NHS Chairs minutes: June 2019

Attendees and apologies

Scottish Ministers

Jeane Freeman, Cabinet Secretary for Health and Sport
Clare Haughey, Minister for Mental Health

Health Board Chairs

Lesley Bowie, NHS Ayrshire and Arran, Vice Chair
Karen Hamilton, NHS Borders
Nicholas Morris, NHS Dumfries and Galloway
Tricia Marwick, NHS Fife
Alex Linkston, NHS Forth Valley
Lynda Lynch, NHS Grampian
John Brown, NHS Greater Glasgow and Clyde/NHS Tayside
Boyd Robertson, NHS Highland
Neena Mahal, NHS Lanarkshire
Brian Houston, NHS Lothian
Ian Kinniburgh, NHS Orkney
Gary Robinson, NHS Shetland
Ian Burgess, NHS Western Isles
Susan Douglas-Scott, The Golden Jubilee Foundation
Carole Wilkinson, Healthcare Improvement Scotland
Madeline Smith, NHS 24, Vice Chair
David Garbutt, NHS Education for Scotland
David Crichton, NHS Health Scotland
Elizabeth Ireland, NHS National Services Scotland
Terry Currie, The State Hospital Board
Tom Steele, Scottish Ambulance Service
Paul Edie, Care Inspectorate
Suzanne Dawson, Scottish Health Council

Scottish Government Officials

Malcolm Wright, Director General for Health and Social Care for the Scottish Government and Chief Executive of NHS Scotland
Shirley Rogers, Chief People Officer and Director of Health Workforce, Leadership, Reform and EU Exit Preparations
Jason Leitch, National Clinical Director
Fiona McQueen, Chief Nursing Officer
Gregor Smith, Deputy Chief Medical Officer
Richard Foggo, Director of Population Health
Alison Taylor, Head of Integration Division
Hugh McAloon, Head of Fair Work and Skills, Children and Young People Mental Health
Andy Corr, PS/Cabinet Secretary Health and Sport
Robert Kirkwood, Head of Corporate Business Management Division
Sarah Hildersley, Corporate Business Management Team: OCENHS

Observers

David Williams, Health and Social Care Integration
Rhona Atkinson, Vice Chair, NHS Grampian

In Attendance

David Bedwell, Executive Support NHS Scotland

Apologies

Joe FitzPatrick, Minister for Public Health, Sport and Wellbeing
Martin Cheyne, NHS Ayrshire and Arran
Esther Roberton, NHS 24
Christine McLaughlin, Chief Finance Officer NHS Scotland and Director of Health Finance, Corporate Governance and Value
John Connaghan, Chief Performance Officer and Director of Delivery and Resilience
Donna Bell, Director of Mental Health
Catherine Calderwood, Chief Medical Officer
Michael Chalmers, Director for Children and Families
Richard McCallum, Deputy Director Health Finance

Items and actions

Welcome, apologies for absence and attendees

The Cabinet Secretary congratulated Malcolm Wright on his appointment as Director General Health and Social Care and Chief Executive NHSScotland.

Minutes and actions from the previous meeting

The minutes of the meeting held on 8 May 2019 were approved.

Ian Kinniburgh on behalf of the NHS Chairs Group provided assurance to the Cabinet Secretary that the actions listed from the last meeting were in hand. A full update on all the actions from the previous meetings will be provided for the Cabinet Secretary via the Scottish Government NHS Chairs Meeting Secretariat.

Action: Ian Kinniburgh, Chair of NHS Chairs Group to provide a written update on all previous actions to the SG Secretariat by 8 July.

Chairs agreed that Integration should be an integral part of the Annual Review process and have set up a group to further look at Annual Reviews. The Cabinet Secretary will be looking at the process over the summer and invited written feedback from the Chairs Group by 8 July. This should be submitted via the Scottish Government NHS Chairs Meeting Secretariat.

Action: Ian Kinniburgh, Chair of NHS Chairs Group to provide a written paper on the Annual Reviews process for the Cabinet Secretary. This should be submitted via the SG Secretariat before 8 July 2019.

In relation to the action point on Citizens Jury recommendations, Ian Kinniburgh indicated this was included in the full update of actions being provided.

Matters arising

At the last meeting the Cabinet Secretary spoke about Hospital at Home in her opening remarks. Malcolm Wright has now written to Chief Executives advising them of plans to implement Hospital at Home in all NHS Boards. In the interim, Chairs were asked to make themselves aware of the plan. Chairs confirmed they were sighted on the programme and would provide a written paper to the Cabinet Secretary in advance of the next meeting.

Action: Ian Kinniburgh, Chair of NHS Chairs Group, to provide a written paper to the Cabinet Secretary on implementation of Hospital at Home programme on behalf of NHS Boards for further discussion at the 26 August meeting. This should be submitted to the SG Secretariat by Monday 29 July 2019.

Cabinet Secretary remarks

The Cabinet Secretary had no additional remarks and moved directly to the Standing Items.

Cabinet Secretary standing items

The Cabinet Secretary handed over to Directors to lead the discussion covering the following topics:

Health and social care integration – NHSCH/19/20/03

Alison Taylor, Head of Integration Division highlighted the paper that had been circulated in advance of the meeting, updating NHS Chairs on work that had been progressed since the last meeting. She thanked Chairs for the submitted self-assessment reports and for the collaborative approach while completing these.

The self-assessments have been evaluated and initial discussions have taken place with all Boards. The next stage will be implementation against the proposals set out by the Review Leadership Group. A new Community Services Framework is also being developed. This work would support improvements such as Hospital at Home.

Alex Linkston, Chair, NHS Forth Valley and Chair of the Integration and Performance Thematic Group had met with officials and highlighted the importance of a more collaborative relationship with CoSLA and developing a shared understanding of any challenges.

Mental health – NHSCH/19/20/04

Hugh McAloon, Head of Fair Work and Skills, Children and Young Peoples Mental Health attended the meeting on behalf of Donna Bell, Director for Mental Health. He spoke about the trajectories in relation to CAMHS and Psychological Therapies, with the latest statistics showing a slight upward trend over recent quarters. Plans were also developing to adopt a Public Health approach to mental health, working across organisations, with a clear focus on prevention.

As part of the Annual Operational Plans Boards were asked to set trajectories to meet by the end of 2020. Most Boards now have a signed off set of trajectories. The SG will continue to work and support all Boards in the efforts to meet standards and set trajectories.

The Director of Mental Health will be writing shortly to Chief Executives of NHS Boards with the highest numbers of patients waiting for treatment for CAMHS and Psychological Services. The ask is for Boards to submit a formal plan on how they will rectify this situation. The situation will continue to be monitored across all Boards.

Ms Haughey, Minister for Mental Health, stressed the importance of addressing quickly children on the longest waits and what support was currently in place.

The Cabinet Secretary invited Ian Kinniburgh to provide feedback here in relation to Agenda Item 7. Written updates had been requested from Board Chairs on the current position in relation to the 40 actions set out in the mental health strategy. Initial reports show that Boards were still working to clarify both local and national initiatives that were in place.

The Cabinet Secretary asked Ian Kinniburgh to submit a paper in advance of the next meeting on 26 August 2019 and that this should be a substantive agenda item at the next meeting.

Action: Ian Kinniburgh, Chair of NHS Chairs Group to provide written paper to on Mental Health Strategy on behalf of NHS Boards for substantive discussion at the next meeting. This should be submitted to the SG Secretariat by Monday 29 July 2019.

Access and performance (including Annual Operating Plans) – NHSCH/19/20/05

Tracy Slater, Head of Elective and Unscheduled Care, attended the meeting and gave a brief update on access and performance.

The discussion then turned to Annual Operating Plans. All Boards have submitted an AOP and these have been through a rigorous review process prior to sign off. Letters have now issued from the Director General to all boards signing off most aspects of the plans.

The Scottish Government and Boards will being monitoring progress on a weekly basis, with swift action expected if there is a deviation from the plan. NHS Boards will be held to account for delivery of these Plans through the Annual Review process, Chaired by Ministers.

The use of evidence and implementation of best practice – NHSCH/19/20/06

Jason Leitch, National Clinical Director introduced the item and shared a presentation with NHS Chairs on “Evidence and Implementation”.

It was recognised that NHS Scotland is a world leader in quality improvement (QI) evidenced by work in patient safety, person-centred care and child health. A well-developed understanding exists across health and social care systems of the technical and social factors required to support the spread and sustainability of quality improvement. There are also in the region of 800 improvement fellows trained in delivering quality improvement across the public sector.

Brian Houston, Chair, NHS Lothian and Chair of the Reform and Innovation Thematic Group set out the work that had been undertaken by the group, identifying 166 innovations, submitted by NHS Boards, where spread could benefit health and social care provision across Scotland.

Chairs welcomed the update and were in agreement to having a more structured centralised approach to the sharing and spread of best practice and innovation. That should not, however, replace local creativity and innovation.

The Golden Jubilee Foundation’s Innovation Centre should also be involved in taking forward any work on this along with Healthcare Improvement Scotland.

Action: Chair of the Golden Jubilee Foundation and Chair of Healthcare Improvement Scotland be involved in relation to innovation and quality improvement work.

Feedback from NHS Chairs private meeting

Ian Kinniburgh, Chair of the NHS Board Chairs Group shared feedback from their morning meeting. This included:

• innovative presentation on the work of the Access Collaborative
• NHS Endowments Funds Governance arrangements
• NHS Chairs Meetings Action Points

Any other business

No further items were discussed.

Date and time of next meeting

The next NHS Chairs meeting will be on Monday 26 August 2019 at 13:00 in the Scottish Health Service Centre, Edinburgh.

Office of the Chief Executive for NHS Scotland
June 2019

NHS Chairs minutes: index page