NHS Forth Valley: What does 'health board escalation' mean for the struggling health board?

Here’s a long-winded, jargonistic headline for you – NHS Forth Valley has been escalated to stage four of NHS Scotland’s National Performance Framework for Governance, Leadership and Culture. But what on earth does that mean?

Basically, the health board that provides healthcare services in the Clackmannanshire, Falkirk and Stirling area now has Scottish Government “oversight”, after a series of failings.

Health secretary Humza Yousaf says his Government has been “engaging with NHS Forth Valley for some time”, especially around GP out-of-hours care and unscheduled care.

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On top of this, Public Health Scotland’s A&E waiting time statistics regularly show NHS Forth Valley is among the worst performers in Scotland. For several weeks in September and October, more than 60 per cent of its A&E patients waited more than four hours to be seen.

Health secretary Humza Yousaf on a visit to Forth Valley Royal Hospital. Picture: Michael Gillen

Mr Yousaf said “the common barrier to improvement in these areas is governance, leadership and culture”.

Health boards in Scotland are rated against NHS Scotland’s National Performance Framework, from stage one to five. Stage one means a health board is “on plan”, and just reports its performance through normal published statistics, such as the weekly A&E waiting time statistics.

At the other end of the escalation scale, stage five means Government ministers would have the power to intervene in the provision of healthcare.

The decision to move to stage four sits with the Director General of Health and Social Care, and occurs due to the “identification of significant weaknesses considered to pose an acute risk to financial sustainability, reputation, governance, quality of care or patient safety”.

A “transformation team” will now report to the Director General and the chief executive of NHS Scotland, giving the Government direct oversight of NHS Forth Valley’s performance against an improvement plan.

With this, Forth Valley has become the only health board in Scotland to be placed at stage four, with NHS Ayrshire and Arran, NHS Borders, NHS Highland, NHS Lothian and NHS Tayside sitting at stage three, meaning there has been “significant variation from plan”, “risks are materialising”, and a “tailored support [is] required”.

For what it’s worth, NHS Forth Valley has said "we welcome the additional support being provided and are committed to working closely with the Scottish Government to deliver any changes or improvements recommended by the assurance board".

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