NHS Chairs minutes: August 2021

Attendees and apologies

Attendees:

Scottish Ministers:

• Humza Yousaf, Cabinet Secretary for Health and Social Care
• Kevin Stewart, Minister for Mental Wellbeing and Social Care 
• Maree Todd, Minister for Public Health, Women's Health and Sport

Health Board Chairs:

• Lesley Bowie, NHS Ayrshire and Arran
• Karen Hamilton, NHS Borders
• Nick Morris, NHS Dumfries and Galloway (Vice Chair of Chairs Group)
• Tricia Marwick, NHS Fife 
• Janie McCusker, NHS Forth Valley
• John Tomlinson, NHS Grampian, Vice Chair
• John Brown, NHS Greater Glasgow and Clyde 
• Boyd Robertson, NHS Highland 
• Neena Mahal, NHS Lanarkshire
• John Connaghan, NHS Lothian
• Meghan McEwen, NHS Orkney 
• Gary Robinson, NHS Shetland 
• Lorna Birse-Stewart, NHS Tayside
• Gillian McCannon, NHS Western Isles
• Madeline Smith, NHS 24
• David Garbutt, NHS Education for Scotland
• Keith Redpath, NHS National Services Scotland
• Susan Douglas Scott, Golden Jubilee Foundation
• Carole Wilkinson, Healthcare Improvement Scotland
• Jim McGoldrick, Public Health Scotland
• David McConnell, State Hospitals Board
• Tom Steele, Scottish Ambulance Service 
• Paul Edie, Care Inspectorate
• Suzanne Dawson, Scottish Health Council

Scottish Government officials:

• Caroline Lamb, Director General HSC and Chief Executive of NHS Scotland 
• Gillian Russell, Director of Health Workforce 
• Jason Leitch, National Clinical Director
• Donna Bell, Director for Mental and Social Care
• Christine McLaughlin, Director of Testing
• Stephen Gallagher, Director of Vaccine Strategy and Policy
• Colin Sinclair, Director of Covid Vaccination Programme 
• Heather Campbell, Deputy Director of Primary Care
• Anne Armstrong, DCNO Designate 
• Michael Kellet, Director of Population Health

In attendance:

• Luan Grugeon, NHS Grampian (Observer)
• Lesley Thomson, Vice-Chair, NHS Lanarkshire (Observer)
• Andrew Fleming, Head of NHS Board Sponsorship (attending on behalf of John Burns)
• Helen Maitland, Unscheduled Care Director (for agenda item 5)
• Tracy Slater, Head of Performance and Delivery (for agenda item 5)
• Roz Barclay, NHS Scotland Executive Support
• Nicola Gordon, NHS Scotland Executive Support
• Nicole Smith, NHS Scotland Executive Support
• Billy Wright/David Bowman, PS/APS Cabinet Secretary for Health and Sport
• Robert Kirkwood, Head of Corporate Business Management Team
• Laurie Whyte, Corporate Business Management Team (Secretariat)
• Hannah Mackay, Corporate Business Management Team (Secretariat)

Apologies:

• Lynda Lynch, NHS Grampian (John Tomlinson attending)
• Martin Cheyne, NHS 24 (Madeline Smith attending) 
• Brian Moore, State Hospital (David McConnell attending)
• John Burns, NHS Scotland Chief Operating Officer (Andrew Fleming attending)
• Dave Caesar, Deputy Chief Medical Officer 
• Tim McDonnell, Director of Primary Care (Heather Campbell attending)
• Amanda Croft, Chief Nursing Officer (Anne Armstrong attending)

Items and actions

Agenda

• welcome, apologies for absence and attendees
• minutes and actions from the previous meeting - (21 June 2021)
• matters arising
• Cabinet Secretary Remarks including Priorities and Areas of Focus
• unscheduled Care/Recovery Plan - (Tracy Slater and Helen Maitland)
• National Care Service consultation - (Donna Bell)
• feedback from Chairs private meeting
• any other business - annual review process 2020/21
• date and time of next meeting - NHS Chairs meeting on 25 October 2021

Minutes

Welcome, apologies for absence and attendees

The Cabinet Secretary for Health and Social Care welcomed everyone to the meeting.

The Cabinet Secretary conveyed his thanks to David Garbutt who has stepped down from Chair of Chairs Group role and welcomed Nick Morris who has taken on the role with Carole Wilkinson as Vice Chair.

Gillian McCannon was congratulated on her successful appointment as permanent Chair of NHS Western Isles and John Connaghan was congratulated on his appointment for Chair of NHS Lothian.  

Thanks were also noted to Jim McGoldrick who has recently retired as chair of Public Health Scotland. Angiolina Foster will take on the role from 1 September 2021.

Apologies had been received from Brian Moore, who had recently been appointed as Chair of State Hospital, however, congratulations were still noted.

A list of those present and apologies is provided at Annex A.

Minutes and actions from the previous meeting

The minutes of the meeting held on 21 June 2021 were approved. 

Matters arising

There were no matters arising from the previous meeting. 

Cabinet Secretary remarks including priorities and areas of focus

The Cabinet Secretary expressed his priorities and areas of focus for NHS Chairs, which included:

• covid-19
• pressures (staff wellbeing and on unscheduled care)
• recovery framework
• delivery of care and wellbeing programmes

Jason Leitch, National Clinical Director, provided an overview of the current state of the pandemic, which included:

• global cases and deaths
• daily cases
• UK position overall

Jason highlighted the following communications should continue to be emphasised:

• get vaccinated
• testing twice a week
• follow the guidance

Unscheduled Care/Recovery Plan

Helen Maitland, Unscheduled Care Director, displayed slides and outlined the current Unscheduled Care Pressures, which included:

• four hour Emergency Access Target was at its poorest performance since 2011
• A and E attendances highest attendances for 9 weeks in a row
• increasing Emergency admissions
• delayed discharges have continued their general upward trend

In addition to this, there was also additional pressures which contributed:

• capacity for assessment and diagnostics
• staffing availability
• increasing attendances
• urgent admissions and higher acuity
• late in day presentations

An outline was provided of the Unscheduled Care Programme and the essential actions which had to be taken. The aim of the Integrated Urgent and Unscheduled Care Programme was highlighted as ‘services delivered that meet individual need for: the right care, in the right place at the right time’. It was noted that would require whole system working which would include:

• focus on recovery within the altered environment and resources
• effective operational response and escalation - across multi-professional and multi-disciplinary working
• optimising resources within current recovery

Tracy Slater, Head of Performance and Delivery, highlighted that the National Recovery Plan was due to launch on Wednesday by the First Minster at the Centre for Sustainable Delivery. She advised that the Plan covered 4 key components, engagement had taken place with various stakeholders and that this would continue once the plan was published.

Caroline Lamb, Director General HSC and Chief Executive of NHS Scotland, highlighted that a commitment was made to review the plan annually. The role of Chairs was outlined as focussing on staff wellbeing and commitment to innovation and improvement.

In discussion, the following was raised:

• there was a need for a Workforce Strategy in context of the Population Strategy. Michael Kellet, Director of Population Health, highlighted that he would share the Population Strategy with Chairs
• concerns were raised around the pressures which winter will bring
• it may be beneficial to share innovation in each health boards to showcase their innovation/good practice

The Cabinet Secretary echoed the importance of care at the right place and expressed that it was important not to lose sight of the unique challenges of island Boards.  

Actions:  

• Michael Kellet to share the Population Strategy with Chairs
• the Cabinet Secretary to take forward the Island Proofing work with Cabinet colleagues

National Care Service Consultation

The Cabinet Secretary introduced this item and outlined that the National Care Service Consultation had been published. The Consultation will run from 9 August – 18 October 2021. Mr Stewart, Minister for Mental Wellbeing and Social Care, highlighted that he has engaged with those who have lived experience and various stakeholders. Mr Stewart expressed that he was encouraging as many people to take part in the consultation as possible and going forward there would be various engagement events, mainly virtually, with the hope some could be carried out in person soon.

Donna Bell, Director for Mental and Social Care, expressed that she was happy to engage with Chairs on this as often as needed and offered to arrange focussed sessions. Nick Morris, Chair of NHS Chairs Group, would liaise with Donna to arrange these sessions. It was highlighted that similar sessions were planned to take place with Chief Executives, Chief Officers and SOLACE.

In addition to the focussed sessions with Donna, Mr Stewart also offered to meet with Chairs to discuss the Consultation. This was welcomed by Chairs. It was agreed that an aim was to reduce the amount of times that service users had to repeat their stories before receiving the correct support.

Nick Morris expressed that Chairs were keen to engage with the consultation and provided assurance that they wanted to improve the service. However, he did highlight that the timescales to respond were tight.   

The timetable for this work was set out and a bill would be produced by the end of first parliamentary term and highlighted that change would be incremental.

Actions:  

• communications to be issued on the National Care Service Consultation to ensure shared directly with NHS colleagues
• Mr Stewart to arrange an additional session on the National Care Service Consultation, if required.

Feedback from NHS Chairs private meeting

Nick Morris, Chair of NHS Chairs Group, summarised discussions from the NHS Chairs’ Private Meeting, which mainly focused on the National Care Service Consultation.  

Any other business

Chairs were alerted to the additional paper circulated for information, on Annual Review Process. The Chairs fed back that they were supportive and wouldn’t want the process to be too onerous. It was suggested that a recorded session may not be the best method but would welcome co-producing. The Cabinet Secretary expressed he was open to suggestions.   

There were no other items of business and the Chair closed the meeting.

Date and time of next meeting

The next NHS Chairs meeting will take place on Monday 25 October 2021.