Scotland's health minister Susan Deacon has hinted that changes could be made to reduce the burden on trusts of preparing for Clinical Standards Board of Scotland reviews, the first of which was published last week.

This could include an overhaul of the type of data collected to 'strip out' duplication and unnecessary audit and the possibility of 'facility' arrangements to cover absences, she told HSJ.

But trusts in England do not expect any additional support or resources to prepare for future Commission for Health Improvement reviews, despite the additional workload.

While the CSBS standards were generally welcomed, some managers voiced concern that the process was not funded and relied on goodwill.

Lothian University Hospitals trust medical director Dr Charles Swainson said: 'Well over 100 people in the trust have been involved, most spending at least 10 hours. Put together with the other trusts across Scotland and That is thousands of hours. This is happening with no additional resources and I do not think it can be sustained at this level.'

CSBS chief executive Dr David Steel accepted that there was a great deal of work involved and said systems were constantly under review. He said the burden should ease as trusts built up the sort of information required. 'We know It is labour intensive, ' he said.

Trusts in England acknowledge that they are devoting significant amounts of time to CHI work, but expect that as time goes on they will find it quicker and easier to do.

Hilary Scholefield, director of nursing at University Hospitals Coventry and Warwickshire trust, which is still working on its action plan following a highly critical CHI review, admitted that workloads have been tough, with some senior staff having to put aside their day-to-day work in order to cope. But she added: 'It is important that this is done correctly rather than simply pushed through. We are all focused on making the improvements.'

Epsom and St Helier trust produced its action plan last week, following its highly critical CHI report. For new chief executive John de Braux, the workload involved was high. But having accepted the importance of the review and the role of CHI, he said it was also necessary.

A project manager was employed to oversee the review process and a similar post will probably be created to ensure the reforms are implemented.

Mr de Braux told HSJ: 'Trusts do see the need for audits and for the work of the other agencies and they can prepare for them.At least you get advance notice. It is really the endless questions from the centre which have a high workload which can be disruptive.'

Sue Davies, associate director of clinical development at Southampton University Hospitals trust, one of the four pilot sites for CHI reviews, said: 'It is not CHI in particular that causes those pressures; It is just the number of inspections that any trust like us has to face. I think there is a question about rationalising that process.

'I do not think It is necessarily going to be the same for us next time and there are administrative aspects of the process that will be streamlined. But although preparing for a review will perhaps be easier, I do not think the review as a whole will. CHI will want to raise standards next time around.'