Single Authority Models: Publication on Progress

Next steps

The Cabinet Secretary for Health and Social Care, Minister for Public Finance and COSLA Presidential team note the progress that local partners have made to date. This has brought clarity, on a cross-sector basis, on the type of local governance reform which can create the right conditions to tackle the biggest challenges in rural and islands settings and deliver local priorities and improved outcomes.

The work so far has also identified a number of key themes to explore and questions to resolve together across diverse interests and with local communities. The current phase of work has involved providing an early assessment of alignment of partners’ preferred options with reform parameters.

The Scottish Government and COSLA will also have a key role in working with national and intermediary organisations to ensure there is a shared understanding of emerging place-based governance reform and the implications for a wide range of interests. We will co-ordinate national engagement activity with local partners, ensuring complementary national and local level approaches. Widespread engagement over 2026-2027 will seek to broaden the conversation to increasingly include leaders from across the health and Local Government sectors, unions and professional bodies.

Local partners will have a key role in ensuring that the voices of local communities, including communities of interest and relevant workforces, are heard and help shape future arrangements in ways which they know will work best. Healthcare Improvement Scotland and COSLA are creating a supplement to the “Planning with People” guidance to set out best practice for joint engagement undertaken by Local Authorities, NHS Boards and Integration Joint Boards to ensure a fully collaborative approach that is clear and consistent.

Given the complexity of health and care pathways across geographic boundaries, and new NHS sub-national planning arrangements, the Scottish Government will work with NHS Boards to ensure alignment with national frameworks such as the Service Renewal Framework and the Population Health Framework.

Ministers and COSLA endorse the approaches taken by local partners and encourage them to continue to make progress towards detailed arrangements. As they continue on this journey, local partners should work across organisational boundaries as far as is possible within existing frameworks. Orkney partners’ ‘Routemap to Reform’ includes a commitment to prioritise new arrangements for shared support services which can achieve efficiencies and help to protect crucial frontline services. Testing new ways of working through shadow arrangements as part of an ambitious process of long-term transformation will help to demonstrate benefits to people and surface further opportunities to strengthen local democracy and deliver sustainable public services.

We invite local partners to work with communities and workforces to develop and refine local governance arrangements, tailored to the circumstances of each participating geography. We recognise that this will have implications for how we work together - within and across - national, regional, local and community levels.

The Scottish Government and COSLA will work alongside local partners to refine proposals and confirm routes to implementation and shadow arrangements. Our overarching focus will be to ensure that any agreed place-based arrangements operate effectively in delivering sustainable healthcare delivery. Our approach to implementation will include close consideration of how to support a successful period of transition for all those affected and making legislative changes where required.

The development of Memorandums of Understanding, or other forms of written agreements, will be explored where local leaders can demonstrate this would further enable them to proceed with confidence in developing and implementing ambitious reforms.