Streamlining NHS construction quality procedures
Scottish Hospitals Inquiry · Scottish Hospitals Inquiry Interim Report · Issued 4 March 2025 · Addressed to: NHS Scotland Assure
Source — verbatim from the inquiry
●Inquiry recommendation
A range of procedures now exists to help ensure health board projects meet appropriate standards. One is the NHS Scotland Design Assessment Process ("NDAP"). There is also a Sustainable Design and Construction Procedure ("SDAC"). In addition, there is the NHS Scotland Assure Key Stage Assurance Review (KSAR) procedure. These can be time-consuming and demanding to complete. There is a risk that they become unduly bureaucratic and focused on process rather than substance. It is important that they be streamlined, and potentially merged, to ensure they are thorough and robust whilst avoiding duplication and unnecessary delay and cost. They must be genuinely helpful to boards and cognisant of the commercial and other pressures likely to affect projects.
Consideration should also be given to how complimentary procedures - such as aspects of the HAI-SCRIBE process set out in SHFN 30 - can potentially be streamlined to avoid duplication with other processes.
Scottish Hospitals Inquiry, Scottish Hospitals Inquiry Interim Report · 4 Mar 2025 Source PDF →
Published evidence summary
Publicly available evidence relating to this recommendation:
- On 17 September 2025, the Scottish Government stated that NHS Scotland Assure had implemented a Key Stage Assurance Review process and was standardising its approach to health infrastructure projects, preparing a consultation with health boards (Scottish Parliament Question S6W-40544, 17 September 2025).
- No published finalised single assurance framework integrating NDAP, SDAC and KSAR processes has been identified to March 2026.
Response — verbatim from government
●NHS Scotland Assure
All 11 recommendations accepted by Cabinet Secretary Neil Gray MSP on 13 March 2025. Progress update 17 September 2025 (GIQ S6W-40544): NHS Scotland Assure has implemented a Key Stage Assurance Review (KSAR) process; specifications of all projects are checked and validated before approval. A new healthcare facility or major refurbishment cannot open unless it has received NHS Scotland Assure sign-off. NHS Scotland Assure is also standardising the approach to health infrastructure projects and associated processes, and is preparing a consultation with health boards on the proposed changes.
NHS Scotland Assure · 13 Mar 2025 Written response →
Evidence trail — what's actually happened since
- 17 Sep 2025 · NHS Scotland Assure NHS Scotland Assure is standardising the approach to health infrastructure projects and associated processes, and is preparing a consultation with health boards on the proposed changes.
- 13 Mar 2025 Cabinet Secretary Neil Gray MSP accepted all 11 recommendations in a parliamentary statement on 13 March 2025. Source →
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