NHS Chairs minutes: June 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
• Angela Constance, Minister for Drugs Policy

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
• Esther Roberton, NHS Lothian
• Meghan McEwen, NHS Orkney
• Gary Robinson, NHS Shetland
• Lorna Birse-Stewart, NHS Tayside
• Gillian McCannon, NHS Western Isles, Interim Chair
• Martin Cheyne, 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
• Paul Edie, Care Inspectorate
• Suzanne Dawson, Scottish Health Council

Scottish Government Officials

• Caroline Lamb, Director General HSC and Chief Executive of NHS Scotland
• John Connaghan, Chief Operating Officer NHS Scotland
• Gillian Russell, Director of Health Workforce
• Jason Leitch, National Clinical Director
• Richard Foggo, Covid-19 Director
• Donna Bell, Director for Mental and Social Care
• Stephen Gallagher, Director of Vaccine Strategy and Policy
• Colin Sinclair, Director of Covid Vaccination Programme
• Amanda Croft, Chief Nursing Officer
• Dave Caesar, Deputy Chief Medical Officer
• Michael Kellet, Director of Population Health

In Attendance

• Craig White, Deputy Director of Healthcare Quality and Improvement Directorate (Agenda Item 9)
• Jack Downie, APS/Minister for Mental Health
• Robert Kirkwood, Head of Corporate Business Management Team
• Laurie Whyte, Corporate Business Management Team (Secretariat)
• Hannah Mackay, Corporate Business Management Team (Secretariat)
• Nicola Gordon, NHS Executive Support
• Nicole Smith, NHS Executive Support

Apologies

• Lynda Lynch, NHS Grampian
• Tom Steele, Scottish Ambulance Service
• Richard McCallum, Director of Health Finance
• Christine McLaughlin, Director of Planning
• Heather Campbell, Interim Deputy Director Primary Care

Items and actions

Welcome, Apologies for Absence and Attendees

1. The newly appointed Cabinet Secretary for Health and Social Care, Humza Yousaf, introduced himself to NHS Chairs and welcomed everyone to the meeting.

2. The Cabinet Secretary conveyed his thanks to Esther Roberton, Chair, NHS Lothian and Neena Mahal, Chair, NHS Lanarkshire who both stand down from their Chair roles on 30 June 2021.  He highlighted the contribution, which they have both made to NHS Scotland over the years and in particular, throughout the pandemic.

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

Minutes and Actions from the Previous Meeting

4. The minutes of the meeting held on 22 February 2021 were approved.

Matters Arising

5.There were no matters arising from the previous meeting.

Cabinet Secretary Remarks

6.The Cabinet Secretary thanked Chairs for their ongoing work throughout the Pandemic.  He expressed that he was looking forward to working closely with Chairs and would welcome an opportunity to meet with them individually/in-smaller groups.  He also looked forward, when appropriate, to visit boards in person. The Cabinet Secretary indicated that he would welcome Chairs contacting him directly, but to alert the Office of the Chief Executive NHS Scotland in the first instance. 

7.The Cabinet Secretary recognised the achievements made to date in the roll out of the vaccination programme and made clear that the response to Covid remained an immediate priority. 

8.Medium-Longer term priorities were highlighted, which included:

• recovery and remobilisation of the NHS
• mental health
• workforce
• National Care Service
• public health services
• innovation

9.NHS Chairs thanked the Cabinet Secretary for his introduction and indicated that they looked forward to meeting him over the summer.

Update on pandemic

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

• global cases and deaths
• UK position overall
• 7 day case rate at a Local Authority level
• vaccinations data
• close contact cases data
• an introduction to Long Covid data

11. It was highlighted that the First Minister would be setting out a plan for the next 6/7 weeks to Parliament tomorrow.  The plan would include the new Strategic Framework and an indication of the approach after level 0.  The Cabinet Secretary expressed his thanks to Jason Leitch and the team of Clinicians for their ongoing hard work.

12. There was a discussion about the ongoing review of physical distancing and capacity within the system.  John Connaghan, Chief Operating Officer NHS Scotland, informed NHS Chairs that deep dives into various parts of the system were being undertaken and follow up conversations with NHS Chief Executives would take place. 

Vaccinations Update

13. Stephen Gallagher, Director of Vaccination Strategy and Policy, introduced the item and provided an overview of the current focus for vaccinations, which included:

• completion on first doses
• the need for a more flexible approach for 18-29 year olds, which could include an increase in drop-in clinics
• pushing need for double dose – All at 8 weeks from 21 June
• need to maximise uptake across Boards
• ensuring that, throughout the programme, the learning is captured
• planning underway for the autumn programme of Covid booster and Flu vaccines

14. Colin Sinclair, Director of Covid Vaccination Programme, then provided a programme update.  Boards are being asked to vaccinate the remaining cohorts as quickly as possible and there was ongoing consideration as to how uptake for the younger cohorts could be increased.  A digital app that allows people to book their own vaccination appointments is now ready and intended for future use.

15. A query was raised whether or not 16-18 year olds would be vaccinated and it was highlighted that JCVI were currently considering this and it was hoped that there would be a decision shortly.

16. The Cabinet Secretary emphasised the importance of flexibility of appointments when vaccinating the younger cohorts and asked Chairs to ensure they follow this up with their Chief Executives and Director of Public Health. 

Action:  NHS Chairs to ensure they feed back the importance of flexibility when vaccinating the younger cohorts, to their Chief Executives and Directors of Public Health.

Minister’s Remarks

21. The Cabinet Secretary introduced Kevin Stewart, Minister for Mental Wellbeing and Social Care and Maree Todd, Minister for Public Health, Women's Health and Sport.  

22. The Minister for Mental Wellbeing and Social Care outlined his commitment to the National Care Service.  The Minister was mindful of the impact that the pandemic has had on mental health and outlined that in February, £120 million had been allocated to support the Mental Health Programme.  The Minister for Public Health, Women's Health and Sport stressed that the pandemic had highlighted further the inequalities which need to be addressed to create a fairer society.  She indicated that, in terms of Women’s Health, there would be a strong focus on endometriosis.

Chair’s Current Area of Focus

23. David Garbutt introduced the item and provided an overview of the NHS Chairs’ current area of focus, which included:

• governance
• innovation
• improving population health

24. John Brown, Chair, NHS Greater Glasgow and Clyde, gave an overview of the key work-streams related to Governance, which included:

• the Blueprint for Good Governance.
• the Active Governance approach.
• the Corporate Governance System.
• support and Development of Board Members.

25. Integrated Governance, across the whole health and care system, was recognised as an important issue.  Ensuring good governance around board endowment funds was also highlighted.

26. David Garbutt provided an update on Innovation.  Tom Steele, Chair SAS, leads a group on Innovation, which is co-chaired by Christine McLaughlin, Director of Planning, and includes representation from Chief Executives and Scottish Government Health and Social Care Directorates.  The Innovation group has lead on several innovations with one being the Endoscopy Pilot.

27. Lorna Birse-Stewart, Chair, NHS Tayside, provided an overview of the Terms of Reference of the group on Improving Population Health and acknowledged the importance of reducing inequalities in relation to Health Outcomes.  A range of Chairs from National and Territorial Boards are included in this group with the aim of ensuring improving population health is embedded into the system.  Lorna further advised that the Terms of Reference for this group were approved by the Board Chairs Group in the morning session.

28. The Cabinet Secretary thanked Chairs for their update and their insight into these areas of work and welcomed a further detailed discussion at a future meeting.  

Drugs Policy

29. The Cabinet Secretary introduced Angela Constance, Minister for Drugs Policy and highlighted that while the Minister reports directly to the First Minister, Ms Constance would work very closely with Health Ministers to address this enormously important issue. Ms Constance provided an overview of two different case studies, which exemplified the drug problem that Scotland faces.  It was underlined that the approach to drugs policy should be consistent with alcohol, mental health and justice system policies.

30. There was a discussion about standards, which have recently been published, and the NHS Chairs role in implementing them.  The importance of collaboration with stakeholders, including the Royal College of Nursing, around treatment offers was also highlighted as vital.

31. Ms Constance informed Chairs that she would be meeting with NHS Chief Executives in August 2021 and that she would welcome the opportunity to discuss the issue further with NHS Chairs later in the year.

Action: Secretariat to schedule Drugs Policy at a future NHS Chairs meeting.

Pride Badge Campaign

32. A new NHS Scotland Pride Badge was designed by a Short Life Working Group in recognition of the multi-factorial and intersectional issues of discrimination and exclusion.  This is an initiative where NHS staff wear a badge to show their support for LGBT+ patients and staff members with emphasis on intersectionality issues. The badge is available to all members of NHS Scotland staff, across all levels of seniority, who agree to take the pledge.

33. The Cabinet Secretary endorsed the Pride Badge Campaign and expressed it was important to send a positive message to LGBT+ patients and staff members.

34. Due to time constraints in the meeting it was agreed that Craig White, Deputy Director of Healthcare Quality and Improvement Directorate, would circulate a narrated presentation.  This would include contact details for further dialogue and cross Board learning in relation to the NHS Scotland Rainbow Badge implementation and provide links to Equality and Diversity work more widely.

Action:  Craig White to circulate a narrated presentation to NHS Chairs on the Pride Badge Campaign.

Feedback from NHS Chairs Private Meeting

35. David Garbutt, Chair of NHS Chairs Group, summarised discussions from the NHS Chairs’ Private Meeting, which included work around governance and the focus on longer-term strategic issues. 

Any Other Business

36. There were no other items of business.

Date and Time of Next Meeting

37. The next NHS Chairs meeting will take place on Monday 23 August 2021.