NHS Greater Glasgow and Clyde emergency department review: response

Overview

Healthcare Improvement Scotland carried out a review of safety and quality of care at the three main Emergency Departments at NHS Greater Glasgow and Clyde:

• the Queen Elizabeth University Hospital
• Glasgow Royal Infirmary
• Royal Alexandra Hospital

See: NHS Greater Glasgow & Clyde Emergency Department Review: March 2025.

This is our response to national recommendations in the review.

Cover letter

From: Cabinet Secretary Health and Social Care Neil Gray
To: Robbie Pearson, Chief Executive, and Evelyn McPhail, Interim Chair, Healthcare Improvement Scotland

I am grateful to Healthcare Improvement Scotland (HIS) for their recent report on findings from its review of the three main receiving Emergency Departments within NHS Greater Glasgow and Clyde (hereafter, “the report”). The recommendations within the report are two fold: recommendations and requirements for NHS Greater Glasgow and Clyde which are encapsulated in an improvement action plan which will be taken forward by the Board; and a number of national recommendations, to be taken forward by the Scottish Government. My purpose in writing to you is to formally acknowledge and respond to the latter.

HIS' review was embarked upon as a result of concerns raised in relation to the Emergency Department of the Queen Elizabeth University Hospital, and included Glasgow Royal Infirmary and Royal Alexandra Hospital, in recognition of known wider, far-reaching system pressures in Glasgow and beyond, and the need for national, strategic intervention to address these. I am grateful to HIS for this action and my Ministerial colleagues and I continue to be appreciative of HIS’ critical role in ensuring patient safety, quality of care and continued improvement across NHSScotland. Implementation of the national recommendations within the report will have tangible, sustained impact across the service.

The report made eleven strategic recommendations across three key themes, with a focus on continuous improvement in response to HIS inspectors observations of current practice across NHSScotland and where gaps have been identified.

When the report was published, the First Minister welcomed HIS’ report and recommendations, acknowledging that performance data for A&E Departments is improving, and affirming that the recommendations are urgent priorities, to ensure that high quality, professional, compassionate care is the experience of all patients. Having given the national recommendations further consideration, I can confirm that the Scottish Government accepts nine of the recommendations and partially accepts two. I have provided a narrative against each recommendation on pages 3 – 7 to set an initial position and intention, as well as set out the rationale for the partial acceptances.

I am acutely aware of the pressures faced by Boards, and the specific, protracted challenges faced within Emergency Departments and, in working to implement the report’s recommendations, I will promote progress at pace. The Scottish Government will work collaboratively with other health and social care organisations in taking forward the report’s recommendations and I should caveat that, where this partnership working is required, full implementation of the recommendations will be dependent on the relevant organisations being able to engage fully, and this is a decision for their respective Executive Teams. 

In accepting these recommendations, I have confidence in moving towards improved outcomes for the people of Scotland.