Crerar Review: Public Scrutiny in Scotland

The Report by Professor Lorne Crerar of the “Independent review of regulation, audit, inspection and complaints handling of public services in Scotland” was published on Tuesday 25th September 2007 on http://www.scrutinyreview.org/

The Crerar review concludes there is widespread agreement that Scotland’s scrutiny system is too complex, costly and burdensome on public bodies. From the evidence gathered, Crerar finds that the scrutiny system doesn’t necessarily scrutinise the right things, has grown in a piecemeal fashion and requires strategic co-ordination.

The Crerar report short to medium term recommendations

• a radical increase in the sharing of information and co-ordination
between bodies.
• a renewed focus on users of services
• involving service users in standards setting
• an increased role for parliament
• fewer scrutiny organisations
• accessible reports by scrutiny bodies
• proportionality - focusing on poorer performing service providers and higher risk situations

Crerar Report - One scrutiny body for all?

In the longer term the report proposes moving to one national scrutiny body, one audit body, and one complaints handling body for the whole public sector.

Crerar report - other recommendations

The Crerar report also recommends that –
• Core risk criteria should be agreed by Ministers and agreed by Parliament to assess the need for current and future scrutiny
• Ministers should redistribute resources and functions from within NHS QIS,
the Scottish Government’s Health Directorates and the Care Commission in relation to private hospitals and related treatment – to an independent external scrutiny organisation
• All external scrutiny organisations should have one “status” with clearly defined lines of accountability to Parliament and to Ministers.
• Where scrutiny is needed, if there is more than one existing organisation, only one should be asked to do the work and be fully responsible and accountable. Creating a new scrutiny organisation should not be an option.

Crerar Report: Principles of scrutiny

The focus should shift to self assessment, supported by risk based, proportionate
external scrutiny. As service provider performance management improves in quality
and ability to reassure users, public and elected members, scrutiny can become
more proportionate to the risks, which in turn frees up delivery organisations to focus
further on improving their front line services. The scrutiny framework should –
􀂃 focus on the needs of the people who use services being scrutinised,
􀂃 drive improvement,
􀂃 ensure that public money is used as efficiently and effectively as possible.
The principles behind the system are for a simplified scrutiny landscape, with a
proportionate and co-ordinated approach.

Crerar Report: The future for Scrutiny bodies

The report does not make specific recommendations in relation to the future of particular scrutiny bodies as this was not the remit of the review. However the report does recommend that in the longer term there should be the development of one scrutiny body and this will have implications for a number of existing bodies.

Crerar Report: A Risk based and Outcome focussed approach to Scrutiny?

The report argues strongly for scrutiny which is risk based and which moves away from scrutinising inputs and processes and towards measuring outcomes.

The full report can be downloaded at http://www.scotland.gov.uk/Resource/Doc/82980/0053065.pdf

Healthcare associated infections study

National Healthcare Associated Infections (HAI) Point Prevalence Survey

This survey, carried out by Health Protection Scotland, is the most
comprehensive study ever undertaken into the extent of infections in Scotland
and leads the way in HAI research in Europe.

The survey recorded the presence of all types of infections in one day for every patient in every acute hospital. The survey found that the prevalence of HAI was 9.5 per cent in acute hospitals
and 7.3 per cent in community hospitals and the cost of these infections was approx. £183m per
year.
The study found that the highest numbers of HAI in acute hospitals were present in care of the elderly, medical and surgical wards.
The HAI task force will take these findings forward and is focusing on the following areas:
• examining the case for introducing an MRSA screening programme - targeting skin and soft tissue infections
• reducing blood stream infections
• ensuring additional surveillance data are put to use in the areas of general medicine and care of the elderly.

Vulnerable Young People transitions research

Scottish Executive: Review of Research on Vulnerable Young People and Their Transitions to Independent Living

The Scottish Executive has published a Review of research on vulnerable young people which was conducted by the Centre For Research on Families and Relationships, The University of Edinburgh ( Authors; Susan Elsley, Kathryn Backett-Milburn, Lynn Jamieson) The Full report is available from www.scotland.gov.uk/research

The report examines available research and data on the issues around vulnerable young people and their transitions from care to indepenedent living.