Excellence in Care Quality of Care Review Guidance Evaluation: May 2026

Executive summary

Background

Quality of Care (QoC) reviews help make sure people receive safe, high-quality care that meets their needs. The Excellence in Care (EiC) programme created national guidance to help health boards across Scotland carry out these reviews in a consistent way. The Quality of Care (QoC) Review Guidance was published in September 2024. A year after its launch, we wanted to understand:

  • how people are accessing and using the guidance.
  • what supports or limits its use.
  • whether it is helping improve care.

How did we evaluate it?

We looked at how many people have accessed the guidance including visits and downloads. We also gathered feedback from users and stakeholders through surveys and interviews and reviewed local and national reporting. Bringing these sources together helped us understand how the guidance is working in practice and what factors influence its impact.

What did we find?

  • Health boards use the guide in different ways. Some have started slowly, some have added it to their local governance processes, and others have used it during leadership assurance visits.
  • Some boards changed their own tools to better match the guidance. Others asked people from other health boards to review their work to make the process more objective.
  • Digital tools like the CAIR dashboard were helpful, but users said they want easier templates
  • and clearer instructions on the Right Decision Service (RDS) platform where the guidance is hosted.
  • Leadership support makes a big difference. When leaders are involved, the guidance is adopted more quickly.
  • Staff said the guidance feels supportive. It helps create a safe space to share good practice and concerns and feels more like learning than inspection.
  • The guidance works in many settings, like hospital wards and nursing homes. People would like more examples for different services.
  • Allied Health Professionals (AHPs) are involved in some areas, but not all. More support is needed to include them consistently.
  • Challenges to adoption of the guidance include:
    • leaders being busy or changing roles
    • limited staff time
    • difficulty fitting the guidance into existing systems
    • issues with accessing or using data
  • Despite these challenges, boards reported improvements in areas such as:
    • staffing
    • communication
    • nutrition
    • falls rates
    • patient experience

What we learned

The QoC Review Guidance is becoming a well-used and valued tool across Scotland. It supports assurance, teamwork, and improvements in safety, staff development, and patient experience. The following elements could enable services to build on current progress:

  • Make the guidance easier to use: Improve the digital platform and develop editable templates that boards can adapt locally.
  • Support involvement from all professions: Provide examples and guidance for specialist and multidisciplinary settings.
  • Share learning: Continue to use EiC networks and Board Clinical Leads to share innovation so boards can learn from each other.