Development of the standards

Healthcare Improvement Scotland has established a robust process for developing standards, which is informed by international standards development methodology.⁵⁶ This ensures the standards:

are fit for purpose and informed by current evidence and practice
set out clearly what people who use services can expect to experience
are an effective quality assurance tool.

The standards have been informed by current evidence, best practice recommendations, national policy and are developed by expert group consensus. The standards have been co-created with key stakeholders and people with lived experience from across Scotland.

Evidence base

A review of the literature was carried out using an explicit search strategy developed by Healthcare Improvement Scotland’s Research and Information Service. Additional searching was done through citation chaining and identified websites, grey literature and stakeholder knowledge. Searches included Scottish Government, PHS, NICE, SIGN, NHS Evidence and Department of Health websites. This evidence was also informed equalities impact assessments.

Standards are mapped to a number of information sources to support statements and criteria. This includes, but is not limited to:

government healthcare policy
approaches to healthcare delivery and design, such as person-centred care
clinical guidelines, protocols or standards
professional or regulatory guidance, best practice or position statements.

Standards development

The development of standards is underpinned by the views and expectations of health care staff, third sector representatives, people accessing the service and the public in relation to gender identity services. The standards development process included:

scope consultation held in January 2023
three development group meetings held between May and September 2023
an editorial review panel meeting in November 2023
13 week consultation on draft standards
final development group meeting in April 2024
final editorial review panel meeting in July 2024.

Information about the development group and editorial panel is set out in section The standards development group and editorial panel.

Consultation feedback and finalisation of standards

Following consultation, the standards development group reconvened to review the comments received on the draft standards and make final decisions and changes. More information can be found in the consultation feedback report, which will be available from Healthcare Improvement Scotland website.

Quality assurance

All development group members were responsible for advising on the professional aspects of the standards. People with lived experience provided input based on their experiences of accessing or waiting to access services. Third sector organisations provided input based on their work with and their knowledge of the experiences of people accessing or waiting to access services. Clinical members of the development group advised on clinical aspects of the work. The chair had lead responsibility for formal clinical assurance and sign off on the technical and professional validity and acceptability of any reports or recommendations from the group.

All development group members made a declaration of interest at the beginning of the project. They also reviewed and agreed to the development group’s terms of reference. More details are available on request from his.standardsandindicators@nhs.scot.

The standards were developed within the Operating Framework for Healthcare Improvement Scotland and the Scottish Government (November 2022). Through independence and transparency, we adhere to the principles of openness, honesty, learning support and constructive challenge to deliver the priorities of Scottish Government.

For more information about Healthcare Improvement Scotland’s role, direction and priorities, please visit: www.healthcareimprovementscotland.org/