NHS Delivery - a new national delivery organisation: consultation

Health and Social Care in Scotland

Scotland’s health and social care system is designed to deliver integrated, person-centred services that support people to live longer, healthier, and more fulfilling lives – wherever they live.

NHS Scotland is made up of 14 territorial NHS Boards, each responsible for delivering frontline healthcare (such as running hospitals) and improving public health in their regions. Alongside these, 8 Special NHS Boards – including NHS Education for Scotland (NES) and NHS National Services Scotland (NSS) – provide national and specialist services that underpin the whole system, from digital infrastructure and workforce education to procurement and innovation. All Boards are accountable to Scottish Ministers, supported by the Scottish Government Health and Social Care Directorates.

Local authorities hold statutory responsibility for social care services and work in partnership with NHS Boards through Integration Authorities. These Integration Authorities are tasked with delivering joined-up health and social care, ensuring that services are responsive to local needs and that people experience seamless care across organisational boundaries.

However, as highlighted in both the Population Health Framework and the Service Renewal Framework, the current landscape is complex and often fragmented.

• National functions such as digital transformation, workforce development, and service innovation are distributed across multiple bodies, leading to duplication, variation, and slower progress on key priorities.
• The frameworks call for a more unified, “Once for Scotland” approach – where national leadership, local delivery, and whole-system collaboration are aligned to deliver prevention, equity, and better outcomes for all.

This consultation is therefore set in the context of a system that is ambitious, but also recognises the need for bold reform to overcome fragmentation and deliver on Scotland’s vision for health and social care.