NHS Chairs minutes: May 2024

Attendees and apologies

NHS Chairs

• Linda Semple, NHS Ayrshire and Arran (on behalf of Lesley Bowie)
• Karen Hamilton, NHS Borders 
• Nick Morris, NHS Dumfries and Galloway
• Patricia Kilpatrick, NHS Fife
• Neena Mahal, NHS Forth Valley, Interim Chair
• Alison Evison, NHS Grampian
• Lesley Thomson, NHS Greater Glasgow and Clyde
• Sarah Compton-Bishop, NHS Highland
• Martin Hill, NHS Lanarkshire
• John Connaghan, NHS Lothian
• Meghan McEwen, NHS Orkney
• Gary Robinson, NHS Shetland 
• Lorna Birse-Stewart, NHS Tayside
• Gillian McCannon, NHS Western Isles
• Susan Douglas-Scott, NHS Golden Jubilee
• Carole Wilkinson, Healthcare Improvement Scotland
• David Garbutt, NHS Education for Scotland
• Keith Redpath, NHS National Services Scotland
• Angiolina Foster, Public Health Scotland
• Irene Oldfather, Scottish Ambulance Service (on behalf of Tom Steele)
• Brian Moore, NHS State Hospital for Scotland

Scottish Government Officials

• Neil Gray, Cabinet Secretary for NHS Recovery, Health & Social Care
• Maree Todd, Minister for Social Care, Mental Wellbeing and Sport
• John Burns ,NHS Scotland Chief Operating Officer
• Paula Speirs, Deputy Chief Operating Officer - Planning and Sponsorship
• Richard McCallum, Director of Health and Social Care Finance, Digital & Governance
• John Harden, Deputy National Clinical Director
• Gillian Russell, Director of Health Workforce
• Fiona Hogg, Chief People Officer
• Angie Wood, Director of Social Care Resilience and Improvement
• Christine McLaughlin, Co-Director of Population Health
• Anne Armstrong, Deputy Chief Nursing Officer
• Alison Strath, Chief Pharmaceutical Officer
• Henry Acres, Social Care Response Unit Head (on behalf of Donna Bell)
• Robert Kirkwood, Head of People and Governance Team
• Aislinn Ní Ghráinne, Strategic Briefing and Insights Unit Head

 
In attendance

• Louise Dowdles, Private Secretary to Cabinet Secretary for NHS Recovery, Health & Social Care
• Fraser McJannett, NHS Executive Support to NHS Board Chairs and Chairs
• Liz Mallinson, Aspiring Chairs Programme
• Nigel Henderso, Aspiring Chairs Programme
• Carol Sinclair, Aspiring Chairs Programme

Secretariat

• Laurie Whyte, Board Governance and Appointments Team
• Kat Dobell, Board Governance and Appointments Team
• Sarah Hobkirk, Board Governance and Appointments Team
• Carol Hunter, Board Governance and Appointments Team

Apologies

• Lesley Bowie, NHS Ayrshire and Arran (Linda Semple attending)
• Martin Cheyne, NHS 24
• Tom Steele, Scottish Ambulance Service (Irene Oldfather attending)
• Suzanne Dawson, Scottish Health Council
• Jenni Minto, Minister for Public Health and Women’s Health
• Caroline Lamb, DG HSC/CE NHS Scotland
• Stephen Gallagher, Director for Mental Health
• Donna Bell, Director of Social Care and NCS Development
• Tim McDonnell, Director Primary Care
• Gregor Smith, Chief Medical Officer
• Andrew Watson, Director for Children and Families
• Douglas McLaren, Deputy Chief Operating Officer - Performance and Delivery

Items and actions

Minutes

Welcome, apologies for absence and attendees

Neil Gray, Cabinet Secretary for NHS Recovery, Health and Social Care welcomed everyone to the meeting and thanked those joining in-person and online, reminding colleagues of Microsoft Teams meeting etiquette and inviting them to participate in discussions by raising their hands.

A welcome extended to Colleagues attending on the Aspiring Chairs programme.

A full list of attendees and apologies is noted in Annex A.

Minutes and actions from the previous meeting 

4.    The minutes of the meeting held on 17 April 2024 were approved, noting an update from NHS Shetland.  

5.    The action noted from the minutes will be discussed under Agenda Item 5 of this meeting.  

Matters arising

6.    There were no matters raised.

Cabinet Secretary remarks

7.    The Cabinet Secretary gave introductory remarks which covered the following:

Appointment of First Minister and Cabinet

8.    The Cabinet Secretary thanked colleagues for their continued support to the NHS at this critical time. Following the appointment of a new First Minister, he was pleased to be continuing as the Cabinet Secretary for Health and Social Care, as were his colleagues Ms Todd as Minister for Social Care, Mental Wellbeing and Sport, Ms Minto, Minister for Public Health and Women's Health and Christina McKelvie, Minister for Drugs and Alcohol Policy. He added that this Government remained committed to the people of Scotland, noting the four key priorities: eradicating child poverty; tackling the climate crisis; building and boosting the Scottish economy; and, for our public services to be effective in delivery to support individuals in their communities.

Government and health priorities

9.    The Cabinet Secretary stated that his priorities for Health and Social Care supported the overarching mission of right care and right time. A debate in Parliament has been provisionally scheduled for 6 June 2024, at which he would set out his vision and plans for national engagement on the future of the NHS in Scotland.  

Whistleblowing and safety

10.    The Cabinet Secretary spoke of Whistleblowing and Safety, stating that a principle of ensuring best service delivery is to ensure the safety of staff and patients. Having recently met with the Independent National Whistleblowing Officer, he was keen to continue to work collaboratively to help remove any barriers faced by individuals in feeling safe to raise their concerns. 

11.    Promotion of a positive culture in our NHS requires everyone having the confidence to speak up, to raise concerns and to be assured that these concerns are properly addressed without fear of repercussions. 
12.    The Cabinet Secretary reminded Chairs that all Health Boards are accountable when it comes to ensuring Whistleblowing standards and procedures are followed.  He noted he would be looking at meeting with Whistleblowing Champions within Boards to discuss this and would be supporting the Speak Up Week in September which would explore how we support the growth of a healthy and sustainable speak up culture across the NHS in Scotland and he encouraged Chairs to actively engage their Board on this. 

Primary care

13.    The Cabinet Secretary thanked Chairs on behalf of Scottish Government officials for their participation in the deep dive on primary care and for their reflections and feedback. Officials would return in the Autumn with an update on the Scottish Government’s plans for reform of Primary Care Services, which will be developed collaboratively with the new Primary and Community Health Steering Group.

14.    The Cabinet Secretary concluded by thanking Chairs for their work in a very challenging environment for delivery and expectations.

Standing Item – NHS Recovery and Performance (NHSC/24/25/05)

15.    The Cabinet Secretary invited John Burns, Chief Operating Officer to lead the standing agenda item on NHS Recovery and Performance. A paper had been circulated to attendees in advance of the meeting and John provided a slide presentation. An extended slide pack would be circulated following the meeting so that Chairs could closer examine the cross Board data and information regarding productivity and improvement. The slides included:

•    planned care
•    unscheduled care
•    cancer waiting times

16.    John Burns advised that the system was broadly stable but still under pressure with a slight increase in Accident & Emergency admissions and the challenge was to find new ways to improve and drive forward for staff and patients.
It was previously agreed with Chief Executives to bring a Planned Care Transformation and Delivery Board together to look at how to deliver productivity including addressing reform work over the next ten years.

17.    Discussion followed around the CfSD improvement work being done and collaboration between Boards. It was acknowledged that clinical behaviour was an area difficult to change and perhaps a more national protocol based approach was required. Clinical set ups should be checked as many changes were made during Covid. John Burns noted the importance of supporting these actions across Scotland to avoid building inequity. He would speak with the CfSD Team on building clinical consensus e.g. around Patient Initiated Review (PIR).

Action: John Burns to speak with the CfSD Team to get a clinical consensus against Patient Initiated Review (PIR).

18.    The Cabinet Secretary reiterated that the sharing of best ideas and looking at where performance is strongest was imperative. Sharing services across Boards and sharing patients, to reduce waiting times and increase performance, should be looked at.  It was agreed that John Burns should provide a regular comparative performance data report to Chairs and Chief Executives. 

Action: John Burns to provide a regular comparative performance data report to Chairs and Chief Executives.

Reform (NHSC/24/25/06)

19.    The Cabinet Secretary invited John Burns, Chief Operating Officer to lead the item on Reform. A paper had been circulated to attendees in advance of the meeting and slides where shared during the meeting. This covered:

•    reforming how we work
•    collaboration: opportunities and challenges

20.    The presentation provided a summary on how the Planning and Delivery Board feeds into the reform agenda. The focus is on simplifying and improving planning and delivery and supporting Boards to deliver sustainable care and quality, efficiently and effectively through collaboration. Key aspects include strong clinical engagement; participation in leadership; engagement with staff, stakeholders, patients and communities; and working with Health Improvement Scotland (HIS) colleagues.

21.    Further advice would be sent to the Cabinet Secretary and Scottish Government colleagues would continue engagement with NHS Chairs and NHS Chief Executives. There is a whole system view of this joining up with Primary Care and Social Care colleagues and the Care and Wellbeing portfolio brings it all together. 

22.    Chairs agreed this was a complicated system challenge with a significant change programme and queried if there was requirement for additional resources around system level organisational development support and if this would be via CfSD. 

23.    The Cabinet Secretary concluded that with engagement being key, there was the opportunity in Parliament, to frame the discussion on how to get to the systemic changes we need on a cross party basis, through First Minister’s Questions and debate time to get consensus in agreement. Collaborative process bound by learning will see an effective route through to continuous improvement and reform.

Feedback from NHS Chairs private meeting

24.    The Cabinet Secretary invited Carole Wilkinson, Healthcare Improvement Scotland, and Chair of NHS Chairs Group, to provide feedback from the NHS Chairs Private meeting. 

25.    Carole Wilkinson noted the themes reflected in the discussion on Monday included:

•    improving Wellbeing and workforce cultures
•    Chairs leadership role 
•    succession planning for CEs; the need for high quality, efficient, effective senior leaders.  
•    nursing and midwifery planning task force update

Any other business

26.    There were no items of other business.

Date and time of next meeting

27.    The next NHS Chairs Meeting will take place on 26 June 2024.  This will be a virtual meeting.  

Board Governance and Appointments Team
22 May 2024