
- Complete the recommended engagement stated in this paper to plan and implement the permanent new service operating model.
Additional information
We have other resources on our website to support understanding of the requirements of the guidance and the planning of engagement activity: