SHI-5 Response Accepted AI-assessed

Streamlining NHS construction quality procedures

Recommendation

A range of procedures now exists to help ensure health board projects meet appropriate standards. One is the NHS Scotland Design Assessment Process ("NDAP"). There is also a Sustainable Design and Construction Procedure ("SDAC"). In addition, there is the NHS Scotland Assure Key Stage Assurance Review (KSAR) procedure. These can be time-consuming and demanding to complete. There is a risk that they become unduly bureaucratic and focused on process rather than substance. It is important that they be streamlined, and potentially merged, to ensure they are thorough and robust whilst avoiding duplication and unnecessary delay and cost. They must be genuinely helpful to boards and cognisant of the commercial and other pressures likely to affect projects.

Consideration should also be given to how complimentary procedures - such as aspects of the HAI-SCRIBE process set out in SHFN 30 - can potentially be streamlined to avoid duplication with other processes.

Published Evidence Summary
The following publicly available evidence relates to this recommendation:
According to the Official government response (13 March 2025) and the SHI-5 Progress update (17 September 2025), the Scottish Government accepted this recommendation on 13 March 2025. According to the update, NHS Scotland Assure has implemented a Key Stage Assurance Review (KSAR) process, which checks and validates project specifications before approval, and requires NHS Scotland Assure sign-off for new healthcare facilities or major refurbishments to open. According to the update, NHS Scotland Assure is also standardising the approach to health infrastructure projects and was preparing a consultation with health boards on proposed changes as of 17 September 2025.
How was this assessed?
Assessed by gemini-2.5-flash on 19 Mar 2026
Checked data held on this site (government responses, progress updates, independent evidence)
External sources searched: www.gov.uk, www.gov.scot, www.parliament.scot, www.legislation.gov.uk, hansard.parliament.uk
This recommendation requires implementation across many organisations. The assessment reflects central policy response, not adoption in individual organisations.
Jurisdiction
Scotland
Response
Accepted
Accepted NHS Scotland Assure
13 Mar 2025

All 11 recommendations accepted by Cabinet Secretary Neil Gray MSP on 13 March 2025. Progress update 17 September 2025 (GIQ S6W-40544): NHS Scotland Assure has implemented a Key Stage Assurance Review (KSAR) process; specifications of all projects are checked and validated before approval. A new healthcare facility or major refurbishment cannot open unless it has received NHS Scotland Assure sign-off. NHS Scotland Assure is also standardising the approach to health infrastructure projects and associated processes, and is preparing a consultation with health boards on the proposed changes.

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Progress Timeline
NHS Scotland Assure states: Official Report
17 Sep 2025

NHS Scotland Assure is standardising the approach to health infrastructure projects and associated processes, and is preparing a consultation with health boards on the proposed changes.

Official Report
13 Mar 2025

Cabinet Secretary Neil Gray MSP accepted all 11 recommendations in a parliamentary statement on 13 March 2025.

Source
Report Scottish Hospitals Inquiry Interim Report 04 Mar 2025
Responsible Bodies
NHS Scotland Assure Primary
Recommendation age 1.1 yr
Last formal update 17 Sep 2025