NHS Chairs minutes: May 2019

Attendees and apologies

Scottish Ministers

• Jeane Freeman Cabinet Secretary for Health and Sport
• Clare Haughey Minister for Mental Health
• Joe FitzPatrick Minister for Public Health, Sport and Wellbeing

Health Board chairs

• Martin Cheyne NHS Ayrshire and Arran
• 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 (by VC)
• Ian Burgess NHS Western Isles
• Carole Wilkinson Healthcare Improvement Scotland
• Esther Roberton NHS 24
• David Garbutt NHS Education for Scotland
• David Crichton NHS Health Scotland
• Elizabeth Ireland NHS National Services Scotland
• Phil Cox The Golden Jubilee Foundation (Vice-Chair)
• Maire Whitehead The State Hospitals Board for Scotland
• 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
• 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
• Jason Leitch National Clinical Director
• Catherine Calderwood Chief Medical Officer
• Gregor Smith Deputy Chief Medical Officer
• Donna Bell Director of Mental Health
• Richard Foggo Director of Population Health
• Diane Murray Associate Chief Nursing Officer
• Alison Taylor Head of Integration Division
• Stephen Lea-Ross Head of Workforce Practice
• Robert Kirkwood Head of Corporate Business Management Division
• Laurie Whyte Team Leader, Corporate Business Management
• Jack Downie DPS/Cabinet Secretary Health and Sport

In attendance

• Chris Campbell NHS Scotland Executive Support

Observers

• Chris Sheridan Scottish Clinical Leadership Fellow
• Jack Fairweather Scottish Clinical Leadership Fellow

Apologies

• Susan Douglas-Scott The Golden Jubilee Foundation
• Terry Currie The State Hospital Board
• Shirley Rogers Chief People Officer and Director of Health Workforce, Leadership, Reform and EU Exit Preparations
• Fiona McQueen Chief Nursing Officer

Items and actions

Welcome, apologies for absence and attendees

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

2. The Cabinet Secretary welcomed Karen Hamilton, Interim Chair, NHS Borders Suzanne Dawson, Chair, Scottish Health Council to their first meeting of the NHS Board Chairs Group.

Minutes of the previous meeting

3. The minutes of the meeting held on 25 March 2019 were approved.

Matters arising

4. There were no matters arising.

Cabinet Secretary remarks

5. The Cabinet Secretary updated Chairs on the following topics:

• Health and Care (Staffing) (Scotland) Bill
• Hospital at Home

6. The Cabinet Secretary informed NHS Chairs that the Health and Care (Staffing) (Scotland) Bill was unanimously passed by the Scottish Parliament on 2 May 2019. She gave thanks to the Bill Team and all stakeholders who have been involved in developing the Bill. This is the first multi-disciplinary workload and workforce planning legislation in the UK. Guidance to accompany the Bill will now be drafted in collaboration with all stakeholders and shared with the Health and Sport Committee.

7. Hospital at Home is an example of good practice which has generated substantial evidence of the positive effect it has on outcomes. The Cabinet Secretary told NHS Chairs that Malcolm Wright, Director General for Health and Social Care/Chief Executive NHS Scotland would be advising NHS Chief Executives of plans to implement ‘Hospital at Home’ in all NHS Boards. She asked NHS Chairs to make themselves familiar with the programme and consider implementing such a programme in their Board area.

Action: NHS Board Chairs to make themselves familiar with the ‘Hospital at Home’ programme and consider implementing such a programme in their Board area (reporting back at the meeting on 26 August 2019).

8. Mr FitzPatrick, Minister for Public Health, Sport and Wellbeing, briefed NHS Chairs on a Partnership Delivery Agreement that is to be proposed to COSLA and Scottish Ministers to support the governance, strategic planning, financial arrangements and service improvement required to reduce the use of and harm from alcohol/drugs. The agreement sets out the role of Alcohol and Drug Partnerships, working with other strategic partnerships, to implement a whole systems approach in line with the Rights, Respect and Recovery (Scotland’s alcohol/drug strategy) and the Alcohol Prevention Framework 2018.

9. Publication of the agreement is expected in June 2019.

Cabinet Secretary standing items

Health and Social Care Integration

10. The Cabinet Secretary updated NHS Chairs on work that had been progressed since the last meeting. She advised that the Scottish Government has appointed David Williams, Chief Officer of the Glasgow Health and Social Care Partnership, as Director of Delivery of Health and Social Care Integration on a secondment basis. He is due to start his new role at the end of May 2019, and will provide additional impetus and focus on successful delivery of the proposals made by the Review Group.

11. The next meeting of the Ministerial Strategic Group is at the end of the month. The MSG will receive an overview report of the self-evaluation returns and will consider the delivery plan which has been agreed by the Review Leadership group. Alison Taylor, Head of Integration Division, Scottish Government, thanked NHS Chairs for their contribution in producing the self-evaluation reports.

12. Malcolm Wright, Director General Health and Social Care/Chief Executive NHS Scotland told NHS Chairs that there was a discussion at the last NHS Chief Executives’ Group meeting about holding a leadership event at the end of the summer with NHS Chairs and Chief Executives, Local Authority Chief Executives, Chief Officers, Chairs of Integrated Joint Boards, SOLACE and COSLA.

13. There was a discussion about the mechanism by which examples of good practice could be identified and spread. Jason Leitch, National Clinical Director advised that Healthcare Improvement Scotland currently hold and gather evidence on best practice and that the Board was looking to develop this area of work further. The Corporate Governance Steering Group (CGSG) of Chairs and the Innovation Group were also looking at good practice across the health and care system.

14. The Cabinet Secretary asked NHS Chairs to work to create an aligned process for identifying and implementing existing good practice across all Boards.

Action: NHS Chairs to create an aligned process for identifying and implementing existing good practice across all Boards (reporting back progress on this at 26 August 2019 meeting)

Access and performance

15. John Connaghan, Chief Performance Officer NHS Scotland and Director of Delivery and Resilience gave an update on access and performance. He thanked NHS Chairs for their contribution to the development of their Annual Operational Plans.

16. The plans have now been reviewed and Malcolm Wright, Director General Health and Social Care/Chief Executive NHS Scotland will respond to NHS Chief Executives shortly in writing. This letter will form a contract between NHS Boards and the Scottish Government for 2019/20.

17. John Connaghan advised NHS Chairs that he intended to begin discussions on the Annual Operating Plans for 2020/21 after the summer, with the aim of having completed plans before Christmas.

18. NHS Chairs were asked to make sure that they are aware of arrangements in their Boards with regards to performance reporting, in particular for cancer, and to raise issues with Scottish Government as early as possible.

Action: NHS Chairs to make sure they are aware of performance reporting processes in their Boards and raise issues with Scottish Government as early as possible

19. There was a discussion about the annual review process. The Cabinet Secretary asked NHS Chairs to feedback their views on the process this year and how they thought integration could be better incorporated. The annual reviews would continue to be led by Ministers.

Action: NHS Chairs to provide feedback on the annual review process with their thoughts on how to better incorporate integration (reporting back views on this at the 24 June 2019 meeting)

Mental health

20. Ms Haughey, Minister for Mental Health, gave an update on Mental Health, which covered:

• ‘Action 15’: increase the workforce
• mental health waiting times standards
• Children and Young Peoples Mental Health Taskforce
• suicide prevention
• review of the Mental Health Act

21. Ms Haughey noted that whilst there have been improvements in performance against the Child and Adolescent Mental Health Services waiting times standard, performance was variable across Boards. She underlined her expectation that by December 2020, if not earlier, all Boards will have met the Waiting Times Standards for Mental Health and have plans in place to sustain performance.

The Sturrock Review: NHSCH/19/20/01

(Stephen Lea-Ross, Head of Workforce Practice, Scottish Government)

22. Stephen Lea-Ross, Head of Workforce Practice, Scottish Government set out the Scottish Government response to the Sturrock Review which was published on 9 May 2019.

23. Whilst the review only examined matters in NHS Highland, there is important learning and reflection for all NHS Boards and the Scottish Government. Stephen Lea-Ross informed NHS Chairs that the Scottish Government would be writing to all Boards to ask that they consider the review and look again at effectiveness of their own internal systems, leadership and governance.

24. A Ministerial led short-life working group is to be convened with representation from NHS Boards, staff-side, Royal Colleges and Professional and Regulatory bodies, to examine how to collectively take forward measures to support open and honest workplace cultures.

25. Boyd Robertson, Chair, NHS Highland gave an overview of the actions that have been taken in NHS Highland since the publication of the review.

The Citizen’s Jury Recommendations on Shared Decision Making – NHSCH/19/20/02 (Gregor Smith, Deputy Chief Medical Officer, Scottish Government)

26. Gregor Smith, Deputy Chief Medical Officer, Scottish Government gave an update on the recommendations from the Citizen’s Jury on shared decision making and the proposed next steps. NHS Board Chairs recognised the recommendations, agreed that NHS Boards have an important role to play helping to fully address them and committed to supporting the implementation of the recommendations in their Health Board areas.

27. NHS Board Chairs were asked to set out what they will do within their Boards to help meet the Citizen’s Jury recommendations.

Action: NHS Board Chairs were asked to set out what they will do within their Boards to help meet the Citizen’s Jury recommendations (before next meeting on 24 June 2019)

Feedback from NHS Chairs private meeting

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

• a presentation on access/quality improvement work
• updates from thematic groups
• Person-centred Visiting
• Letter from the Standards Commission on the analysis of a survey issued to members of Boards of devolved public bodies

Any other business

29. No further items were discussed.

Date and time of next meeting

30. The next NHS Chairs meeting will be on Monday 24 June 2019 at 13:00 in the Scottish Health Service Centre, Edinburgh

NHS Chairs minutes: May 2019

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