HIS – Healthcare Improvement Scotland

united kingdom_flag  Glasgow, Scotland

"Healthcare Improvement Scotland values the opportunity to contribute to the work of the International health technology assessment (HTA) community, and to promote robust, evidence-based advice to improve healthcare decision-making and quality of care".
– Dr. Susan Myles, Professional Lead, SHTG, Director, HIS


History and Structure

Healthcare Improvement Scotland is a not-for-profit organisation. It is a health body whose purpose is to support healthcare providers in Scotland to deliver high quality, evidence-based, safe, effective and person centred care; and to scrutinise those services to provide public assurance about the quality and safety of that care.


The work programme of Healthcare Improvement Scotland directly supports Scottish Government priorities and health care decision making through an integrated cycle of improvement with patient focus and public involvement at the heart of all we do.

Our work programmes cover:

  • Evidence; we gather the strongest evidence to issue the best advice to healthcare professionals.
  • Improvement; we work with NHSScotland staff to put that advice into practice.
  • Scrutiny; we check that staff are following our advice and then publish reports on our findings.

Healthcare Improvement Scotland is the body in Scotland with statutory responsibilities in relation to HTA; specifically, ‘the evaluation and provision of advice to the health service on the clinical and cost effectiveness of new and existing health technologies including drugs’.

How Healthcare Improvement Scotland works

The HTA function within Healthcare Improvement Scotland underpins the evidence element central to the integrated cycle of improvement outlined. Three key groups are hosted or supported by the organisation to undertake medicine and non-medicine technology assessments and clinical guidelines respectively:

  • Scottish Health Technologies Group (SHTG)
  • Scottish Intercollegiate Guidelines Network (SIGN)
  • Scottish Medicines Consortium (SMC)

We also work in close partnership with the Scottish Patient Safety Programme (SPSP) and the Scottish Health Council (SHC).

Under its HTA programme, Healthcare Improvement Scotland works in close partnership with healthcare professionals across the service, other NHS agencies in Scotland, local NHS boards, academic institutions and the Scottish Government to ensure that the findings of technology assessments are fully contextualised to the systems of provision of healthcare within Scotland.

The HTA programme also has a history of effective engagement with patients and the public via voluntary agencies, charities, etc, and through a pool of Healthcare Improvement Scotland public partners. HTAs, systematic reviews and guidelines are normally summarised in a publication specifically written for patients and the public.

Brief summaries of the three groups hosted or supported by Healthcare Improvement Scotland to undertake medicine and non-medicine technology assessments and clinical guidelines respectively are outlined below:

Scottish Health Technologies Group (SHTG)
The remit of the SHTG is to provide independent advice on the evidence about the clinical and cost effectiveness of non-medicine technologies likely to have significant implications for patient care in Scotland. This advice supports the planning and decision making processes in NHS boards. SHTG produce a range of outputs, including: horizon scanning reports; health technology assessments, systematic reviews, rapid reviews; advice statements and innovative medical technology overviews (IMTOs).

Scottish Intercollegiate Guidelines Network (SIGN)
The aim of SIGN is to improve the quality of health care for patients in Scotland by reducing variation in practice and outcome, through the development and dissemination of national clinical guidelines containing recommendations for effective practice based on current evidence. SIGN also produces patient booklets, which explain the recommendations in the clinical guideline. The SIGN programme covers a wide range of topics, many of which relate to the NHS priority areas of cancer, cardiovascular disease, and mental health.

Scottish Medicines Consortium (SMC)
The SMC provides advice to NHS Boards and their Area Drug and Therapeutics Committees across Scotland about the status of all newly licensed medicines, all new formulations of existing medicines and new indications for established products.

This advice is made available as soon as practical after the launch of the product involved and provides a single source of timeous advice to support the planning and decision making processes in NHS boards.

SMC has a horizon scanning programme which supports financial planning in Health Boards across Scotland through the provision of early intelligence on new medicines in development.

SMC also hosts the Scottish Antimicrobial Prescribing Group; its primary objective is to co-ordinate and deliver a national framework for antimicrobial stewardship to enhance the quality of antimicrobial prescribing and management in Scotland.

Dissemination Activities for SHTG

The Healthcare Improvement Scotland website www.healthcareimprovementscotland.org is a key tool for disseminating information and capturing ideas and feedback. The site includes the work programme, processes, consultation papers and publications. Healthcare Improvement Scotland uses a direct mailing list and networks to disseminate its advice. It also participates in educational initiatives and facilitates workshops and seminars on methodological developments.

Current projects for SHTG

Work is currently underway on a number of non-medicine HTA projects, including:

  • HTA on the appropriate and cost effective use of interactive antimicrobial wound management products
  • IMTO on DySIS colposcopy for cervical screening.
  • Evidence note on patient self-monitoring of oral anticoagulation therapy (update of evidence note 50)

A number of new topic referrals are also being considered for inclusion in the work programme including; MRI-guided focused ultrasound surgery, extracorporeal shock wave therapy for acute and chronic wounds, the use of blood pressure monitoring machines in the home setting for hypertension and the Scopeguard® sheath for cystoscopic procedures.

Future Plans for SHTG

  • The IMTO process (formerly the primary submission process) which enables manufacturers and other stakeholders to make a direct case for the adoption and diffusion of a non-medicine technology within NHSScotland is currently being piloted.  The pilot process will conclude in summer 2015, and at that stage a comprehensive review of the IMTO process to-date will take place.
  • Healthcare Improvement Scotland is developing a strategic delivery plan for non-medicine technologies.
  • Developing methods to establish a proactive element within the SHTG work programme to ensure responsiveness to strategic developments and production of timely advice for NHSScotland.


Agency Information


Country: United Kingdom
Description of population served: National
Population served (mil): 5.1
Current HTA budget (mil USD): 0.7
Permanent staff: 12
Consultants: 0
Ongoing TA projects: 2

Contact Information

Director: Dr. Susan Myles, Professional Lead, SHTG
Contact person: Dr. Susan Myles, Professional Lead, SHTG

Healthcare Improvement Scotland
Delta House, 50 West Nile Street
G1 2NP Glasgow, Scotland United Kingdom

Tel: +44 141 241 6998
Fax: +44 141 248 3778
Internet: http://www.healthcareimprovementscotland.org
Email: Susan.Myles2@nhs.net