This blog is part of an ongoing series offering updates on policy, scrutiny and consultation activity and analysis relating to the Scottish Government’s Public Service Reform (PSR) Strategy. Our last update was published on 9 October 2026.
Since October, the rate of announcements and publications has slowed down somewhat and there has been ongoing engagement between the Government and local authorities on restructuring proposals.
As we flagged previously, the Cabinet Secretary had suggested that the Government’s Workforce Management Framework was due to be published in early October. SPICe has since received clarification from Government officials that there is not yet a confirmed publication date for this document.
There has, however, been a trickle of emerging detail on proposals around NHS reform, along with outputs from scrutiny across the wider reform agenda coming from parliamentary committees as they publish their pre-budget findings and recommendations. There has also been an interesting precedent set by the UK Government in its Autumn 2026 Budget.
Health board restructuring
In early October, there was little detail on the Government’s proposals to reduce the number of territorial health boards. In a written update to the Health, Care and Sport Committee on 20 October, the Cabinet Secretary for Health and Care largely reiterated points that she had already made in evidence and speeches. She did, however, clarify that “a move to two new territorial health boards can be effected using existing powers under the National Health Service (Scotland) Act 1978”.
On 22 October, the Government published a factsheet entitled “Health and care reform: staff information”. This responded to themes from engagement with NHS staff following the announcements surrounding health board restructuring. This confirmed clearly that the basis for the proposed model was the existing, albeit recent, sub-national planning approach. The factsheet also made it clear which aspects of reform would be explored as part of developing the business case, and the areas in which no decisions had been made, such as the future of Integration Joint Boards. It also clarified the previous employment commitments which would be upheld, such as Fair Work principles and Agenda for Change, Medical and Dental terms and conditions. The document explains that:
Staff will transfer automatically into the new boards in their current roles, with no change to pay, terms or conditions.
And that:
NHS organisations will consider a range of measures where change is needed, including workforce redesign, redeployment, retraining and reskilling, natural turnover, vacancy management and, where appropriate, voluntary exit arrangements. The focus is on managing change in a planned, sustainable way, while protecting and improving patient services.
On 3 November 2026, The Herald reported on “leaked” documents prepared for the inaugural meeting of the NHS Simplification Programme Board, which suggested that procurement was underway for external consultants to draw up a full business case in final draft by 31 March 2027. These documents are not yet in the public domain so SPICe cannot verify any details. However, during pre-budget evidence to the Health, Care and Sport Committee on 4 November 2026, the Cabinet Secretary confirmed that the programme board had been established and had met, and said:
The procurement for the business case work and the modelling has now been completed, so we will be motoring ahead with the full business case, which I want to see by the end of next spring.
Committee pre-budget scrutiny
Over the past month, the majority of the Parliament’s subject committees have completed evidence-taking and published their findings on pre-budget scrutiny 2027-28. PSR has been a prominent theme across scrutiny for most committees.
For many committees, pre-budget scrutiny has provided an opportunity to seek more clarity on plans for PSR within their portfolio areas, which has added to the body of evidence on the Scottish Government’s perspective. For instance, the Cabinet Secretary for Public Service Reform set out an overview of the strategic direction of PSR across the justice portfolio for the Criminal Justice Committee in correspondence dated 22 October 2026.
At the time of writing, eight of the 12 committees that carried out pre-budget scrutiny had published their findings. The Criminal Justice Committee and the Equalities, Human Rights and Civil Justice Committee included PSR as a specific focus from the outset of scrutiny. A further four (Education and Gaelic, Europe, External Affairs and Culture, Finance and Public Administration, and Rural Affairs) included sections and recommendations in their reports and letters on PSR. Of the four committees that have not yet published their findings, all either focused on or took evidence covering PSR.
The Public Service Reform Committee’s recommendations included a focus on the need for more detail on various aspects of PSR policy, and requests for ongoing monitoring data. This includes clarity around workforce and efficiency targets, pay policy, and detail that will help the Committee to understand impact. Similar themes arose in the recommendations made by the Finance and Public Administration and Equalities, Human Rights and Civil Justice Committees. The PSR Committee, along with the Rural Affairs, Europe, External Affairs and Culture and Education and Gaelic Committees sought more clarity on the announcements made in the Programme for Government, including anticipated implementation costs, expected savings, timescales and risk assessments, and detail on how the PSR agenda fits into other policy commitments.
Investing in and supporting prevention and understanding how outcomes play a role in decision-making was a key theme, even though it wasn’t always tied directly to PSR. Recommendations in these areas came from the PSR, Finance and Public Administration, Equalities, Human Rights and Civil Justice, Europe, External Affairs and Culture and Education and Gaelic Committees. The Finance and Public Administration, Public Service Reform and Equalities, Human Rights and Civil Justice Committees all sought a response from the Government on when the new National Performance Framework will be published, and how it will serve to connect PSR, the budget and outcomes.
As in recent years, SPICe will be publishing a broader analysis of cross-committee themes in pre-budget scrutiny in advance of the Scottish Budget on 3 December.
UK Budget
On 28 October 2026, Chancellor John Healey presented the UK Budget. There were some interesting parallels for Scotland. A focus on the use of digital innovation and its ability to support the delivery of significant reductions to the size and cost of the civil service and boost NHS productivity will be a familiar theme to anyone following the PSR journey in Scotland.
One of the more subtle announcements in the Budget was a commitment to introduce a new category of ringfenced spending at the spending review in 2027, described as preventative departmental expenditure limit (PDEL). There is a close connection between preventative spend and the PSR agenda, of which prevention is a key pillar, so this is an interesting development.
The suggestion of introducing PDEL originated with Demos and the Health Foundation in 2023. According to Demos, PDEL would create a baseline for prevention and greater accountability for spending on prevention, would signal the importance pf prevention, and would improve long-term decision-making.
As we explored in a SPICe briefing on Preventative spending in Scotland, implementing PDEL into the budgeting process would require fundamental revisions to public accounting approaches. It is not yet clear how this would feed through into Scottish budget allocations, or how it might be implemented beyond a central government level.
CIPFA’s post budget analysis concluded:
This year’s lesson – ask for a pony and you just might get it.
However, it goes on to note that the budget “does not establish whether PDEL will be a new expenditure control or operate within existing arrangements, nor does it commit additional funding”. The Institute for Government’s post-Budget analysis highlights the importance of the next steps around definition and implementation of PDEL. It’s likely that we may have to wait until next year’s UK Spending Review to see what preventative budgeting looks like at a UK level, how that might impact on Scotland, and how the approach differs from the ongoing work of the Scottish Government’s Prevention Unit.
Freedom of Information requests as a source of detail
In the face of a continued lack of detail on certain areas of reform, there remains a steady stream of Freedom of Information (FOI) requests looking for more detail. For example, a response published on 9 November 2026 sought correspondence between the Scottish Government and the local government sector on reform proposals.
The media have reported on the use of FOI requests to seek information not just from the government, but also from public bodies themselves, such as the Press and Journal’s October 16 article about a campaigner who wrote to all health boards for detail on whether they were consulted on restructuring proposals prior to the Government’s announcements.
Scottish Information Commissioner David Hamilton has spoken recently about the challenges facing Scotland’s FOI regime after the number of FOI requests received by Scottish public bodies grew by 13% in 2025-26 compared to the previous year. This was attributed in part to a rise in the use of AI to generate requests, but also to increasing awareness of the FOI process among the public and a raised demand for transparency in public governance. Taken together, the reliance on the FOI process in helping the public to understand Government decision-making, and the impacting pressure placed on public bodies in responding to these requests, are areas to watch within the PSR landscape.
Looking forward
Over the coming month, the Government’s initial three-month period of engagement on local government reforms will come to a close. We will also have the first Scottish Budget of this session laid before Parliament, and potentially more detail on how public service reform and the Government’s work on preventative budget tagging is reflected in the budget. Might committees start to see some of the detail they’re looking to get their teeth into?
Ailsa Burn-Murdoch, Senior Researcher, SPICe