FAQ

SCSWIS and HIS will be new public bodies charged with improving the quality of social care, social work, children's services and healthcare services. They will also be charged with providing more streamlined and better co-ordinated scrutiny of service quality. They will do this by

regulating and inspecting
assessing risk
providing guidance and advice
influencing policy and standards
supporting improvement, and
reporting publicly.

The new bodies will integrate their activities and focus on service users to provide a comprehensive picture of how the needs of people using services are met - from service strategy and design, the assessment of need through to the quality of services provided to individuals.

When will we know about the structures of the bodies?

Tentative business models have been developed for both SCSWIS and HIS and will guide planning and preparation until the shadow teams take on their responsibilities. Internal and external stakeholders will consider the implications of the business models for possible structures, inspection programmes, methodologies, resources and timescales by Spring 2010..

When will there be a shadow management team in place?

A great deal of work has been taken forward in preparation for the shadow management teams (new Chairs, Chief Executives and senior teams) being in place around Autumn 2010. We expect to advertise both Chair positions in early April, with appointments being made by end July 2010. The Chairs will be involved in the recruitment of the new Chief Executives. Board Members and key senior managers will be recruited in late 2010. The first Chief Executives will be appointed by Scottish Ministers. Preparatory work has begun with a view to filling both positions by end August 2010.

How will you manage the transition?

All the tasks required to achieve the transition which need taken forward by April 2011 are being set out in a revised project plan. The Plan will clarify all the key tasks, how and when they will be taken forward. We will post the revised project plan showing the business and continuity issues to this website in February.

It will be for the shadow teams to decide whether to adopt the preparatory work which the scrutiny bodies team is undertaking in conjunction with the existing bodies and take it forward or adopt other approaches. We are working with the bodies on business and continuity planning to address these and other issues that may arise during the transition.

How are you engaging with stakeholders?

The Scrutiny Bodies Project team continue to engage with staff directly affected by the changes, primarily through a monthly staff bulletin. There are monthly meetings between the Scrutiny Bodies Project Team and trade union representatives (minutes are available here).

There is a six weekly bulletin for external stakeholders (to which they can subscribe here). There is also a well-attended stakeholder Reference Group with representatives from within and outside the SG which continues to meet regularly to share progress on the project and discuss any issues which stakeholders raise.

The Scottish Parliament's Health Committee suggested one body rather than two as proposed. What's the Scottish Government's response?

Creating one body would mean a large and complex organisation, covering a diverse range of services. Ministers do not believe this would be the best approach at this stage, even though the Crerar review suggested there could in the future be a single scrutiny body covering all public services.

Ministers recognise that the challenge of bringing together the existing bodies with different cultures and different methodologies for delivering assurance and supporting improvement into two new scrutiny bodies should not be underestimated - and that it will take time.

What's the position with fees?

There are no plans to move away from a fee charging regime for registered care services. It is only right that the cost of public assurance about the quality of care services be borne by those services themselves, through the registration process.

What's the position with the grading schemes which are currently in place

We expect the new arrangements to build on positive developments, like the use of grading, which we know is welcomed by the public and is very much in line with the scrutiny improvement agenda.

Why is HIS being establish as a health body, is this not as independent as NDPB status?

HIS will be established in primary legislation through the National Health Service (Scotland) Act 1978. This will give it a clear status and identity as a health body, and allow it to work closely with NHS professional staff, while ensuring that it has the legal status, autonomy and independence of an NDPB.

"Self-evaluation won't work" - why is the Government going down this route?

Self-assessment (self-evaluation) was a key element of Crerar's thinking and is a strong theme in Scottish Government's reform programme, especially, but not exclusively, for local authority services. Supporting the growth and wider use of self-assessment over time will enable external scrutiny to be scaled back.

The Bill contains no provisions in relation to self-assessment by local authorities and other regulated bodies. It does, however, put in place changes which will allow scrutiny programmes to be developed which are more proportionate and risk-based.

What will be the role of Scottish Health Council?

The Scottish Health Council is currently a part of NHS Quality Improvement Scotland, but with its own distinct identity and a Chair appointed by ministers. The Public Services Reform (Scotland) Bill provides for this status to continue within Healthcare Improvement Scotland.

The Scottish Health Council plays an important role in supporting public engagement and patient focus in the NHS that we wish to see as part of Healthcare Improvement Scotland. We would also wish to see HIS as a whole demonstrating a strong commitment to the values of public involvement and patient-centredness. There might be a case at some point in the future for absorbing fully the role and functions of the Scottish Health Council into HIS, and the legislation should allow sufficient flexibility for this to happen.

What about the role of Scottish Social Services Council?

The Scottish Social Services Council's role as set out in the Regulation of Care Act will remain. Some minor amendments are being made. There will also be a requirement for the Chairs of the bodies to be on each other boards.

How will the Independent healthcare sector be regulated?

There are already National Care Standards in place covering a wide range of independent healthcare services, including independent specialist clinics and dentists. We believe that there are relatively small numbers of independent healthcare providers in Scotland, other than in dentistry where most providers also offer NHS services. The costs to the public sector and providers of extending regulation are potentially significant. We are considering with the Care Commission and NHS Quality Improvement Scotland whether there is a case for further regulation and, if so, how this might be approached.

Will there be a different regime for independent healthcare?

The provisions in the PSR Bill set out the regulatory framework for the regulation of independent healthcare services. It will be for HIS to determine how to interpret and deliver these requirements. The consultation will help clarify the range and types of services and the extent to which they should be regulated by HIS. It is important, however, to recognise that professionals working in these areas are also subject to professional regulatory standards and processes, for example those of the General Medical Council and the General Dental Council, and these provide substantial safeguards for the public;

How will the Government continue to be advised on social work issues?

Ministers will establish a post of Chief Social Work Adviser within the Scottish Government to provide policy advice on professional social work issues. The Chief Social Work Adviser (CSWA) will provide professionally-informed advice to officials and to Ministers, to assist the effective development of a wide-range of policies affecting social work and social care and to ensure that these interests are given due cognisance in wider policy development.

The CSWA will work closely with officials across Government, with SCSWIS, SSSC and with relevant professional interests, to ensure that such advice is up-to-date, evidence-based and well-informed. The Bill makes provision for Scottish Ministers to request advice on social work issues from SCSWIS and for SCSWIS to inform Scottish Ministers of any social work issues that they think Scottish Ministers should be aware of.

What's the current position with the legislation?

The Bill passed Stage 1 on 7 January 2010. Stage 2 will run from 26 February to 8 March with the Stage 3 debate at end March. Royal Assent is expected around April/ May 2010.

A small number of Stage 2 amendments are being prepared, mostly technical. A few respond to issues raised by stakeholders. There will also be a significant number of regulations and these are being prepared and will be consulted on and finalised over the next 12 months.

What will be in regulations?

The Regulations will set out the detail of the registration, inspection and reporting process and the requirements on care and IHC services. These will replace the regulations under the RoC Act.

What is the current position with the Mental Welfare Commission for Scotland (MWCS)?

Following on from consultation over the summer the Government informed Parliament of intention to bring forward a range of amendments at Stage 2 in relation to the Commission. The intention is that the Commission will remain as an independent body with functions which are primarily about the protection of the rights of individuals with mental disorder or learning disability, the amendments which will seek to clarify that role. There will also be minor amendments to to place the Commission under a duty to raise matters of concern with HIS and SCSWIS, as appropriate; and similarly, HIS and SCSWIS will be made subject to a duty to a duty to consult with the Commission in respect of certain areas of their work which relate to mental health services.

The Government will also take the opportunity to update the Commission's current governance structure. This is both to ensure that the Commission's board structure works better for it in future, as well as ensure that service users and others with expertise and knowledge of mental health services are more formally involved with the work of the Commission in future.

Archived FAQ - 18 January 2010

What is the definition of a scrutiny body? Is it just about inspection?

Are existing bodies not carrying out sufficiently good scrutiny already?

What will the new bodies do?

Why not make it just one new organisation?

Will there be reduction in scrutiny?

How will the new bodies be established?

What will be in the Public Services Reform Bill?

What is the legislative status of the two new bodies?

What will be the names of the new bodies?

Won't it be difficult for healthcare services operating in the private sector to be regulated by an organisation that is part of the NHS?

What are the benefits of these changes?

How will the new organisations be structured?

What about the other issues which affect staff?

What is the policy position on the care regulator being self-financing from fees?

How are you consulting with those affected and keeping people informed?

Why did you not have a "proper" formal consultation process on the draft Bill?

What engagement has there been with the Trade Unions representing the employees of the existing bodies?

What is the timetable?

Will services registered with the existing bodies have to start anew with the new organisations?

The Care Commission and HMIE award grades to services. Will this continue?

Will it be business as usual for SWIA, the Care Commission, NHS QIS and HMIE until April 2011?

How will complaints handling be done?

There is a lot of support for the National Care Standards' focus on the person receiving the service. Will that clarity be compromised?

Same applies to the emphasis the Care Commission now places on user and carer participation in service delivery and in the regulatory process itself. Will that be lost?

What was the reason for reviewing the decision to put MWCS in new healthcare scrutiny body for the moment?

What is the definition of a scrutiny body? Is it just about inspection?

Scrutiny does usually include inspection activity, but increasingly, it is also about improving the quality of services. Some scrutiny bodies also register new services and investigate complaints. Many also have an enforcement role and can make requirements, recommendations or even close down services. For the purpose of reforming the public sector, the Scottish Government takes a very broad view of the range of activities a scrutiny body can undertake.

Are existing bodies not carrying out sufficiently good scrutiny already?

Individually yes, they are already carrying out good scrutiny, but the public sector in Scotland has evolved in a very piecemeal way. As a result some service providers and the public often feel that too many bodies are scrutinising the same service providers, or there is wave after wave of inspection from different organisations. Ministers want to reform the situation and streamline the scrutiny process.

What will the new bodies do?

With the exception of independent healthcare regulation, all of SWIA's and the Care Commission's work will be carried out by the new social work and social care body. The work HMIE currently does inspecting child protection services provided by local councils and developing a model of inspection for integrated children's services will also transfer to this new body.

The work of NHS QIS, plus the regulation of independent healthcare currently carried out by the Care Commission, will transfer to the new healthcare body.

Why not make it just one new organisation?

That would create a very large new organisation with many responsibilities. Ministers feel it would be a step too far at this stage and would not necessarily achieve the required improvement.

Will there be reduction in scrutiny?

It will reduce the amount of external scrutiny for some very good services. The scope and intensity of scrutiny will be proportionate to the level of risk.

Vulnerable people who use services must continue to be safeguarded and protected. The widely accepted principles of better regulation, that scrutiny should be targeted and proportionate are increasingly being applied by scrutiny bodies nationally and internationally. This means doing more work with poorer services to help them improve and less with those that consistently deliver good quality service.

How will the new bodies be established?

The Public Services Reform Bill was introduced on 28 May 2009 to the Scottish Parliament and contains the proposals to establish the new bodies.

Diagram showing a Bill's process through the Scottish Parliament. The Finance Committee will be the lead Committee for the Public Services Reform Bill.

What will be in the Public Services Reform Bill?

Parts 4 and 5 of the Bill includes the legislative provisions for the establishment of the two new improvement and scrutiny bodies and the dissolution of the existing bodies. Part 6 of the Bill places new duties on scrutiny bodies in relation to user focus and working collaboratively.

There will be no major changes to existing legislation on the regulation of social and health care.

What is the legislative status of the two new bodies?

The final decision is for the Scottish Parliament as part of the Public Services Reform Bill. The healthcare body is likely to be a special health body within the NHS. The social services and social work body is likely to be a Non-Departmental Public Body (NDPB).

What will be the names of the new bodies?

The final decision is for the Scottish Parliament as part of the Public Services Reform Bill. The names on the Bill are:

Social Care and Social Work Improvement Scotland (SCSWIS); and

Healthcare Improvement Scotland (HIS).

Won't it be difficult for healthcare services operating in the private sector to be regulated by an organisation that is part of the NHS?

This has not been raised as a significant concern by providers of independent healthcare services for whom the emphasis is on rigorous scrutiny that highlights the quality of their services. Many of these organisations also provide services to the NHS and as far as possible the new healthcare body will integrate its work in relation to the NHS and independent healthcare across all its functions.

What are the benefits of these changes?

Having fewer organisations involved will be easier for everyone, but particularly the public, to understand and access
It will reduce the amount of external scrutiny for some very good services. The scope and intensity of scrutiny will be proportionate to the level of risk
Inspectors will have more time to concentrate on getting better outcomes for the people who use services
Less bureaucracy and better value for money from having fewer scrutiny organisations.
Self-evaluation will be further developed so that service providers can develop and enhance their own quality assurance system
There will be new legal powers to require closer and more effective joint working by scrutiny bodies. It will no longer just depend on goodwill and voluntary joint working

How will the new organisations be structured?

When the new bodies are established, one of their first tasks will be to develop their structures, but we can say some things at this stage:

Each organisation will have one Board led by a Convenor (or Chair) and one Chief Executive
Rationalisation of the senior management structure is likely in the social services and social work body where the functions of two existing bodies are being brought together
Cost savings and efficiencies are expected to arise through new ways of working, better coordination and greater integration between the two new bodies and more flexibility from sharing services
Ministers have clearly said there will be no compulsory redundancies arising from these changes.

What about the other issues which affect staff?

It is too early to be clear about other issues we know are important to the staff in the existing organisations - such as office locations, harmonisation of terms and conditions, pensions, voluntary severance. We will keep everyone fully informed as these issues are addressed.

What is the policy position on the care regulator being self-financing from fees?

No change is expected (currently 42 per cent of the Care Commission's income comes from fees charged to service providers) but there may be a review of fee structures before 2011. It is a matter for Ministers to consider.

How are you consulting with those affected and keeping people informed?

A series of consultation events with a wide range of interest groups has been undertaken. A conference for service users and their carers and equality organisations was held on 26 June 2009 ( http://www.scotland.gov.uk/Topics/Health/Scrutiny/PublicEvent). Details of future events will appear on this website.

Stage 1 of the Public Services Reform Bill will allow the Scottish Parliament to hear stakeholder's views.

Why did you not have a "proper" formal consultation process on the draft Bill?

The tight timeframe for progressing the Bill has not allowed time for a formal consultation. Instead we have been actively engaging with stakeholders, including the bodies themselves to develop the legislation. The bodies and their stakeholders are now engaged in preparatory work for the new bodies.

What engagement has there been with the Trade Unions representing the employees of the existing bodies?

The first consultation meeting with the Trade Unions took place on February 2, 2009 and there have been monthly meetings since then. The Trades Unions have representation in the project structure (http://www.scotland.gov.uk/Topics/Health/Scrutiny/WhosWho) with seats on the Programme Board and the Change Delivery Group. They are also involved in the task teams driving the legislative and business change.

What is the timetable?

The legislation to set up the new bodies will be part of the Public Services Reform Bill. The timetable is:

Public Services Reform Bill introduced to Parliament May 2009
Following Royal Assent the Bill becomes an Act of the Scottish Parliament in 2010. We will then start recruiting the Boards and Chief Executives.
The new organisations will start up April 2011

Will services registered with the existing bodies have to start anew with the new organisations?

There is a precedent for all services registered before the start date of a new regulator to be "deemed registered" by the new body. This is a decision for Ministers to consider.

The Care Commission and HMIE award grades to services. Will this continue?

We expect the new arrangements to build on positive developments, like the use of grading, which we know is welcomed by the public and is very much in line with the scrutiny improvement agenda.

Will it be business as usual for SWIA, the Care Commission, NHS QIS and HMIE until April 2011?

They all have ambitious programmes of work over the next two years and will be pressing ahead with them. It's important for public assurance and protection of the people who use services that there is no disruption and a smooth transition to the new bodies. These organisations are also making a very strong contribution to the planning of the changes and will help ensure the smooth transition.

How will complaints handling be done?

The new bodies will have a complaints procedures for how they handle complaints against their own actions. SCSWIS will under section 64 of the PSR Bill handle complaints about care services. (Effectively the current system will continue for the new bodies).

There is a lot of support for the National Care Standards' focus on the person receiving the service. Will that clarity be compromised?

No. The new legislation will be more flexible, with powers from Ministers to develop and publish standards and outcomes. A review of the National Care Standards will begin later in 2009, but we would expect the service user focus to remain strong and take account of the new arrangements and structures.

Same applies to the emphasis the Care Commission now places on user and carer participation in service delivery and in the regulatory process itself. Will that be lost?

No, the new bodies will be expected to fully involve people who use services, families and carers in the regulatory process.

What was the reason for reviewing the decision to put the Mental Welfare Commission (MWCS) in the new healthcare scrutiny body for the moment?

Ministers decided that there should be more time for consultation with MWCS stakeholders' and for a review of the organisation's role and responsibilities to take place. The review is now underway and we can expect to have proposals in relation to the MWCS to consider at Stage 2 of the Public Service Reform Bill process.

Page updated: Friday, January 22, 2010

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