Health inequalities: Place and Wellbeing Programme Board minutes - August 2023

Attendees and apologies

• Linda Bauld (Chair), Chief Social Policy Advisor, Scottish Government
• Anna Baxendale, Head of Health Improvement, NHS Greater Glasgow and Clyde
• Bob Benson (deputising), Non-executive Board member, NHS Tayside
• Sam Cassels, Place Principle Advisor, Scottish Government
• Chik Collins, Director, Glasgow Population Health Centre
• Matt Lowther (deputising), Head of Communities and Local Partners, Public Health Scotland
• Gerard McCormack, Head of Transformation, Performance, and Improvement, Improvement Service
• Josh McGinlay (deputising), Senior Policy Officer, Scottish Government
• Dona Milne, Director of Public Health, NHS Lothian
• Niamh O'Connor, Deputy Director for Population Health Strategy and Improvement Division
• Denise Patrick, Portfolio Dashboard and Statistics lead, Scottish Government
• Susan Paxton, Director, Scottish Community Development Centre
• Sarah Thompson (deputising), Communities Team Leader, Wellbeing and Prevention, Scottish Government
• Kim Walker, National Programme Director, NHS National Services Scotland
• Craig Waugh, Statistician in Health and Social Care Analysis, Scottish Government
• Valarie White, Director of Public Health, NHS Dumfries and Galloway
• Arlene Reynolds, Senior Professional Adviser in Public Health, Scottish Government

Apologies

• Lorna Birse-Stewart, Chair, NHS Tayside
• Ellie Crawford, Primary Care, Scottish Government
• Angela Davidson, Deputy Director for Improving Mental Health and Wellbeing, Scottish Government
• Nicola Dickie, Chief Officer for Health and Social Care, Convention of Scottish Local Authorities
• Eddie Follan, Chief Officer for Health and Social Care, Covention of Scottish Local Authorities
• Susan Gallacher, Preventative and Proactive Care, Primary Care Programme Lead, Scottish Government
• Michael Kellet, Director of Strategic Planning and Performance, Public Health Scotland
• Lynn MacMillan, Head of Health Inequalities, Scottish Government
• Fraser McJannett, Programme Director, Executive Support Team, NHS Scotland
• Lynne Nicol, Deputy Director Planning and Quality, Scottish Government
• Gordon Paterson, Director of Social Care, NHS Education for Scotland
• Carol Potter,Chief Executive, NHS Fife
• Kerri Todd, Head of Health Improvement, NHS Lanarkshire

Items and actions

Welcome and apologies

Linda Bauld, Chief Social Policy Advisor with Scottish Government, opened the meeting and welcomed the members and guests to the Place and Wellbeing Programme Board. Deputies and guests were invited to introduce themselves. Apologies from Board members are noted at the bottom of the minutes.

Introduction

Linda Bauld provided the Board with an overview of the agenda and the noted areas in particular that the presenters would like to draw attention to.

Minutes from previous meeting

The minutes were approved by the Board.

Programme update

Emma Wylie, Programme Manager for the Place and Wellbeing Programme, from NHS National Services Scotland, provided a verbal overview of the key developments for the Place and Wellbeing Programme that has occurred since the last Programme Board.

The overall RAG status is green. Progress has been made towards key objectives. A few updates have been made to the key risk slides, which now includes a trend column to highlight any changes to ratings since the previous Board meeting.

A new section has been included within the Anchors Highlight Report to highlight key deliverables, which will be discussed further in the meeting. The Board were then asked for their views to see if they find the additional information helpful and would like the same approach taken for workstreams Enabling Local Change (ELC) and Communities.

The call was opened for comments. Bob Benson, Non-Executive Board Member of Tayside NHS Board, enquired how Place and Wellbeing Programme are keeping the Directors of Public Health (DPH) up to date. In discussion, Dona Milne, Director of Public Health, NHS Lothian, replied that she represents DPHs on the Board and sends an update around after each meeting to all DPHs. Kim Walker, National Programme Director, welcomed the inclusion of deliverables in the Highlight Reports, which in turn will help provide a beneficial insight to Programme development for the Care and Wellbeing Portfolio Board. Linda Bauld agreed with Kim Walker and agreed that the board would like the team would work up the deliverables for the other two workstreams.

Decision 8

• The Board agreed to include the deliverables and trend column to the Enabling Local Change, and Communities Highlight Reports for the next meeting

Anchors Workstream update

Úna Bartley, team lead for the Place and Wellbeing Programme, explained to the Board the aim of the Anchors workstream, then provided a verbal update on the latest developments since the last Programme Board.

Recent focus has been around identifying and consulting on an appropriate set of metrics, to help the Boards baseline where they are as Anchor institutions, in relation to procurement, land and assets, and workforce. The next steps are to agree a final set of metrics to be reviewed at the Anchors Delivery Group on 31 August, before being brought back to the Place and Wellbeing Programme Board for sign off.

The Anchors Communications Strategy that was signed off earlier this year is now at implementation stage, and work continues to identify the assets and platforms needed to update a wide range of stakeholders within NHS Boards, Scottish Government, and other interested parties. Public Health Scotland (PHS) involvement to communicate the work by use of Microsoft Teams and regular update sessions has made good process.

 A positive meeting was held with Procurement Task and Finish Group, and categories of spend by Boards that can realistically be local.

To support the Anchors workstream, test sites are in the process of being established with NHS Boards, to understand the enablers and barriers that prevent more local spending on goods and services, and greater use or disposal of land for community benefit.

Enabling Local Change Workstream update

Chris Stothart, lead for the Enabling Local Change workstream within the Place and Wellbeing Programme, introduced the ELC workstream, then provided a verbal update on the latest developments since the last Programme Board in June.

Contributions have been provided to the DG Communities team coordinating the Scottish Government’s response to the Parliamentary Committee’s post-legislative scrutiny of Part II of the Community Empowerment (Scotland) Act. A copy of the final letter will be shared with the Board.

A follow up meeting was held last week with key stakeholders to review and confirm the draft themes and activities from the June 6th discussion to recommend a set of deliverables for the next 6 to 12 months to the Place and Wellbeing  Programme Board and for stakeholders to also consider the need for a Delivery Group to oversee the work moving forward. A third meeting has been proposed to agree a final set of deliverables that were not finalised due to time constraints, to draft a workplan and to establish a Delivery Group for the work.

Five potential activities emerged from the discussion, which attendees felt could be progressed over the next 6 to 12 months. The first, focused on working with local partners and relevant networks to identify good practice examples and to better understand the barriers experienced locally. The second is to continue to collaborate with, support and learn from the pilot sites of the Localised Working Programme and the Shaping Places for Wellbeing Programme, and other relevant pilot/pathfinder sites. Third, prepare an entry on CPP working for the upcoming Annual Delivery Plan guidance that will be issued to health boards to support the development of 23/24 plans. Fourth, encourage health partner's involvement, using a health in all policies approach, to inform the development of plans led by other CPP partners. The final, fifth theme was to continue to engage with the lead CPP Policy team and to stay connected with a number of developments– Place Director role refresh, monitoring and accountability frameworks in light of VHA, and progressing recommendations from the Parliamentary Committee's report

As there was a general consensus to establish a Delivery Group to oversee the work, CS will look to seek approval from the Board to establish the Group at the next Programme Board. Updates will be provided on the planned tasks for the next reporting period to the Board.

The call was opened for comments. The Board were in support to learn more from other pathfinders, to help gain experience of conducting pilot projects across the wider portfolio landscape, and to have focus around the public service reform activity. The Board suggested that it could be beneficial to have people at corporate level of public health and strategic planning etc, to help steer initial conversations, to then at the right time invite other health specialist involvement on the ground. Anna Baxendale, Head of Health Improvement for NHS Greater Glasgow and Clyde, noted the joint strategic needs assessment requirement that was included in the recent Annual Delivery Plan guidance as a possible way to link this work up locally.

Action 12

• Chris Stothart to keep the Board updated on the planned tasks for the next reporting period for ELC

Care and Wellbeing Dashboard update

Denise Patrick, Portfolio dashboard and statistics Lead for Scottish Government, who is leading the development of the Care and Wellbeing Portfolio Dashboard, provided the Board with a presentation on how the Dashboard is structured and latest developments.

The purpose of the Dashboard, which is based around the Marmot framework, has been designed to be a tool to support the Portfolio by providing access to the latest data to help monitor progress in population health outcomes and health inequalities. The Dashboard is to be used at national and local level and help provide that evidence to understand if outcomes are improving or not. One part of the Dashboard enables the user to look at health trends in Scotland across a number of domains with indicators selected to understand improvement within each domain (ie. Life expectancy).

Good progress has been made on the Dashboard’s development. PHS has published updates to various indicators to ensure the availability of the latest data and also the inclusion of equality breakdowns where possible. Work is underway to look at hosting the Dashboard under the Scottish Public Health Observatory (ScotPHO) platform in the longer term, which has similar focus on the requirements of the Care and Wellbeing Portfolio Dashboard.

The next steps will comprise of indicator reviews i.e. the testing of the Care and Wellbeing Portfolio indicator set, user engagement by building relationships and shared learning, and the oversight of developments of the Dashboard through the established Care and Wellbeing Portfolio Analysis Oversight Group and the ScotPHO Steering Group.

The call was opened for comments. Linda Bauld noted that the limitations that are currently impacting the Dashboard data is the frequency of data, where the majority are annual, and the level of information that the data can drill down to. Denise Patrick explained how the ScotPHO platform will help overcome challenges due to the vast range of indicators available. Engagement from Care and Wellbeing Portfolio programmes and local partners is required to help shape the detailed monitoring at policy level. Sam Cassels, Place Principle Advisor, Scottish Government, expressed interest in stage of development that the Dashboard can be used to develop local and national plans. Denise Patrick noted that some data is available to partners but there are some indicators that may not have all the data, which still need to be developed. Matt Lowther, Head of Communities and Local Partners, Public Health Scotland, flagged particular interest in the place outcomes indicators, which both points will be picked up further with Denise Partrick.

Localised Working Programme update

Valerie White, Director of Public Health for NHS Dumfries and Galloway, and Matthew Lowther provided a presentation on the Localised Working Programme (LWP), sharing year one learning from pathfinder sites and PHS, and describing next steps.

Work has been ongoing since 2022 which has brought together various expertise at local and national level, and around CPPs. An enhanced support model has been used through three pathfinder sites, which are progressing at difference paces. An Oversight Group has been established to provide leadership and support to the pilots. A year one learning report was signed off on 5th May 2023.

Overall, the LWP work has worked well, with the aid of transparency and building of trust and the inclusion of senior level buy-in. LWP are currently working through understanding the respective roles of PHS and local public health teams, and who is working where and why. A wide range of project requests have been received, which will help provide insights into how the LWP might need to restructure to support the work.

The next steps include gaining input from the new Chief Exec for PHS Scotland, Paul Johnston, and the new Director of Place and Wellbeing, Ruth Glassborow, who are both committed to the PHS work with local colleagues. LWP are keen to look at other models that are in place outside of the current work, possibly topic-based.

The call was opened for comments. Dona Mline emphasised the importance of understanding the engagement and relationships between local authorities and COSLA and how they work together. Linda Bauld agreed with the comment made by Dona Milne and highlighted the need to keep all parties up to speed with developments.

Action 13

• Programme Team to circulate the CWP Dashboard, and LWP slides to the Board

Community-led Health and Wellbeing update

Kimberley Smith, Communities Workstream lead for the Place and Wellbeing Programme, provided a verbal update on the Communities workstream.

The Communities Core Group who supports the delivery of the work plan, met in June to discuss options for local stakeholder engagement. The purpose of the engagement would be to test the understanding learned from national representatives with local organisations to help steer the required actions and priorities. An update on the approach will be provided at the next Programme Board in October.

The engagement work at national level continues which included the attendance at a recent Third Sector Interface Chief Officers Network meeting. A meeting is also planned on 9 August with the Community Health Assets project which is examining how community-led organisations use asset-based approaches to improve health and wellbeing.

The grant mapping exercise is almost complete and recommendations for actions will be shared at the next Programme Board in October.

The call was opened for comments. Linda Bauld stated that there will be a deep dive on Communities at the next Programme Board in October. Sarah Thomson, Communities Team Leader for Wellbeing and Prevention team, Scottish Government, highlighted the challenges faced by community organisations in securing funding and made reference to the identified risk on internal buy-in and the importance of this.

AOB

Niamh O’Connor, Deputy Director of Population Health Directorate, Scottish Government, provided an update for the Board’s awareness on the recent developments at Portfolio level, notably support from the Cabinet Secretary for NHS Recovery, Health and Social Care to produce a 10-year Population Health Plan.

The Cabinet Secretary is content that this work progresses under Place and Wellbeing as a fourth workstream. A meeting is scheduled with the Cabinet Secretary at the end of September. Discussions around co-producing the plan with Public Health Scotland are in the early stages. A Directors of Public Health Development session is scheduled in September, which will provide an opportunity to have an early discussion on approach to developing a long term plan.

Linda Bauld thanked Niamh O’Connor for the update and stressed the importance of having strong focus on the issued raised, with co-creation being an absolute key. Linda Bauld also thanked all who contributed to the meeting and summarised the key focus for the next Programme Board.