NHS Scotland - blueprint for good governance: second edition
The second edition of the Blueprint for Good Governance, shares the latest thinking on healthcare governance. Including definitions of 'good governance, active governance and collaborative governance'. Further emphasis on support mechanisms and continuous improvement to support best practice.
E. The NHS Scotland Performance Management Framework
E.1 As the sponsor of the NHS Boards, the Director General for Health and Social Care has put in place a performance management framework to assist the Scottish Government in ensuring that the NHS Boards are delivering services and targets to the required standards, within budgets and with the appropriate governance.
E.2 The NHS Scotland Performance Management Framework provides five stages of a Ladder of Escalation that provides a model for intervention by the Scottish Government when there are concerns about a NHS Board’s ability to deliver the expected standards, targets and governance.
E.3 The model not only describes the stages of performance but also the level of support that would be provided by the Scottish Government Directorates for Health and Social Care at each stage.
| Stage | Description | Response |
|---|---|---|
| 1 | Steady state ‘on-plan’ and normal reporting | Surveillance through published statistics and scheduled engagement of Annual Review and Mid-Year Reviews. |
| 2 | Some variation from plan; possible delivery risk if no action. | Local Recovery Plan – advice and support tailored if necessary. Increased surveillance and monitoring by Scottish Government. SG Directors aware. |
| 2 | Significant variation from plan; risks materialising; tailored support required. | Formal Recovery Plan agreed with Scottish Government. Milestones and responsibilities clear. External expert support. Relevant SG Directors engaged with CEO and top team. DG aware. |
| 4 | Significant risks to delivery, quality, financial performance or safety; senior level external support required. | Transformation team reporting to Director General and CEO NHS Scotland. |
| 5 | Organisational structure/ configuration unable to deliver effective care. | Ministerial powers of Intervention. |
E.4 The Ladder of Escalation’s use is not limited to specific performance measures and may be triggered by concerns about specific services or broader organisational issues.
E.5 The Performance Management Framework is overseen by the National Planning and Performance Oversight Group, a sub-group of the Health and Social Care Management Board. The Oversight Group considers various forms of intelligence and makes subsequent recommendations to the Health and Social Care Management Board on escalation, de-escalation and/or the provision of enhanced support for NHS Boards.
Contact
Email: ocenhs@gov.scot
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