To ask the Scottish Government whether it will provide an update on what actions have been taken to address the recommendations in the Scottish Hospitals Inquiry Interim Report: The Royal Hospital for Children and Young People and Department of Clinical Neuroscience, Edinburgh.
As you are aware, the Scottish Hospitals Inquiry (The Inquiry) has examined the planning, design and construction of the Royal Hospital for Children and Young People and the Department of Clinical Neuroscience (RHCYP DCN) in Edinburgh. In March this year, Lord Brodie, Chair of the Inquiry, published his findings in the Inquiry’s interim report. The report details 11 recommendations based upon the research and evidence supplied in document and oral testimony at the inquiry.
Once again, I would like to express my gratitude to Lord Brodie and his Inquiry team for their dedication and diligence in gathering evidence and producing a report that has provided important lessons for those undertaking health infrastructure projects in the years ahead. I would also like to thank all the witnesses who contributed their time and effort to providing evidence to the inquiry.
The Scottish Government has, and continues to, make improvements to policies and practices, alongside our NHS partners.
One such improvement is the establishment of NHS Scotland Assure. NHS Scotland Assure provides a coordinated approach to the improvement of risk management in new buildings and health infrastructure projects across the NHS in Scotland. NHS Scotland Assure also provides assurance that the healthcare built environment is safe and fit for purpose and has improved support to Health Boards on technical matters. Their work also includes a programme of learning that is intended to enable Health Boards to assist NHS Scotland Assure in how it can better support other health boards about to go through the same process.
NHS Scotland Assure has implemented a “Key Stage Assurance Review” process, which recognises the importance of having detailed specifications, which comply with relevant Infection Prevention and Control guidance. The specifications of projects are checked and validated before any approval can be given. Now a new healthcare facility or major refurbishment cannot open unless it has received NHS Scotland Assure’s sign off.
To achieve greater clarity, NHS Scotland Assure is also standardising the approach to health infrastructure projects and associated processes, and is now preparing a consultation with health boards on the proposed changes.
I acknowledge that that process will take time and is demanding to complete, but this work is firmly rooted in the prioritisation of improvements to the outcomes and quality of health capital projects.
As part of its 2023–2026 strategy, NHS Scotland Assure is developing a framework of training and lessons learned that will be accessible to all Health Boards via a shared intranet site. This supports the Inquiry’s recommendation for more accessible, specific training and guidance to aid NHS Boards in their daily activities. The framework aims to provide expertise and evidence-based advice that helps reduce risk, supports the delivery of a sustainable healthcare service, and improves the healthcare experience across Scotland.
In addition, Infection Prevention (IPC) Workforce Strategic Plan now supports the development of a skilled and sustainable workforce; particularly in relation to Infection, Prevention and Control specialists. Alongside this, the Scottish Government have also published role descriptors for IPC staff and are engaging closely with NHS Education for Scotland and NHS Boards to support the continued development of their IPC staff.
I am also able to advise that an additional phase for the requirement for validation for revenue-funded projects means that for any future revenue-funded project, the Scottish Government will include a provision that strengthens the healthcare provider’s power to ensure that the completed facility is fit for purpose and constructed in accordance with the healthcare provider’s requirements. For capital funded projects, contracts for the construction of new hospitals now allows for validation, which will be undertaken on behalf of the health board in accordance with technical guidance.
The Scottish Government also recognises the need for a risk assessment to be implemented should there be a change in the arrangements for funding a project. The procuring NHS body, working in conjunction with the Scottish Government, will assess whether work done on the project up to that point is suitable for the revised project. The rationale for decisions taken will be formally submitted to the NHS Capital Investment Group for approval. The Scottish Government will also adjust its procurement process to accommodate a gateway meeting prior to Financial Close at which a common understanding of the health board's brief is agreed and recorded.
I agree with Lord Brodie’s recommendation that communication between Health Boards and its patient groups should be improved. I can confirm that discussions between the Scottish Government and NHS Boards are actively taking place to identify any gaps in communication planning and consider if national guidance is required. I understand much of the communication will be delivered on a one to one basis by healthcare staff direct to patients or their families. These communications plans should work effectively alongside the internal communications processes that each local health board has in place to brief staff and ensure accurate and timely information sharing.
I acknowledge the huge amount of work which is already underway by the Scottish Government and its NHS partners. I am confident that we can continue to grow and improve the areas which still require refinement so that patients and families can always feel safe in our hospitals.