NHS Scotland inspections at risk of ‘conflict of interest’ at Healthcare Improvement Scotland, warns OECD

Scotland’s healthcare scrutiny body is in danger of “marking its own homework” and should be split in two, according to the Organisation for Economic Cooperation and Development (OECD).

In a new wide-reaching report into the NHS across the UK, the OECD delivers 19 recommendations to Scotland. It says Scotland has “comprehensive and ambitious” quality strategies but should keep scrutiny independent.

The mixing of scrutiny and quality improvement activity within Healthcare Improvement Scotland could represent a conflict of interest, it adds, suggesting “formally separating the scrutiny and assurance directorate into a distinct and independent entity” should be considered.

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A national reporting system like one in Denmark is needed, the report suggests, to benchmark local patient safety work and allow patients and their families to report unsafe events.

Health Secretary Shona Robison said the recommendations would help government drive improvement.

“We are clear that we currently have strong, robust regulation processes in place. This includes Healthcare Improvement Scotland, which can conduct unannounced, in-depth, inspections across the healthcare sector. Its reports are used to identify issues and provide the basis for improvement.

“If necessary HIS can refer any points they identify to other regulators, or indeed the appropriate authorities for criminal investigation.

“There are already two on-going reviews of scrutiny in Scotland - one specific for health and one wider ranging across the public sector. We will consider the specific OECD recommendations on scrutiny alongside these reviews.”

The OECD report praised Scotland’s commitment to integrating health and social care, but said GPs must have a much “deeper” involvement in local care planning. Health and social care inspectorates should be better aligned, it said.

In the UK as a whole, the report recognised the NHS puts more energy into health care quality improvement “than any other country in the world”, but “despite this, the quality of health care is no better than average”.