The Scottish government says there "are no current plans" for Scotland's three cancer networks for West, East and North Scotland to be included in the reorganisation of the NHS into two subnational regions. However, ministers have indicated that the creation of a North of Scotland regional medicines formulary might now not go ahead.

Last November, the Scottish government issued instructions to NHS boards requiring them to move from a three region planning and collaboration approach – made up of groups for the West, East and North of Scotland – to two subnational planning structures for a Scotland East and Scotland West.

In the process, the previous North Region bringing together six NHS boards – NHS Highland, NHS Grampian, NHS Tayside, NHS Western Isles, NHS Orkney and NHS Shetland – to serve the needs of 1.4 million people, was scrapped.

Separately, three regional cancer networks had developed. The West of Scotland network (WoSCAN), centred on the Beatson in Glasgow; the Edinburgh Cancer Centre serving three NHS boards – NHS Lothian, NHS Fife and NHS Borders – making up the Southeast Scotland Cancer Network (SCAN); and the North of Scotland Cancer Network, later renamed the North Cancer Alliance.

In answer to a parliamentary question from Highland MSP, Tim Eagle, health secretary Neil Gray clarified that arrangements for NHS Highland, NHS Grampian an NHS Tayside, centred on cancer services at Raigmore in Inverness, Aberdeen Royal Infirmary and Ninewells in Dundee, will remain as they are.

In his answer, Mr Gray stated:

‘DL (2025) 25, Implementation of Sub-National Planning: Co-operation and Planning Directions 2025 came into force on 13 November 2025. This document requires health boards to organise themselves into two collaborative sub-national structures – Scotland East and Scotland West – to co-operate in planning and delivering the objectives specified in the Directions. The objectives stated in the directive are as follows:

• ‘Treatment time guarantee for orthopaedic elective care services’
• ‘Emergency healthcare services’
• ‘Once for Scotland approach to business systems’
• ‘Mycare.scot service’

‘There are no current plans for cancer services to be organised within this subnational structure.

‘The Scottish government and the newly established National Scottish Cancer Collaborative (previously Scottish Cancer Network) continue to work closely with the three regional cancer networks, Southeast Scotland Cancer Network, West of Scotland Cancer Network and the North Cancer Alliance, to align on national direction and to provide for once for Scotland solutions where appropriate.’

A North of Scotland formulary?

In late 2014, the first chapters of a joint East Regional Formulary went live providing advice for prescribers across NHS Lothian, NHS Borders and NHS Fife.

Work to create unified advice for the West, comprising NHS Greater Glasgow & Clyde, NHS Lanarkshire, NHS Forth Valley, NHS Ayrshire & Arran, and NHS Dumfries & Galloway – with a population of 2.7 million people – is well underway.

Highlands and Islands MSP, Tim Eagle, asked what impact the move to two subnational planning structures for the West and East of Scotland will have on plans to create a North regional medicines formulary to complement those for the East and West.

In her response, Minister for Public Health and Women’s Health, Jenni Minto MSP indicated that NHS boards may now rethink their plans.

In her written answer, Ms Minto stated:

‘This work is being taken forward by health boards using a regional collaborative consensus model, which builds upon proven existing local governance and decision-making processes for formulary development.

‘Work to establish a formulary for the north region has not yet begun, however, as the new sub-national planning structures are implemented, we expect health boards to evolve their approach to regional formulary work and consider the possible impact this will have on both the established and developing regional formularies.’

Read more about the subnational NHS regions: New directions to NHS on staffing and deficits; Staff express concern over latest NHS reform plans; NHS boards told to collaborate as two regions

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