An Organisation for Economic Cooperation and Development (OECD) report has said that the Scottish NHS needs to do more to learn from its mistakes and performance. This follows on from the call for an independent regulator for NHS Scotland as was raised earlier this year after failures were identified within the organisation.
The OECD report is positive about the work that Healthcare Improvement Scotland (HIS) undertakes in terms of inspecting and reviewing healthcare services against quality standards; however the argument is that HIS is too closely linked with assessing its own work to provide a truly independent account of the services that it is inspecting. The report is also positive about the ‘bottom-up’ approach to healthcare improvement as evidenced on the ground throughout Scotland’s healthcare providers but this should be more strongly supported by national frameworks.
Whilst the report does not go so far as to explicitly call for an independent regulator, the role that HIS undertakes, both inspecting and improving the same services, does not appear to be transparent or accountable. HIS is responsible for identifying and improving poor care, effectively crossing the divide of a regulator whose main goal is to inspect and regulate the service. CQC, the English equivalent of HIS, seems to be moving to a more supportive regime of regulation but it would appear that the Scottish model fails to have the appearance of an independence the public demands.