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

Attendees and apologies

• Linda Bauld (Chair), Chief Social Policy Advisor, Scottish Government
• Sam Cassels, Place Principle Advisor, Scottish Government
• Ellie Crawford, Primary Care Strategy Unit, Scottish Government
• Eddie Folan, Chief Officer for Health and Social Care, COSLA
• Jacqui Jensen (Deputising), Community Council member, North Inch and Muirton Council
• Michael Kellet, Director of Strategic Planning and Performance, Public Health Scotland
• Dona Milne, Director of Public Health for NHS Lothian
• Niamh O'Connor, Deputy Director for Population Health Strategy and Improvement Division
• Gordon Paterson, Director of Social Care, NHS Education for Scotland
• Susan Paxton, Director, Scottish Community Development Centre
• Arlene Reynolds, Senior Professional Advisor in Public Health, Scottish Government
• Joanna Swanson (Deputising), Person-centred and Quality team, Scottish Government
• Sarah Thomson (Deputising), Communities Team Leader, Scottish Government
• Kerri Todd, Head of Health Improvement, NHS Lanarkshire

Apologies

• Naureen Ahmad, Deputy Director for General Policy, Scottish Government
• Marion Bain, Public Health Advisor, Scottish Government
• Lorna Birse-Stewart, Chair, NHS Tayside
• Chik Collins, Director, Glasgow Centre 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
• Lynn MacMillan, Head of Health Inequalities Unit, Scottish Government
• Gerard McCormack, Head of Transformation, Performance and Improvement, Improvement Service
• Fraser McJannett, Programme Director, Executive Support Team, NHS Scotland
• Lynne Nicol, Deputy Director Planning and Quality, Scottish Government
• Carol Potter, Chief Executive, NHS Fife

Items and actions

Welcome and apologies

The Chair opened the meeting and welcomed the members and guests to the Place and Wellbeing Programme Board. Apologies from Board members are noted at the bottom of the minutes.

Introduction

Linda Bauld, Chief Social Policy Advisor with Scottish Government, noted that she was pleased to be taking on the role as Chair for the Place and Wellbeing Programme Board and thanked Elizabeth Sadler, Deputy Director for Vaccine Policy with Scottish Government, and Board members for their support through the previous meetings. Emma Wylie, new Programme Manager for the Place and Wellbeing Programme, from NHS National Services Scotland, was asked to provide an overview of the recent changes to membership.

Emma Wylie noted the changes to membership. Marion Bain, Deputy Chief Medical Officer within Scottish Government, is now a member of the Care and Wellbeing Portfolio Board and has appointed Arlene Reynolds, Senior Professional Adviser in Public Health within Scottish Government, to replace her position on the Programme Board. We are currently looking at Mary McAllan’s steer, Director of Covid Recovery and Public Service Reform within Scottish Government, to replace former member Jane O’Donnell, previously the Deputy Director for Local Government and Analytical Services within Scottish Government, who has moved back to COSLA as their new Chief Executive.

Michael Kellet, Director of Strategy, Governance and Performance at Public Health Scotland has attended the Board to represent Public Health Scotland until the new Director for Place and Wellbeing is in position. Ruth Glassborow, will take over from Michael Kellet on the Programme Board from September as the Director of Place and Wellbeing at PHS.

Minutes from previous meeting

Overall, the minutes were approved by the Board. Arlene Reynolds has a few comments that will be fed back by email.

Programme update

Emma Wylie provided an overview of the Place and Wellbeing Programme highlight reports and the key developments that has occurred since the last Programme Board. The Communities Core Group have agreed Terms of Reference and are reviewing options for wider stakeholder engagement. In the Anchors workstream, the metrics work continues where analysts are consulting on available data to support the NHS Boards.

Focus continues with Community Planning Partnerships for the Enabling Local Change workstream who met with Community Planning improvement boards to explore ways to build ties between various boards to enhance health contribution.

There are several key Programme risks, particularly around funding and resource availability which may impact the priority level for Anchors.

Emma Wylie clarified that due to the issue around funding and the involvement required from various strands and the limited time they have to progress the actions; extra support is being pursued to assist with the work.

Enabling Local Change update

Chris Stothart, Enabling Local Change Workstream Lead, provided an overview of workstream progress since the last Programme Board. Various engagements have taken place with workstreams and stakeholders to help raise awareness of the work underway and make key connections. Through several of these engagements, Chris Stothart was able to identify representatives from several organisations and networks to contribute to and inform the workstream through the key stakeholder group.

Since April, two Localised Working Programme Oversight Group meetings have taken place. The first reviewed and confirmed the draft summary report. This report, which will soon be available to share, captures progress and learning across the three pathfinder sites during phase one, outlining variation in activities at each site and identifying early benefits.

The second meeting focused on governance and next steps, with members recommending to continue supporting the three pathfinder sites. As an intro to this agenda item, Linda Bauld shared how at a recent public health system leadership catch up, it was agreed that over time it may make sense for the Localised Working Programme to come under and report through this workstream, possibly by autumn. Chris Stothart will work with leads to explore this further.

To support the work required to strengthen health’s contribution to Community Planning Partnerships, a meeting was held with various stakeholders which included Public Health Scotland, Improvement Service, Community Planning Managers Network and Health Promotion Managers. From the meeting’s conversations, five key themes were drawn out, which are now being drafted out as proposals. Work is ongoing to draw out specific activities under each theme and to inform the direction of travel for the workstream over the next few years.

Linda Bauld asked for any thoughts from the Board. Ellie Crawford, Primary Care Strategic Unit Head within Scottish Government comment was in relation to theme four and asked what is in place to address common issues or challenges that impact Community Planning Partnerships, and the health-related space. A question from Dona Milne, Director of Public Health at NHS Lothian, was on what consideration is being given to how Community Planning Partnerships function, describing challenges with health offers not being taken up. Dona Milne suggested participation in Community Planning Partnerships may not be the best use of acute colleague’s time and that it would be worth the group considering this further before pursuing.

Sam Cassels, Place Principle Advisor within Scottish Government, queried the level ambition for this work and importance of key stakeholders’ contributions and commitment to the work, which starts by getting the right people in the same room to take the work forward. Sam Cassels felt health could play a greater leadership role in Community Planning Partnerships and would like to see that worked through further. Michael Kellet agreed with the comments made by Ellie Crawford and Sam Cassels and raised concerns about the amount of time needed to define what good looks like, which may delay progress. Michel Kellet recommended being bold around governance to bring similar workstreams, like Localised Working Programme, under this workstream as soon as possible to help unify.

Action 5

• Chris Stothart to discuss with the key stakeholder group the common issues or challenges that may impact Community Planning Partnerships, specifically in the health-related space

Action 6

• Chris Stothart to seek examples of the successful work achieved within Community Planning Partnerships from the Health Promotion Managers Network and to capture and describe evidence of both the process and outcomes of health’s contribution to Community Planning Partnerships

Decision 7

• the Board endorsed the paper with the acknowledgement of further actions needed

Community-led Health and Wellbeing engagement approach

Kimberley Smith, Communities Workstream Lead, and Susan Paxton, Director for the Scottish Community Development Centre, provided a verbal update on the Communities workstream. There has been a good response to an internal grant mapping survey that was issued to policy teams across the Health and Social Care Directorate within Scottish Government. The report from the survey, with recommendations for next steps, will be brought for discussion at the Programme Board in October. The team are also aligning with Scottish Government’s Commercial Value for Money team to influence grant-making practice across government.

A meeting with Common Health Assets is scheduled in August to agree alignment with the current project as well as a potential larger research project currently applying for funding – with a specific link being made to community organisations trusted by minority ethnic communities. An update on progress will be provided to the Board in the autumn.

The Terms of Reference for the Communities Core Group has been agreed and will be shared with the Board. The first action for the Group is to agree a local engagement approach to gather evidence on how we address the challenges the community and voluntary sector faces. This process will build on what we already know, and the Group is using the Visioning Outcomes in Community Engagement (VOiCE) software to frame the engagement process. A full engagement strategy will be brought to the Board at a later date.

Action 7

• Susan Paxton to share the agreed Communities Core Group Terms of Reference with the Board

Action 8

• members to share any examples of local partnership working with the team

Action 9

• Susan Paxton to contribute to the overall deliverables template for the Programme (along with the other workstream leads) for reporting into the Care and Wellbeing Portfolio Board, to be shared with the Programme Board at the next meeting

Monitoring and evaluation for Anchors

Katherine Myant, Analytical Unit Head with Scottish Government, provided an update on the progress made to date and next steps. A set of metrics is in train across the three strands of Anchors (Workforce, Land and Assets, and Procurement). The first step in doing this was to develop a set of criteria for the metrics which was agreed by the Anchors Delivery Board. In terms of current progress, a set of draft metrics has been developed for procurement but there have been some challenges with land and assets and workforce which are currently being worked through with the aim of having draft metrics available for both within the next couple of weeks.

There are plans for draft metrics to be tested on specific health boards over the summer, which will help to identify practical issues in the process to gather data. The next steps are to take the tested metrics to the Anchors Delivery Group in August for sign off; then subsequently be brought to the Programme Board in October for formal sign off.

Anchors are also working with Public Health Scotland on evaluation at a national level. Public Health Scotland are currently considering completing the theory of change and the possibility of undertaking an evaluability assessment for the workstream.

Linda Bauld asked for clarification on the qualitative approach to developing metrics that was being proposed for the Land and Assets strand. Katherine Myant replied that they were considering a number of options, such as asking Health Boards to provide case studies which could then be assessed and assigned a score.

Dona Milne advised that it would also be good to ask about failures when looking at case studies and provide few examples of the challenges Boards have faced. She also queried who the Health Boards were reporting into. Úna Bartley, Team Lead for the Place and Wellbeing Programme with Scottish Government, noted that the plans go back into Scottish Government’s Performance Management Team, and the Anchors workstream also have oversight of the work undertaken.

It was noted that NHS Lothian have offered to be a test site for the Land and Assets strand which will help us understand some of the challenges in relation to that strand. It was also noted that the Property Transaction Handbook will be the focus of the Land and Assets Task and Finish Group on 26 July.

Úna Bartley noted that the metrics work has flagged the need to look at who are target groups for the Workforce strand, and that we will prepare a paper on that and the final set of metrics for the October meeting of the Programme Board.

Action 10

• Úna Bartley and Katherine Myant to provide progress update on Public Health Scotland work on the theory of change and the evaluability assessment at the October Programme Board

Action 11

• Úna Bartley and Katherine Myant to provide an update on final set of metrics for the Anchors workstream at the October Programme Board