Single Authority Models: Publication on Progress
This document describes how Single Authority Models might support place-based strategic planning and service delivery to meet local needs more effectively. It also includes an overview of the approaches being taken in three rural and islands authority areas.
Approach and Reform Parameters
Ministers and COSLA leaders are grateful to Health Boards and Local Government for submitting draft preferred options. This builds on significant locally-led work, quarterly meetings with the Cabinet Secretary for Health and Social Care, Minister for Public Finance and the COSLA Presidential Team, along with Council Leaders, Health Board Chairs and senior officers from across all participating geographies. In addition, regular place-specific check-ins support work at officer level.
This investment of time across sectors reflects the opportunity which SAMs create for rural and islands areas to once more be at the vanguard of local governance reform in Scotland, and to generate valuable learning for other parts of the country. To support this locally-led activity, the Scottish Government was pleased to make a financial investment of up to £0.9m through the Public Service Reform Invest to Save Fund 2025-26.
In response to a request from local partners, the Scottish Government issued guidance on reform parameters within which any alternative arrangements must operate:
- Accountability to Scottish Ministers: suitable lines of accountability to Scottish Ministers must remain in place.
- Clinical Governance arrangements: health bodies will retain their respective responsibilities for clinical governance.
- Workforce: proposals should ensure no detriment to the workforce and be developed with involvement from all relevant staff groups and through meaningful discussions with trade unions.
- Primary Care - Independent Contractors: policy and strategy will continue to be set nationally.
- Reserved matters: some health law is not devolved to the Scottish Parliament. Matters such as professional regulation are addressed at UK level. Anything that falls within this category is out of scope.
In addition, the Scottish Government hosted a session to develop a Theory of Change with local partners, led by Professor Linda Bauld, Chief Social Policy Advisor. This built on Chatham House roundtable discussions with academics and former public sector leaders and helped to inform a shared understanding of the key issues and opportunities. Local partners reported finding the process useful and we hope they might consider developing their own Theories of Change, tailored specifically to local circumstances and preferred models for reform.