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

Attendees and apologies

• Linda Bauld (Chair), Chief Social Policy Advisor, Scottish Government
• Chik Collins, Director, The Glasgow Centre for Population Health
• Angela Davidson, Deputy Director for Improving Mental Health and Wellbeing, Scottish Government
• Susan Gallacher, Preventative and Proactive Care, Primary Care Programme Lead , Scottish Government
• Ruth Glassborow, Director of Place and Wellbeing, Public Health Scotland
• Vicki Harris (deputy), Primary Care Strategy Team Lead, Scottish Government
• Calum Irving, Deputy Director, Strategic Third Sector and Public Service Leadership, Scottish Government
• Lynn MacMillan, Head of Health Inequalities Unit, Scottish Government
• Sam Martens (deputy) , Policy and Business Analyst, NHS National Services Scotland
• Gerard McCormack, Head of Transformation, Performance, and Improvement, Improvement Service
• Shelia McCole (deputy), Non-executive member, NHS Tayside
• Niamh O'Connor, Deputy Director of Strategic Capability Division, Scottish Government
• Gordon Paterson, Director of Social Care, NHS Education for Scotland
• Susan Paxton, SDSC Acting Director, Scottish Community Development Centre
• Kerri Todd (also representing Donna Milne), Head of Health Improvement, NHS Lanarkshire

Apologies

• Arlene Reynolds, Senior Professional Adviser in Public Health, Scottish Government
• Carol Potter, Chief Executive, NHS Fife
• David Cowan, Head of Regeneration, Architecture and Place Unit, Scottish Government
• Dona Milne (Kerri Todd representing), Director of Public Health, NHS Lothian
• Eddie Follan, Chief Officer Health and Social Care, COSLA
• Ellie Crawford, Primary Care, Scottish Government
• Fraser McJannett, Programme Director, Executive Support Team, NHS Scotland
• Lorna Birse-Stewart, Chair, NHS Tayside
• Lynne Nicol, Deputy Director of Planning & Quality, Scottish Government
• Margo Murphy, Anchors Lead for Place and Wellbeing Programme, Scottish Government
• Marion Bain, Deputy Chief Medical Office, Scottish Government

Items and actions

Welcome and apologies

Linda Bauld, Chief Social Policy Advisor, Scottish Government, commenced the meeting and welcomed the members and guests to the Place and Wellbeing Programme Board. Membership changes were noted - Marion Bain, Deputy Chief Medical Office, Scottish Government, has replaced Arlene Reynolds, Senior Professional Adviser in Public Health, Scottish Government, and Sam Martens, Policy and Business Analyst, NHS National Services Scotland has replaced Fraser McJannett, Programme Director, Executive Support Team, NHS Scotland. Sheila McCole, (deputy), Non-executive member for NHS Tayside, has replaced Bob Benson, non-executive member for NHS Tayside, as the new deputy for Lorna Birse-Stewart, Chair, NHS Tayside. 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 Board meeting

With the exception of a role title amendment, the minutes from the meeting on 10th October were approved by the Board.

Programme update

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

Workstream activities are currently seen as on track. The Community Core Group met on the 2nd of November to discuss national engagement. The Group’s next workshop on 14th of December is to discuss local engagement findings. The initial Population Health Plan (PHP) workshop held in November to begin discussions on what new policies, approaches or actions could feature within the PHP. Further workshops are planned, the next one scheduled on 15th December.

Work continues to mitigate the existing programme risks with an aim to reduce the scores down. There are no new risks to report.

The call was opened for comments. Kerri Todd, Head of Health Improvement, NHS Lanarkshire, asked if the invites for the second PHP workshop has been extended to colleagues outside Scottish Government. Lynn MacMillan, Head of Health Inequalities, Scottish Government, replied that several meetings have been held with for example, local government, Directors of Public Health, NHS Board Chief Executives and NHS Board Chairs to discuss PHP. The current workshops are being held with policy leads to look at an integrated approach to health harming activity.

Overview of Anchors Strategic Plans

Úna Bartley, team lead for the Place and Wellbeing Programme within Scottish Government, provided an overview of the Anchor Strategic Plans received from NHS Boards to date, and proposed next steps in providing feedback and support to Boards to help them to progress their plans.

All Boards understood the concept of an anchor institution and how it would help tackle health inequality. Many plans were contextualised with information on their local population. A number of the larger Boards in urban areas are already working with other local anchors. At least half of the Boards had used the progression framework, which had been developed by PHS.

Several Boards had good governance structures in place and recognised the importance of working with their local community planning partnerships and local employability partnerships.

Most plans had more detail and focus on the workforce and procurement strands. The area deemed the weakest part of the plans was around the land and assets strand.

Úna Bartley proposed that initial feedback be given to NHS Boards in January with meetings held in February with any Boards where their plans fell short of minimal requirements. After the baseline data is submitted by Boards in March 2024, meetings will be set up in April and May to discuss their plans. These discussions will also help to focus any ask in the 2024/25 Annual Delivery Plan guidance.

The call was opened for comments. Angela Davidson, Deputy Director for Improving Mental Health and Wellbeing, Scottish Government, queried if a lack of focus on priority groups around workforce in the plans could potentially cause issues on understanding how the Boards are supporting the Child Poverty agenda. Úna Bartley responded that following the last Programme Board meeting, Boards have been asked to provide information on which of the priority family groups they are targeting through their employability work. Ruth Glassborow, Director of Place and Wellbeing, Public Health Scotland, noted that they have aligned their child poverty, workforce and anchor teams together which will help progress the child poverty agenda.

Sheila McCole, Non-executive member, NHS Tayside, asked what engagement there is with local authorities given their experience in asset transfers. Kerri Todd, Head of Health Improvement, NHS Lanarkshire also highlighted that many Local Authorities are further ahead in developing community wealth building than NHS Boards. Úna Bartley noted that a key expectation is that Boards will develop partnerships at a local level with local authorities and others to avoid duplication of effort and to learn from existing good practice, especially in relation to asset transfers and workforce.  It was also noted that this will be a key area of focus for discussion with Boards when Susan Gallacher, Preventative and Proactive Care, Primary Care Programme Lead , Scottish Government, meets with them next year to discuss their ASPs but noted the ASP was there to highlight NHS Boards role on leadership and responsibility in meeting the Anchors requirements.

It was noted that community groups may find it confusing to identify who to engage with to discuss accessing and taking on NHS assets. Director, The Glasgow Centre for Population Health, asked about the expectation of NHS Boards as anchor institutions and if any analysis has been done to understand the potential impact on outcomes. Úna Bartley noted that PHS are hoping to undertake an evaluability assessment of the Anchors workstream, which will help us have an understanding of potential impact.

Gordon Paterson, Director of Social Care, NHS Education for Scotland highlighted the work being done by NHS Education for Scotland (NES) on child poverty as part of the United Nations Convention on the Rights of the Child (UNCRC) then queried if NHS Boards as Anchors have taken this into consideration. Úna Bartley noted to take this away for consideration.

Enabling Local Change Delivery Group Meeting Outcomes

Chris Stothart, Enabling Local Change Lead for Place and Wellbeing Programme, provided the Board with an update on the outputs from the initial ELC Delivery Group (ELCDG) which was held on 28th November.  The initial meeting went well with good representation and participation from organisations and networks. Work continues to understand if representation from Health Improvement Scotland (HIS) is required.

Objectives two and three continue to be reported via this Workstream and to the Programme Board, however they will be led separately by their respected groups. These objectives are still important dependencies that will impact on Objective 1.

The Terms of Reference were updated to clarify and define the groups role and accountability structures. The Community Planning Improvement Board (CPIB) has asked for representative to sit on this delivery group going forward. There is focus on the government structures to understand where members are representing across different Boards and Groups.

Work will be done with the Chair to reflect on the discussions and update the delivery plan accordingly in preparation for the next meeting, to be held in February 2024. An entry on Community Planning has also been included within the 24/25 ADP Guidance.

AOB

No AOB was raised. Linda Bauld thanked the Board for their contributions and also encouraged the Board to review the Highlight Reports for the workstreams and mentioned the upcoming change of lead for Communities.

The next Programme Board meeting will take place on 15th February 10.30 – 12:00.