Major service change reports

Major service change reports

The guidance followed in publishing this report has since been superseded by the Planning with People guidance

NHS Lanarkshire's consultation on the replacement or refurbishment of University Hospital Monklands

This report sets out our assessment of whether NHS Lanarkshire's engagement and consultation process for the replacement or refurbishment of University Hospital Monklands followed Scottish Government guidance, which requires that NHS boards seek, listen to and act on the views of potentially affected people and communities when proposing changes to services.

Our report reflects the position up until the end of NHS Lanarkshire's public consultation (15 October 2018). We assessed the process through the feedback received directly from patients, the public and other stakeholders, our attendance at public meetings, and other information available to us.

Based on the evidence outlined in this report, our view is that NHS Lanarkshire has partially followed the national guidance set out by the Scottish Government.

A report on NHS Lanarkshire’s consultation on the Replacement or Refurbishment of University Hospital Monklands
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File type: pdf
File size: 2 MB
Publication date: June 2019

A number of matters remain outstanding: the engagement process and the range of consultation activities undertaken by NHS Lanarkshire enabled local people to be informed about and give their views on the proposals. Through this process, a number of questions and concerns were raised by people about the basis on which options were assessed. Further work is currently being undertaken by NHS Lanarkshire in response to these concerns, and we consider it will be important for NHS Lanarkshire to engage further with local people once this work is complete.

Our view is that the requirements of the national guidance will not be fully met until this further work and engagement is progressed, in order that the views of local people in respect of this further activity can be understood and can inform any decisions which may subsequently be made regarding the proposals.


We recommend that in order to meet the requirements of the national guidance, NHS Lanarkshire should:

  1. Review the outcome of external assurance activities e.g. assessment of decontamination and groundwork costs, travel times in the travel and transport analysis, and consider whether this may require revisiting the option appraisal process if there are any material differences in relation to information that has been used to assess the options.
  2. Complete and publish a full, updated, equality impact assessment that takes into account the evidence received through the public consultation together with appropriate demographic and socio-economic information, and sets out any proposed mitigating actions to take account of potential adverse impacts on any groups.
  3. Communicate the additional external assurance work that has taken place to respond to the concerns raised during consultation and the outcome of this activity. This should include consideration of alternative options that have been put forward by respondents during the consultation.
  4. Engage with local people and communities in relation to this additional information to ensure their views are understood and can be fully taken into account when any decisions are being made.


In June 2019, an Independent Review Panel published its findings on aspects of NHS Lanarkshire's consultation on the Monklands Replacement/Refurbishment Programme.

In response to the recommendations from both the Independent Review Panel and our assessment, NHS Lanarkshire undertook further engagement, including option appraisal on the most suitable location for the most suitable Monklands Replacement Project.

We published a follow-up assessment report in November 2020.

Last Updated: 15 November 2021