Single Authority Models Stakeholder Group minutes: March 2025

National updates

The Minister for Public Finance welcomed attendees to the first meeting of this group also involving the Cabinet Secretary for Health and Social Care and local partners from across all participating geographies. The group will meet quarterly over 2025.

Ministers want to see Single Authority Models (SAMs) improve outcomes for people. Local partners should work together to develop models and Ministers will continue to advise on the nature and extent of the fixed parameters which new arrangements must work within. Ministers recognise that the each place will move at a different pace when developing specific arrangements which can best address their local priorities.

The COSLA President highlighted the potential to enable a decisive shift towards prevention and reiterated that local government has no interest in clinical governance coming under the control of any SAM.

SG officials confirmed that the SAM information note, included with meeting papers, is designed to support local engagement. The note aims to respond to feedback from partners about the need for information which more fully enables them to enter into locally-led policy development. It also seeks to reinforce the commitment to a collaborative approach with a level of formality which ensures all voices are heard. This will be an iterative process and SG officials will wish to work closely with all partners to agree regular information notes as part of a wider communications strategy.

Other national updates include funding for independent collaborative leadership support for a process of dialogue in Orkney. The CnES request for external support on financial analysis and legal/ HR advice also features in SG SAMs workplan. This is being explored on a cross-portfolio basis and budget is protected.

Comments from partners included the public finance/ reform imperative to develop detailed models over the course of 2025 and the value in Ministers defining the scope of potential changes.

Local updates

Orkney partners are in early stages of joint work. The agreed facilitated sessions will initially include local NHS, IJB and council interests. Four guiding principles of policy development have been jointly agreed: bringing benefits to Orkney’s communities, local accountability, simplified governance and reduced bureaucracy, and a clear role and remit.

CnES has produced several possible models for consideration which require input from partners to develop a joint proposal. The close working with Argyll and Bute Council could extend to include Orkney partners now they have resumed active involvement. The financial analysis and other work requested will deliver good value as it will be applicable to any geography considering alternative models. 

NHS Western Isles noted that the meeting papers provide a more complete overview of the agenda and welcomed the scope for local variation. This work takes place within the context of wider NHS Renewal and will require close engagement with staff and communities. Internal dialogue has just begun and a more developed position, informed by a process of local collaboration, will be ready by the next Ministerial meeting in June.

Argyll and Bute Council noted that the papers and discussion are in line with the work they are undertaking locally. There is logic to the timeline, which will be influenced by the scope of proposed models and associated requirements for engagement across all relevant workforces. The proposed nationally-led work on parameters, including NHS governance, and financial analysis will be useful as local partners decide on a preferred model. Further clarity on the extent to which a SAM might expand to encompass a wider suite of functions (e.g. Enterprise, Further and Higher Education and Housing) will also inform decisions on the best type of model.

The Minister for Public Finance agreed that where there is bandwidth we should keep sight of potential involvement from across the wider landscape, but we must make progress on “core” arrangements focused on local government and health and social care functions.

NHS Highland remains committed to the development of a SAM for Argyll and Bute. Ongoing work with Highland Council to agree a move away from the lead agency model for social care means that both parts of the system are in flux at similar times. It will be important that NHS Highland also experiences the benefits of simpler, more effective, governance arrangements when working with partners both geographies.

Indicative Milestones

SG officials introduced the indicative milestones paper. This provides timelines for national and local activity over the remainder of 2025 and is set within  the wider context of 2026-27 implementation. Milestones, at the stage, are illustrative and generic to all geographies. Future iterations will reflect place-specific milestones and identify dependencies between national and local activity.

The NHS renewal agenda is a major priority which runs in parallel to SAMs. Both agendas should be reflected in respective plans including implications for staff capacity. Sufficient time and resource must be allocated to SAMs development in order to get it right.

NHS partnership working includes a statutory duty to engage with staff on matters that affect them (Staff Governance Standard). More broadly, well timed and effective communications which provide clarity on how the work is sequenced will be a key element throughout the process. Meaningful involvement from staff groups should be woven through the policy development process, including those phases which inform decisions on preferred models. 

The Cabinet Secretary for Health and Social Care highlighted that the workforce will hold many of the answers to the questions we need to answer to arrive at the optimum SAM arrangement.