NHS Chairs minutes: June 2022

Attendees and apologies

Health Board Chairs

• Lesley Bowie, NHS Ayrshire and Arran
• Karen Hamilton, NHS Borders
• Nick Morris, NHS Dumfries and Galloway (Chair of Chairs Group) 
• Tricia Marwick, NHS Fife
• Janie McCusker, NHS Forth Valley
• John Tomlinson, NHS Grampian
• John Brown, NHS Greater Glasgow and Clyde
• Boyd Robertson, NHS Highland
• Martin Hill, NHS Lanarkshire
• Andrew Fleming, NHS Lothian (attending on behalf of John Connaghan)
• Meghan McEwen, NHS Orkney
• Gary Robinson, NHS Shetland
• Lorna Birse-Stewart, NHS Tayside
• Gillian McCannon, NHS Western Isles
• Carole Wilkinson, Healthcare Improvement Scotland (Vice Chair of NHS Chairs Group)
• Suzanne Dawson, Scottish Health Council
• Martin Cheyne, NHS 24
• David Garbut, NHS Education for Scotland
• Susan Douglas-Scott, NHS Golden Jubilee
• Keith Redpath , NHS National Services Scotland
• Angiolina Foster, Public Health Scotland
• Brian Moore, State Hospital
• Tom Steele, Scottish Ambulance Service
• Paul Edie, Care Inspectorate

Scottish Government officials

• 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
• Caroline Lamb , Director General HSC and Chief Executive of NHS Scotland
• John Burns, NHS Scotland Chief Operating Officer
• Gillian Russell, Director of Health Workforce
• Paula Speirs, Deputy Chief Operating Officer, Planning and Sponsorship
• John Harden, Deputy National Clinical Director (attending on behalf of Jason Leitch)
• Richard McCallum, Interim Director of Health Finance and Governance and Value (attending from 15:00)
• Richard Foggo, Co-Director Population Health
• Donna Bell, Director of Social Care and NCS Development
• Alex McMahon, Head of Chief Nursing Officer Directorate
• Tim Mcdonnell, Director for Primary Care
• Michael Kellet, Co-Director Population Health

In attendance

• Mike McCormick , NHS 24 (Vice Chair)
• Roz Barclay, NHS Scotland Executive Support
• Nicola Gordon, NHS Scotland Executive Support
• Robert Kirkwood, Head of the Office of the Chief Executive
• Kat Dobell, OCENHS Team
• Hannah Mackay, OCENHS Team
• Carol Hunter, OCENHS Team
• Kelly Savage, Private Secretary, Cabinet Secretary for Health and Social Care

Apologies

• John Connaghan, NHS Lothian (Andrew Fleming attending)
• Jason Leitch, National Clinical Director
• Gordon James, Deputy Chief Operating Officer Performance and Delivery
• David Miller, Chief People Officer
• Christine McLaughlin, Co-Director Population Health
• Jonathan Cameron, Interim Director for Digital Health and Care
• Stephen Lea-Ross, Deputy Director of Health Workforce
• Gregor Smith, Chief Medical officer
• Stephen Gallagher, Director of Vaccination Strategy
• Michael Chalmers, Director for Children and Families

Items and actions

Agenda

• welcome, apologies for absence and attendees
• minutes and actions fro the previous meeting on 30 May 2022
• matters arising
• Cabinet Secretary remarks
• readout from NHS Scotland strategic session on 14 and 15 June 
• national care service update
• resource spending review 
• feedback from chairs private meeting
• any other business
• date and time of next meeting
• • NHS Chairs meeting on 05 September 2022

Welcome, apologies for absence and attendees

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

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 30 May 2022 were approved.

Matters arising

There were no matters arising from the previous meeting.

Cabinet Secretary remarks

The Cabinet Secretary highlighted the following key areas:

• COVID-19 infection rates were continuing to rise both in society and across the workforce. This was having an effect on waiting times and the capacity of the system to respond to demand. Boards should be aware of the risk this presented
• discussions are ongoing with officials around the waiting list backlog, particularly around excessive waits of more than two years. The Cabinet Secretary indicated that he would be in touch with boards in relation to this
• the challenge of the financial situation was recognised, with the resource spending review providing the financial framework for the health and care portfolio to plan and work within
• the National Care Service (NCS) Bill had been introduced to Parliament last week and further detail be provided later in the meeting
• the Monitoring and Evaluating Scotland's Alcohol Strategy (MESAS) monitoring report on alcohol consumption and pricing was published in June 2022. Work on unit pricing and potential alcohol advertising restrictions was underway. This is an issue of high public interest and the importance of ensuring a robust evidence base on any developments was highlighted
• the NHS event in Aberdeen on 21 and 22 June had been well attended and provided an opportunity for colleagues to come together and reflect, not only on the challenges faced by the system but also highlighted the opportunities and determination to move forward while ensuring the wellbeing of staff

The Cabinet Secretary concluded by thanking the NHS Board Chairs for their leadership and continued resilience over the past few years through all the challenges

Readout from NHS Scotland strategic session on 14 and 15 June

John Burns, NHS Scotland Chief Operating Officer, provided an update on discussions from the two day Strategic Session held on 14 and 15 June 2022. It was agreed with NHS Board Chief Executives that it would be appropriate to spend some dedicated time looking at future challenges as we progress through a process of recovery, renewal and consider reform. All of which required to be framed in the Care and Wellbeing portfolio approach and viewed in the three Horizons. The focus was to create a practical programme of outcome focussed work. Discussions included:

• ‘Once for Scotland’ or ‘One Scotland” approach, with consistency across Scotland and implementing best practice across all Boards, where appropriate. The governance structures to support this are being looked at. Each of the 22 NHS Boards have their own legal responsibility and accountability around delivery, with the importance of data sharing and good governance being highlighted
• multidisciplinary teams (MDT) to address demand on Health and Social Care system, focussing on Care at Home and the pathways between the community and hospitals to provide services
• reforms around workforce and service models of the future including re-deployment and the need to make opportunities clearer and easier for people to access appropriate roles
• the need to have a core data set for primary care and community services to support redesign and reform and to make good investment choices
• planned care - the aim is to reduce long waits sustainably while recognising the challenges and work required to sustain planned care over future COVID-19 waves and winters NHS Chief Executives have been engaged on practical steps and will bring forward a position quickly
• winter planning is linked to urgent and unscheduled care. The collaborative was launched on 01 June and NHS Boards are looking at high impact changes that will improve patient and staff experience. Learning from last winter which was the worst in terms of demand on the Health Care system, will inform business continuity planning for the winter ahead. The aim is to have clear business continuity actions by the end of July
• recognition that the NHS does not hold all the answers to the health and care challenges and that close work with partners such as the CPPs would be vital
• robust engagement with communities about what we are trying to do as a National Health Service and Health Care system. Services need to adapt to the way the public behave and communications work needs to be sensitive, whilst simplifying messages and learning from the COVID-19 experience of messaging through the media

The Cabinet Secretary highlighted the concern around the sharing of data and work is required by the Scottish Government around breaking down digital barriers. He also emphasised the importance of drawing all agencies together in this work and highlighted the valuable role that navigators had played in helping those affected by violence.

The Cabinet Secretary also reinforced the importance of engagement and communication with communities, setting out where services can be delivered locally, regionally or nationally. This needs to be clearly set out.

National Care Service (NCS) update

Donna Bell, Director of Social Care and NCS Development provided an update on the National Care Service (NCS).

• the NCS Bill was laid in Parliament on Monday 21 June and published on Tuesday 22 June. Three areas have been identified as priority projects:

• • human rights and the Human Rights Charter
  • national and local structures
  • electronic health and care records

It was expected that further priority projects would be identified over the next few weeks whilst working with partners and service users.

It was highlighted that this is the start of the process and a huge amount of work needs done over the next few years. However there are lots of things that can be done through proactive care programmes such as “Getting it Right for Everyone”. Work continues with COSLA around recruitment, retention and a number of other key areas.

Kevin Stewart, Minister for Mental Wellbeing and Social Care agreed there had been issues with data in the past. Discussions had taken place with industry around real-world data. It is believed that there is now a foundation for making a change on sharing data across Health and retaining the publics’ confidence. Further sessions on data and the NCS will be brought to future meetings once more detail is available.

The Cabinet Secretary added that discussions regarding the NCS will be ongoing for some time. The Bill is a framework that enables us to define goals and the granular details will come via co-design. It will help to address some of the key issues but there will be demographic challenges. One area of great interest is the ethical framework and the use of anonymous data amid concerns that data has not been shared properly in the past. It was re-iterated that the public need reassurance that their data would be protected.

Action: Secretariat to arrange a future session on the use of data and the National Care Service in collaboration with Donna Bell.

Resource spending review

Richard McCallum, Director of Health Finance and Governance and Value, provided an update on the Resource Spending Review (RSR).

The spending review provides an overarching financial framework to support our focus on four key Scottish Government priorities:

• tackling child poverty
• addressing the climate crisis
• securing a stronger, fairer, greener economy
• delivering excellent public services

Priorities as a portfolio are linked to the Scottish Government’s overarching priorities and reflected in the RSR.  About 44% of overall Scottish Government spending will be allocated to the Health and Social Care portfolio and includes support for:

• recovery of NHS services and delivery of ongoing COVID-19 services including support for sustainable vaccinations workforce
• ongoing direction of work to support investment in community health services. Continued investment in and improvement of our multi-disciplinary approach, rooted in the GP contract, to improve integration with mental health, addiction and social care service
• £250 million for tackling drugs-related deaths as part of our national mission
• Taking forward plans for delivery of the NCS with enabling legislation currently being introduced in Parliament

However these priorities will be taken forward within an extremely challenging financial context and a whole system response will be required to use resources as efficiently and effectively as possible.  

Chairs were asked to provide support to their Chief Executive and Executive Team in relation to this work as well as maintaining focus on value for money and affordability.

Richard McCallum highlighted that Chairs could engage with him individually if they require clarity on capital projects.

Feedback from Chairs private meeting

Nick Morris, Chair of Chairs Group, provided feedback from the positive conversations on recruitment and developing the leadership profile which had taken place at the private chairs meeting.

Any other business

Maree Todd, Minister for Public Health, Women's Health and Sport updated Chairs on the abortion summit earlier that day. This was largely focussed on enabling safe access to abortion services. Currently there were no barriers to women accessing the Early Medical Abortion at Home service with some areas content to post out medication. However the importance of consistency between NHS Boards was highlighted. It was expected that all NHS Boards work to Healthcare Improvement Scotland (HIS) standards. It was highlighted that when women have to travel to England for an abortion, they should have travel and accommodation expenses paid for upfront by NHS Boards. Under 16’s should not be travelling to England to access the abortion service.

There is a long-term commitment to working with NHS Boards and making improvements. Ms Todd advised she would be contacting NHS Boards with regards to an early medical abortion at home evaluation on safety and efficiency. The aim was to bring all NHS Boards into line regarding the maximum gestation period. It was also noted there may be funding available for training for Clinicians, where appropriate.

Date and time of next meeting

The next NHS Chairs meeting will take place on 05 September 2022.