The National Care Standards in Scotland, created under the Regulation of Care (Scotland) Act 2001, describe what people using a range of care services in Scotland can expect. They have been produced for 23 different services including care homes, independent hospitals and private medical and dental practices. The standards are one of the measures by which the Care Inspectorate and Healthcare Improvement Scotland assess the quality, safety and effectiveness of care.
It has been considered that the expectation and policy background has changed significantly since the publication of the Standards and the Scottish Ministers have committed to review them.
It has been agreed that the standards will be developed across three levels. Level one is to produce overarching principles which will underpin the new National Care Standards and which will apply to all health and social care services in Scotland including hospitals and NHS surgeries. Level two entails the development of general standards which apply across a number of related services or in specific sectors. Level 3 will involve producing specific standards which apply to particular settings.
A public consultation on the seven draft overarching principles ran from October to December 2015. The results of the consultation were published in February 2016 and confirmed that five principles had been agreed:
- Dignity and respect
- Be included
- Responsive care and support
Following the agreement of the five overarching principles, the National Care Standards Development Group and the Review team has been working with stakeholders to develop general standards for a wide range of health and social care settings. The Care Inspectorate and Health Improvement Scotland have been involved in this process.
The new National Care Standards will be centred on the rights and wellbeing of people experiencing care and will have a wider relevance than the previous 23 standards, which were specific to different registered care settings. Instead they will be applicable across all health and social care provision, including services that are not registered. The general standards being drafted are common to all individuals experiencing care, and will be complemented by some specialist standards for particular needs and care settings. The Care Inspectorate and Healthcare Improvement Scotland will use them to inform their current reviews of inspection methodology.
It is hoped that by Autumn 2015 the general and specialist standards will be issued for consultation. The new standards are to be rolled out in April 2017.
Unlike in England and Wales, in Scotland there is no one regulator monitoring the performance of all healthcare services in Scotland.
Healthcare Improvement Scotland (HIS) is currently responsible for regulating independent hospitals, voluntary hospices, and private psychiatric hospitals. HIS inspections of NHS hospitals and services in Scotland currently focus on two key areas – ensuring hospitals are safe and clean and ensuring the care of older people.
The Care Inspectorate (formal name Social Care and Social Work Improvement Scotland) monitor standards in the care services in Scotland. The Care Inspectorate’s statutory duties include furthering improvement in the quality of social services and undertaking joint inspections of services for adults and children.
The change to National Care Standards will not be straightforward as there is not one overarching regulator governing all health and care services in the Scotland. As the HIS is not currently inspecting NHS services in relation to national standards, careful thought will have to be made as to how NHS services are monitored in relation to this. This difficulty could support the notion that a single agency incorporating the responsibilities of both the Care Inspectorate and Healthcare Improvement Scotland may be a welcome change to ensure a consistent approach throughout Scotland.