NHS Chairs minutes: May 2022

Attendees and apologies

Health Board Chairs

• Robert Martin, NHS Ayrshire and Arran (Attending on behalf of Lesley Bowie)
• Karen Hamilton, NHS Borders
• Nick Morris, NHS Dumfries and Galloway (Chair of Chairs Group)
• Janie McCusker, NHS Forth Valley
• John Tomlinson, NHS Grampian
• Ian Ritchie, NHS Greater Glasgow and Clyde, Vice Chair (Attending on behalf of John Brown)
• Boyd Robertson, NHS Highland
• Martin Hill, NHS Lanarkshire
• John Connaghan, NHS Lothian
• Meghan McEwen, NHS Orkney
• Gary Robinson, NHS Shetland
• Graeme Martin, NHS Tayside (Attending on behalf of Lorna Birse-Stewart)
• Gillian McCannon, NHS Western Isles
• Carole Wilkinson, Healthcare Improvement Scotland (Vice Chair of NHS Chairs Group)
• David Garbutt, NHS Education for Scotland
• Morag Brown, NHS Golden Jubilee (attending on behalf of Susan Douglas-Scott)
• Keith Redpath, NHS National Services Scotland
• Martin Cheyne, NHS 24
• Angiolina Foster, Public Health Scotland
• Brian Moore, State Hospital
• Tom Steele, Scottish Ambulance Service
• Suzanne Dawson, Scottish Health Council
• 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
• Paula Speirs, Deputy Chief Operating Officer - Planning and Sponsorship
• Gordon James, Deputy Chief Operating Officer - Performance and Delivery
• Stephen Lea-Ross, Deputy Director of Health Workforce (Attending on behalf of Gillian Russell)
• John Harden, Deputy National Clinical Director (Attending on behalf of Jason Leitch)
• Richard Foggo, Covid-19 Director
• Donna Bell, Director of Social Care and NCS Development
• Michael Kellet, Director of Population Health
• Stephen Gallagher, Director of Vaccination Strategy
• Jonathan Cameron, Interim Director for Digital Health and Care
• Rachel Dunk, Head of Chief Nursing Officer Directorate (Attending on behalf of Alex McMahon)
• Siobhan Mackay, Directorate for Primary CRE (Attending on behalf of Tim Innes Fyfe McDonnell)

In attendance

• Roz Barclay, NHS Scotland Executive Support
• Nicola Gordon, NHS Scotland Executive Support
• Robert Kirkwood, Head of the Office of the Chief Executive
• Laurie Whyte, OCENHS Team
• Kat Dobell, OCENHS Team
• Carol Hunter, OCENHS Team
• Samantha Burns, Deputy Private Secretary to Cabinet Secretary for Health and Social Care

Apologies

• Lesley Bowie, NHS Ayrshire and Arran (Robert Martin attending)
• Tricia Marwick, NHS Fife
• John Brown, NHS Greater Glasgow and Clyde (Ian Ritchie attending)
• Lorna Birse-Stewart, NHS Tayside
• Susan Douglas-Scott, NHS Golden Jubilee (Morag Brown attending)
• Gillian Russell, Director of Health Workforce (Stephen Lea-Ross attending)
• David Miller, Chief People Officer
• Jason Leitch, National Clinical Director (John Harden attending)
• Gregor Smith, Chief Medical officer
• Alex McMahon, Chief Nursing Officer
• Richard McCallum, Interim Director of Health Finance and Governance and Value
• Christine McLaughlin, Director of Testing
• Tim Mcdonnell, Director of Primary Care (Siobhan Mackay/Innes Fyfe attending)
• Michael Chalmers, Director for Children and Families 

Items and actions

Agenda

• welcome, apologies for absence and attendees
• minutes and actions form the previous meeting (24 January 2022)
• matters arising
• Cabinet Secretary remarks
• updates on pandemic (John Harden)
  • Monkey Pox update
  • delayed discharge update (John Harden)
  • modelling (John Burns)
• national treatment centre and elective care (John Burns)
• feedback from Chairs private meeting
• any other business
• date and time of next meeting)
  • NHS Chairs meeting on 27 June 2022

Welcome, apologies for absence and attendees

The Cabinet Secretary for Health and Social Care welcomed everyone to the meeting. He thanked colleagues for their flexibility around the timing of the meeting, given that it had been rescheduled.

Minutes and actions from the previous meeting

The minutes of the meeting held on 24 January 2022 were approved.

Matters arising

There were no matters arising from the previous meeting.

Cabinet Secretary remarks

The Cabinet Secretary thanked NHS Chairs for their ongoing support and leadership of their boards. He acknowledged that health and social care systems were still pressured, particularly in the lead up to the public holiday weekend. He indicated that reducing delayed discharges would need to be prioritised in preparation for the coming winter.

Update on the pandemic

John Harden, Deputy National Clinical Director provided an update on the coronavirus pandemic. He advised that the numbers of people testing positive for coronavirus remained relatively flat, with a slow downward trend.

The Cabinet Secretary noted there seemed to be a disparity between Scotland and the rest of the UK, with cases being significantly higher in Scotland. It was suggested that Scotland may be experiencing the aftermath of the omicron virus but the data is less clear on this. Geography may also be a contributing factor for higher rates on the islands.

Monkey pox

It was noted that there are currently four cases of monkey pox in Scotland, with the outcomes of a four further tests expected. There are currently 100 tests done per day but this may change over time.  John Harden confirmed that work was being undertaken with agencies to ensure that information was being sent out to those in affected communities. He advised that the monkey pox virus is less transmissible than COVID-19 and that transmission is primarily from close contact.

Delayed discharge

Donna Bell, Director of Social Care and NCS Development, gave an update on delayed discharges. Discussions with NHS Boards about reducing delayed discharges have been positive but there are still around 13,650 people waiting for assessment for a package of care in the community and to leave hospital. Discussions have taken place on a regular basis with COSLA and local areas to identify solutions but it was recognised that workforce remained a critical factor. It was highlighted that a different approach to attraction and development of workforce will be taken forward, which will cover both domestic and international recruitment.

There was a discussion about planning for winter and it was noted that preparations should begin now, and that a whole system approach will be required. The work of the Social Care Group should link with winter planning which is being taken forward by John Burns, NHS Scotland Chief Operating Officer.

The Cabinet Secretary informed Chairs that he was keen to involve people in discussions around Adults with Incapacity (AWI), reflecting that it was important to manage the balance between the rights of the individual and ensuring best care in the most appropriate setting.

Kevin Stewart, Minister for Mental Wellbeing and Social Care explained that delayed discharge was still low in some parts of the country, with good examples of innovation. For example, he noted that Granite Care Consortium in Aberdeen has built into the contract access for staff to step up or step down care.

Modelling

John Burns, provided an overview of work being taken forward for both whole system modelling and COVID-19 modelling. He advised that COVID-19 modelling was now taking place on a fortnightly instead of weekly basis using the Four Worlds system. Other factors like flu and adverse winter scenarios need to be factored in and the whole system modelling tool will be used at national level.

Chairs were informed that funding had been agreed for one more year and the Implementation Group will provide assurances and confidence that the modelling tool is delivering what is required. It was noted that improvements in data gathering would be required within community/primary care.

National treatment centre and elective care

John Burns, NHS Scotland Chief Operating Officer, led an update on the National Treatment Centres and Elective Care. It was agreed that this should be scheduled at a future meeting, to allow for a more in-depth discussion.

It was acknowledged that recent world events, such as the pandemic, have impacted on elective care but that it was important that elective care was considered in the same way as planned care. There was a discussion about clinical prioritisation and how to balance clinical priority and long waits. John Burns indicated that guidance will be provided to NHS Boards to support them to reduce waits. The guidance will help to ensure due diligence and scrutiny across all programmes.

Action: Secretariat to arrange for future agenda item on national treatment centres and elective care.

NHS Chairs confirmed that all Boards are committed to supporting this work and that their main role is to ensure that productivity and efficiency in their boards are improving.

Feedback from Chairs private meeting

Nick Morris, Chair, NHS Dumfries and Galloway (Chair of Chairs Group) provided an update from the Chairs Private meeting. He indicated that the theme of their meeting had been about integrated planning processes and the Care & Wellbeing Portfolio. They discussed:

• finances
• infrastructure
• delivery services

It was noted that a key challenge will be around the ownership of design programmes for service changes and how they are aligned with teams in local areas. NHS Chairs welcomed the collaborative approach of Scottish Government officials.

The Cabinet Secretary added that he looked forward to making arrangements for visits to NHS Boards.

AOB

Maree Todd, Minister for Public Health, Women's Health and Sport made colleagues aware of wider work being taken forward in response to ‘Scotland’s National Population Strategy’.

Date and time of next meeting

The next NHS Chairs Meeting will take place on 27 June 2022.

Office of the Chief Executive for NHS Scotland.