Approval Processes

 

• Less than £1 million : Full Business Case (to be considered and approved locally)

• £1 million - £5 million : Initial Agreement, Outline Business Case and Full Business Case (where such a project is above the NHS Body’s delegated limit SGHSC CIG approval is required)
• £5 million+ : Initial Agreement, Outline Business Case, Full Business Case (all require SGHSC approval)

For IM&T Projects

• Less than £0.5 million : Full Business Case
• £0.5 million - £2 million : Initial Agreement and Full Business Case
• £2 million+ : Initial Agreement, Outline Business Case, Full Business Case

Note: Previous references to Standard Business Case is no longer relevant.

All hub projects require Initial Agreement, Outline Business Case, Full Business Case (all require SGHSC approval). This process mirrors the New Project Request and Stage 1 and Stage 2 approvals process with hubco.

CIG has no scope in approving projects led by Local Authorities where the Health element falls below the NHS Board’s existing delegated limit. NHS Boards must follow their own governance arrangements to ensure that contributions to such schemes represent value for money and are affordable. Again, the health element of a project will be part of the New Project Request and Stage 1 and Stage 2 approvals process with hubco.

Where the specific Health element of such projects is above the Board’s existing delegated limit and project specific funding is sought from SGHSC, normal approval rules will apply and CIG approval must be sought by the lead NHSScotland body involved (even if the overall project is to be LA led) sponsoring an appropriate business case.

There is no delegation for new NPD (or similar) schemes. All such schemes require SGHSC approval.

The refinancing of existing PPP/NPD schemes requires SGHSC approval.
 
Approval of service variations will typically be the responsibility of the NHS Board under contractual change control procedures. Where any additional capital works are considered as a variation to an existing PPP contract, regardless of whether these are funded by public or privately sourced capital, those in excess of the Board's designated limit are subject to SGHSC approval.

Approval of service variations will typically be the responsibility of the NHS Board under contractual change control procedures. Where any additional capital works are considered as a variation to an existing PPP contract, regardless of whether these are funded by public or privately sourced capital, those in excess of the Board's designated limit are subject to SGHSC approval.

Third party developer schemes have been used to support infrastructure developments particularly within primary care settings. Although independent contractors such as GPs and GDPs are responsible for the provision of premises for the delivery of services, where they are contracted to supply for NHSScotland their rent and rates costs are to be met by NHS Boards. All projects funded by Third Party Development and other ways involving new premises for Independent Contractors then are subject to the same business case rules as any other proposed NHSScotland premises development.

This will:

• improve transparency on value for money for NHSScotland;
• provide greater consistency of process, and;
• avoid confusion where proposed developments are composites involving contractor premises and other services such as Community Health delivered directly by a NHSScotland body.

Within the SGHSC for projects above Board delegated limits, the Chair of CIG has delegated authority to approve projects with a capital cost of up to £5 million. For projects between £5 million and £10 million the CIG will, following the successful consideration of a Business Case, make a recommendation for approval to SGHSC Director of Finance and Information who has delegated authority to approve. In the case of schemes with a capital cost in excess of £10 million the CIG will make a recommendation to the Director General Health and Social Care.

The SGHSC Capital Investment Group (CIG) oversees the approval process for business cases across NHSScotland where the value of the capital project is greater than the delegated limit.

This role covers all infrastructure investment regardless of the ultimate funding route pursued by the procuring organisation.

By approving the business cases submitted to it, the CIG gives NHSScotland bodies the assurance of SGHSC support for the strategic justification for progressing capital schemes whilst sending a clear indication to the private sector of the projects which are supported by SGHSC. The CIG role is vital in providing the necessary assurances to both Scottish Ministers and SGHSC Management Board that proposals are robust, affordable and deliverable.

The CIG also acts as a forum for the development, promotion and distribution of best practice and guidance within capital planning and development whilst providing the SGHSC with an overview of the strategic direction of NHSScotland.

The chair is responsible for providing the secretary. Membership of the CIG is comprised of representatives from the following Directorates/Divisions/Branches of Scottish Government:

• Health Finance - Capital
• Directorate of Delivery and Performance
• Analytical Services (Economists)
• Primary Care Division
• Health Finance
• Information Management and Technology
• Chief Medical Officer Directorate
• Joint Improvement Team
• Chief Dental Officer

Advice and support on capital planning, procurement, construction and facilities management issues is also provided by NHS NSS and SFT.

Furthermore, and dependant on the nature of a particular case, relevant policy and clinical colleagues will also be consulted on the content of business cases.

CIG members play an important role and undertake to:

• To declare any conflict of interest that may arise in the course of a review as soon as it is identified
• To conduct and complete all reviews in a professional and efficient manner
• To conduct and complete all reviews within the timetable established
• To ensure attendance at CIG meetings and where this is not possible, to provide a deputy with sufficient authority to approve or reject business cases
• To ensure all business cases receive a consistent degree of scrutiny in accordance with the appended pro-forma and with best practice
• To review progress and Post-Project Evaluation reports and provide an overview report on projects, incorporating and disseminating lessons learned.

Within the CIG process Health Finance and Integration Team plays the following key roles

• To place the dates of the CIG meetings, and dates for the submission of business cases on the Capital Planning website
• To acknowledge receipt of a business case the same day it is received
• To circulate the agenda, business cases and any relevant papers in advance of the CIG meeting
• To record the minutes and decisions of the CIG meetings
• To circulate the minutes, decisions and recommendations of the CIG meetings to SGHSC Management and appropriate Scottish Minister(s)
• To maintain a record of the progress of endorsed projects
• To maintain a record of the progress of conditions attached to CIG decisions
• To ensure that public versions of the approved business case are submitted to the Scottish Parliamentary library (SPICe) within 1 calendar month of their approval
• To monitor receipt of Post Project Evaluation reports
• To maintain a record of issues raised, lessons learned and actions taken during the CIG process

NHSScotland Bodies identify and develop projects, ideally working closely with the SGHSC to access support and advice, and to evaluate the project and procurement options. This will include preparing where appropriate an Initial Agreement (IA), Outline Business Case (OBC), and Full Business Case (FBC) or Full Business Case Addendum (FBC(A)) for the project.
Prior to submission, NHSScotland bodies should discuss the timing of the submission of the business cases to CIG with Health Finance & Infrastructure section of Scottish Government.
For projects above delegated limits and with the exception of appointment of a Development Partner made under Frameworks Scotland NHSScotland Bodies are not able to commence the procurement process for a contractor until SGHSC approval is received for the appropriate outline business case.

All the business cases are circulated to the members of CIG to consider not only the content of the business case but also the deliverability of the project and to examine the extent to which the project matches the national, regional and local priorities as articulated in Local Delivery Plans and associated Property and Asset Management Strategies (PAMS). Each CIG member will focus on their specialist specific area of the business case, for example financial or clinical aspects, and submit their comments to Capital and Facilities in advance of the meeting. The CIG member can however comment on other aspects of the business case if he/she considers it appropriate.

Health Finance & Infrastructure will collate the comments, seeking further clarification from the NHSScotland Body if necessary, before the CIG meet to take a collective decision about the project. The CIG members, acting as a group, decide whether or not to approve the project, and if endorsed, make the appropriate recommendation to the Director of Finance or Director General, or seek the appropriate clarification from the NHSS Body(ies) on issues to be resolved prior to a recommendation for approval.

As from 1 January 2005 every person is now entitled to make a request for information to a public authority (such as a NHS Board) under the Freedom of Information Act.
The Freedom of Information Act aims to increase openness and accountability in government and across the Scottish public sector by ensuring that people have the right to access information held by Scottish public authorities. It also applies to companies wholly owned by a public authority and, if designated, it may even apply to private companies carrying out a function for a public authority, for example under a contract.

The Act applies to all recorded information, however old or recent, and whoever produced it. There is a strong presumption under the Act that information will be disclosed. However there are exemptions for key interests – eg commercially sensitive information, policy/internal deliberation.
Part 2 of the Act provides full details of these exemptions. This can be accessed at:
www.scotland-legislation.hmso.gov.uk/legislation/scotland/acts2002/20020013.htm

Guidance for Scottish public bodies on the implications of the Freedom of Information Act in relation to the procurement process and the release of information has been prepared by the Scottish Procurement Directorate and is available on the Scottish Government website at:
http://www.gov.scot/Resource/Doc/1265/0006892.pdf

NHS Boards must now consider the new powers available to the public for accessing information under the Freedom of Information Act. It is therefore advised that NHS Boards should ensure that all information relevant to the Business Case and contract is made accessible (the SPD guidance gives advice on timing of release). This includes the FBC Executive Summary and the “Plain English Summary” of the contract as well as all submitted annexes. This differs from current practice where supporting sections or annexes considered too technical or detailed may have been omitted.
Initial Agreements (IAs), Outline Business Cases (OBCs), Full Business Cases (FBCs) and contracts may still be edited to remove text of a commercially sensitive nature but it must be clearly stated in these documents what information has been excluded on the grounds of commercial confidentiality. Removal should be considered with reference to exemptions under the Freedom of Information Act. Any documents which contain references to suppliers must be cleared with the appropriate supplier(s) before publication.

Irrespective of the capital value of the project, IAs, OBCs and FBCs should be made publicly available no later than one month from the announcement of its approval, PPP contracts within one month of financial close.

For schemes in excess of £5 million, it is now mandatory for NHS Boards to set up a section of their website dedicated specifically to such projects. The approved Business Cases/contracts should be placed there together with as much relevant documentation and information as possible.

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As a general principle, the acceptance of confidentiality agreements by public bodies, other than in exceptional circumstances, is discouraged, and this applies equally to terms included in tender documentation and conventional contracts.
The inclusion of terms which restrict the disclosure of information relating to the contract beyond those restrictions permitted in the Act i.e. the information constitutes a trade secret or its disclosure under the Act would, or would be likely to, prejudice substantially the commercial interests of any person, should be strongly resisted.
If the NHS Board decides to disclose, and contractor/ bidder/supplier/ information is involved, the contractor/bidder/supplier should be informed of the decision prior to release where possible.

Where a contractor/bidder/supplier has been given the opportunity to identify sensitive material and has done so (and any declared period of sensitivity has not expired) consultation is needed if the request refers to that information. Where no sensitive material has been identified, consultation is not strictly necessary but as a courtesy it is recommended that the contractor/bidder/supplier be notified that a request has been made and given the opportunity to make representations if they so wish.

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The Act specifically applies to information and carries no duty to disclose discrete documents. Indeed care should be exercised when considering whether to release a document provided by a supplier to ensure that any potential copyright issues have been considered. Normally it will be acceptable in copyright terms for a copy of a document to be provided under the Act if that is the best or most reasonable way of providing the information, but in many cases, where disclosure is appropriate, it will be preferable to extract information from documents or possibly provide a summary, provided it satisfies the request