NHS Delivery - a new national delivery organisation: consultation

What Will Change

The creation of NHS Delivery marks a fundamental shift in how Scotland will deliver national support for health and social care. Ministers have identified three strategic objectives for the new organisation:

• To drive and support innovation, especially in digital transformation, workforce development, and service infrastructure – by bringing together functions that are currently fragmented across multiple national bodies.
• To deliver on a Once for Scotland basis, ensuring that national services are consistent, joined-up, and free from duplication, so that every part of the system benefits from best practice and shared expertise.
• To streamline structures, reducing unnecessary complexity and focusing resources where they make the greatest impact.

Why This Change Is Needed

Scotland’s ambitions for health and social care require more than incremental improvement. Currently, digital transformation, workforce education, and service innovation are split across NES, NSS, and other bodies. This fragmentation leads to:

• Overlapping responsibilities and confusion about who leads on what.
• Duplication of effort, wasted resources, and slower progress.
• Missed opportunities to deliver truly integrated, prevention-focused, and digitally enabled care.

As an example, a recent review of digital delivery found that the current approach is no longer fit for purpose. Expectations around digital, data, and innovation have grown rapidly, but our capacity to deliver at scale has not kept pace.

Digital transformation is not simply about upgrading technology or moving from paper to electronic systems. It is about fundamentally redesigning how services are delivered, ensuring that care is more person-centred, efficient, and accessible. This transformation will enable staff to work in new ways, support the development of new skills, and make it easier for people to manage their own health and care.

Importantly, digital transformation must be inclusive, ensuring that everyone, regardless of background or circumstance, can benefit from new digital tools and services. It will support the redesign of care pathways, improve data sharing and decision-making, and empower both staff and citizens. NHS Delivery will play a central role in leading this change, embedding digital innovation across the system, supporting workforce development, and ensuring that technology is used to drive better outcomes for all.

Driving Innovation

Innovation is critical to the future success of NHS Scotland and significant energy is being invested in the development of partnerships between Government, the NHS, academic institutions, and industry to identify, evaluate and scale the solutions that we need to be make our services sustainable and effective in the long term. Through our Public Service Reform Strategy, we highlight the importance of capitalising on the benefits that come with digital innovation and intelligent automation, and this is reinforced through our Operational Improvement Plan for NHS Scotland.

Both NES and NSS are already pivotal to the ambitions of the SRF in relation to digital capabilities, namely ‘Delivering services which are accessible through digital technologies, with people and our workforce able to access and make use of the right information’. Indeed, the vast majority of existing national digital capabilities are provided by one or other of these bodies. This includes delivery of significant new services such as the Digital Front Door. However, we also know that there are other organisations outwith NES and NSS who have some responsibility for digital transformation, change management and pathway redesign. The expectations around the use of digital have grown exponentially, but our capacity and approach to delivery have remained relatively static. Increased expectations, coupled with an increase in the number of organisations with an interest, has led to a diffusion of activity and a lack of clarity about which delivery partner is best placed to lead on what aspects of digital. A review of digital delivery earlier in 2025 recommended a strengthening of digital delivery capability, supported by centres of excellence in areas such as change management, engagement, design and implementation.

Of course, opportunities for innovation are not limited to digital. Findings from Audit Scotland identify that, despite NHS Scotland having implemented a range of projects and initiatives aiming to improve productivity and outcomes for patients in recent years, these have not necessarily had the desired impact on headline indicators. Audit Scotland recognises that productivity is multi-faceted and influenced by a wide range of factors. It is therefore critical that our approach to driving progress is as integrated and coherent as it can be.

Both NES and NSS have significant capacity to support innovation. This was most keenly demonstrated through their response to the Covid-19 pandemic to ensure delivery of services within the context of a rapidly changing environment. As part of a culture of continuous improvement, work has been undertaken to implement lessons learned from that experience and to take into account different ways of working – thus maximising impact to respond to the needs of partners across the system.

Building on this, NES has established a Learning and Innovation Directorate tasked with delivering innovation priority action themes which can support innovative practice through workforce education, training, research and workforce redesign:

• Developing new learner pathways to support workforce diversification, as part of multidisciplinary teams.
• Building complementarity between human skills and emerging technologies to best meet service requirements.
• Unlocking the future of learning through emerging technologies, including Extended Reality (XR) and Artificial Intelligence (AI).
• Collaborating with strategic partners to support the development of research, innovation and entrepreneurial skills.

Innovation is also embedded across NSS service areas, for example:

• National Procurement has a dedicated team to field enquires and support regulated procurements in the innovation pathway and works with key partner organisations to manage prioritised projects.
• NHS Scotland Assure, through research, innovation and intelligence, monitor and manage healthcare environment risks to ensure guidance and advice are based on best practice and best evidence.
• The Scottish National Blood Transfusion Service partners with research bodies to advance innovation, safety and evidence-based practice in blood, tissue and cellular therapies
• The Digital and Security Service ensures digital innovation and improved outcomes for colleagues, patients and the public through working with partners to develop and facilitate digital solutions to enable transformative systems.

Whilst these achievements are welcomed, there is much to be gained by bringing together this activity under one roof. In doing so we will create increased opportunities, more clearly identify synergies and encourage the promotion and adoption of best practice across the entirety of NHS Scotland. Having a national Organisation to act as the focal point for innovation across our health system will ensure that this agenda remains central to the planning and delivery of services going forward. This could, for example, build on the joint work both organisations already do as partners in the ‘ANIA’ collaboration (Accelerated National Innovation Adoption)

Delivering on a Once for Scotland Basis

Building on their role in driving innovation, we see significant and immediate potential for greater integration in the way NES and NSS currently deliver core services and support to their partners. Both organisations already work effectively together, and we want to build on this.

Looking beyond the immediate opportunities associated with bringing together the functions of NES and NSS, we see significant potential for NHS Delivery to lead on the design and delivery of other services which could be more effectively managed on a Once for Scotland basis, limiting duplication of activity and effort across NHS Scotland and ensuring the availability of best-in-class support which is familiar to colleagues and partners irrespective of where they are based. The delivery of shared services is not only critical to ensuring the long-term sustainability of services but is also the right thing to do if we are to ensure continued value for money for the public. Throughout 2026 we will bring forward further proposals on the potential for the integration of other corporate and support services and wider infrastructure which are currently delivered on a local basis with a view to these being provided by NHS Delivery going forward.

Streamlining Structures

Bringing NES and NSS together is a critical step towards a more effective, sustainable, and future-ready health and social care system. By unifying these national bodies, we can unlock significant efficiencies – making better use of assets, streamlining organisational structures, and enabling a more flexible and responsive deployment of our highly skilled workforce. This will allow us to focus the collective talent and expertise of both organisations on delivering the clear ambitions of the Service Renewal Framework.

Over time, these changes are expected to generate financial savings, supporting the long-term sustainability of Scotland’s health and social care system. But the benefits go beyond efficiency alone. A single delivery organisation will enable more joined-up and timely decision-making on cross-cutting issues, reducing duplication and accelerating the pace of improvement across digital transformation, workforce development, and service innovation.

For partners and stakeholders, this change will simplify engagement with NHS Scotland – removing confusion about which organisation leads on national services, and making it easier to collaborate, innovate, and deliver for the people of Scotland.

The detailed design of the new organisation will be shaped by its Board, Chief Executive, and leadership team, with further development expected well beyond the initial merger. The future structure and remit of NHS Delivery will continue to evolve, informed by ongoing engagement and the changing needs of Scotland’s health and care system—ensuring that the organisation remains responsive, ambitious, and aligned with the long-term goals set out in the SRF and PHF.

What NHS Delivery Will Enable

Driving Innovation

NHS Delivery can act as the single national engine for innovation – especially digital transformation – across health and social care.

• No more fragmented leadership: One organisation will be responsible for delivering national digital platforms, supporting the workforce to develop new skills, and ensuring that innovation is embedded in every part of the system.
• Clear accountability: The public, staff, and partners will know who is responsible for delivering change.
• Faster adoption of new technologies: By uniting expertise from NES and NSS, NHS Delivery will accelerate the rollout of digital tools, AI, and new models of care – helping Scotland keep pace with global advances.

Delivering Once for Scotland Services

• Consistent national services: NHS Delivery will ensure that digital, workforce, and support services are delivered to the same high standard everywhere in Scotland.
• Eliminating duplication: By integrating functions, NHS Delivery will reduce waste and free up resources for frontline care.
• Supporting local delivery: National solutions will be designed to support local teams, making it easier for staff and citizens to access the right information and services.

Streamlining Structures

• Simpler, more effective national leadership: NHS Delivery will replace multiple overlapping bodies, making the system easier to navigate for staff, partners, and the public.
• Better use of resources: By focusing national expertise in one organisation, Scotland can invest more in what works and stop what doesn’t.

A Transformational Opportunity

This is not just about consolidating two organisations. It is about creating the conditions for Scotland to deliver on its boldest ambitions:

• A health and social care system that is truly prevention-focused, digitally enabled, and person-centred.
• National leadership that can drive change at scale and pace, supporting local teams to deliver better outcomes for every citizen.
• A system that is fit for the future – able to adapt, innovate, and deliver for Scotland’s changing needs.

NHS Delivery will be the enabler for this transformation. Making it possible to move from aspiration to action, and from fragmentation to true national leadership.

We are seeking your views on:

• Do you agree with the intention to create a new national organisation to drive forward digital transformation and system change, beginning with the merger of NES and NSS?
• What immediate opportunities or priorities should NHS Delivery focus on from Day 1?
• Are there services or functions currently delivered by other organisations that you believe should be integrated into NHS Delivery to improve consistency and reduce duplication?