Quality of care reviews

Healthcare Improvement Scotland is introducing new comprehensive assessments of the quality of healthcare. This is part of a programme of work to implement a new framework-based approach to comprehensive assessment and external quality assurance of the care provided in NHSScotland.


Our aim is to deliver an operational review methodology that is proportionate, sustainable and focused on quality improvement. The proposed  methodology is  currently being tested with the service.

The new approach is due for phased implementation across Scotland from autumn 2017. It will include tools and guidance which have been co-produced with stakeholders to support internal self-assessment and external validation of the quality of care.

Anticipated improvements

We expect this new approach will lead to improvements including:

  • Clear, consistent and joined-up quality assurance using a core methodology that still remains flexible.
  • Increased collaboration with stakeholders to reduce duplication, identify priorities and sustainability issues, and share intelligence, learning and good practice.
  • Increased consistency through use of a common quality framework for service provider self-assessment and external validation of the quality of care, which will also support identification of any variation in the perception of care delivered.
  • Use of overarching measures, evidence, shared intelligence and open dialogue to support early identification of issues.


We are working closely with other programmes of work where there are overlaps and interfaces to the quality of care reviews programme, such as the National Care Standards and the Excellence in Care work. We will also be engaging with external stakeholders directly, and indirectly through professional groups, organisations or individuals represented on the working groups, to share key messages and provide opportunity for engagement and feedback.

Quality framework and self-assessment tool

A shared quality framework will underpin service provider self-assessment and external validation of the quality of care. It will provide consistent guidance to services, and to those externally quality assuring them, about what good quality care looks like, and how this can be evidenced.

The draft quality framework developed in 2015 has been reviewed and streamlined in response to the consultation feedback and has been aligned to the agreed National Care Standards principles. An initial set of indicators/measures has also been drawn up.

This will help to assess quality of care ‘in the round’ using the various quantitative and qualitative data available and existing measurement approaches. The revised Quality Framework and overarching indicators/measures will be used to inform a self-assessment tool for the testing phase.


We are undertaking a series of test exercises to apply the revised framework and self-assessment tool at different levels within service settings or an organisation. This will help determine if the qualitative and quantitative data available is sufficient to inform a robust external assessment of quality of care.

One of the test exercises is a full pilot thematic review within an NHSScotland Child and Adolescent Mental Health Service.

Further detail

Further detail on the quality of care reviews programme, including indicative timescales, is available in our frequent asked questions for healthcare staff.

If you would like more information or have any questions, please email the quality of care reviews team at:

Published resources