NHS Chairs minutes: October 2024

Attendees and apologies

Health Board Chairs

• Linda Semple, NHS Ayrshire and Arran (Acting)
• Karen Hamilton, NHS Borders 
• Marsali Craig, NHS Dumfries and Galloway (Interim)
• Patricia Kilpatrick, NHS Fife 
• Neena Mahal, NHS Forth Valley (Interim)
• 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
• Keith Redpath, NHS National Services Scotland
• Ann McKechnie, Public Health Scotland (Vice Chair)
• Suzanne Dawson, Scottish Health Council

Scottish Government Officials

• Neil Gray, Cabinet Secretary for Health and Social Care
• Maree Todd, Minister for Social Care, Mental Wellbeing and Sport
• Caroline Lamb, DG HSC/CE NHS Scotland
• John Burns, NHS Scotland Chief Operating Officer
• Fiona Hogg, Chief People Officer
• Anne Armstron, Interim Chief Nursing Officer
• Alison Strath, Chief Pharmaceutical Officer
• Alan Gr, Director of Health and Social Care Finance
• Stephen Gallagh, Director of Mental Health
• Amy Wilson, Director of Health Workforce
• Donna Bell, Director of Social Care and NCS Development
• Christine McLaughli, Co-Director of Population Health
• Richard Foggo, Co-Director of Population Health
• Angie Wood, Interim Director, Social Care Resilience, and Improvement
• Paula Speir, Deputy Chief Operating Officer - Planning and Sponsorship
• Douglas McLaren, Deputy Chief Operating Officer - Performance and Delivery
• Fiona Bennett, Interim Deputy Director NHS Scotland Finance
• Robert Kirkwood, Head of Office NHS Chief Operating Officer 

Secretariat      

• Laurie Whyte, Board Governance and Appointments Team
• Kat Dobell, Board Governance and Appointments Team
• Carol Hunte, Board Governance and Appointments Team
• Fraser McJannett, NHS Executive Support to NHS Board Chairs and Chairs - Policy and Business Analyst    

Other Attendees – Aspiring Chairs Programme

• Evelyn McPhail, Healthcare Improvement Scotland 
• Colin Campbell, NHS Shetland

Apologies    

• Martin Cheyne, NHS 24
• David Garbut, NHS Education for Scotland (Vice Chair Attending)
• Tom Steele, Scottish Ambulance Service
• Angiolina Foster, Public Health Scotland (Vice Chair Attending)
• Annie Gunner Logan, NHS Education for Scotland (Vice Chair)
• Christine McKelvie, Minister for Drugs and Alcohol Policy
• Jenni Minto, Minister for Public Health and Women's Health
• Gregor Smith, Chief Medical Officer
• Tim McDonnel, Director Primary Care
• John Harden, National Clinical Lead for Quality & Safety 
• Andrew Watson, Director for Children & Families
   

Items and actions

Minutes

Welcome, apologies for absence and attendees

Caroline Lamb, DG HSC/CE NHS Scotland welcomed the Chairs group and thanked them for accommodating the change of time for today’s meeting. Caroline advised the Cabinet Secretary was running late and she would begin the meeting in his absence, with a slight change to the order of items in the agenda with the presentation on delayed discharge being the first item discussed.

Caroline welcomed Evelyn McPhail, Healthcare Improvement Scotland and Colin Campbell, NHS Shetland who joined the call as part of the aspiring chairs programme.

Caroline also welcomed Amy Wilson to her first meeting of the NHS Chairs group as the Director of Workforce on an interim basis.

A full list of attendees and apologies is noted in annex a.

Minutes and actions from the previous meeting

The minutes of the meeting held on 12 August 2024 were approved with one amendment to the attendees list for NHS Tayside, showing Beth Hamilton as Vice Chair attending on behalf of Lorna Birse-Stewart.

The following action was noted at the last meeting and is now complete.

• Angie Wood to ensure CRAG data is accessible to NHS Chairs and to ensure whole system approach includes Integration Joint boards. This information is now sent to Chairs monthly and Caroline encouraged sharing this information with boards to understand the situation across Scotland.

Delayed discharge

Caroline invited Angie Wood, Interim Director, Social Care Resilience, and Improvement to update colleagues on delayed discharge and the work underway through CRAG. A paper was circulated prior to the meeting and Angie provided a slide presentation which summarised the current position and available data.

It was noted that whilst improvement plans are in place and there have been a number of targeted interventions, but that more work needed to ensure that the whole system would be able to maintain services over the winter period. NHS Chairs were asked to review and consider what further actions could be taken.

A discussion followed with NHS Chairs indicating an appreciation for the data being made available to them. Key points included:

• it would be beneficial if data could include information on flow through hospitals - national data was not the same as what was available to boards locally and did not illustrate the challenges for boards with multiple integrated joint boards
• recognition of the experience of the non-executive members who sit on integrated joint boards and how their input could be valuable to CRAG
• a request for future presentations to highlight where significant successes had occurred and how they had been achieved
• a request for information about the capacity/availability of care home beds and what is possible regarding local capacity and how relative it is to the funding available for social care support
• recognition that the recruitment and a competitive salary for social care workers was key – the latest pay increase via COSLA (putting care workers over £15 per hour basic salary) was welcomed
• agreement that boards need to focus on what they can do with the resources available, what can be done in collaboration
• acknowledgement of the financial challenges moving into winter

Angie Wood summarised, noting the key point around flow, keeping up with demand and the requirement for there to be a balance between capacity and expectations. All NHS Chairs were asked to consider how best to share good practice.

Action: Angie Wood to see what data can be gathered on capacity in social care and engage with NHS Chairs to share good practice examples at the next meeting of NHS Chairs.

Cabinet Secretary opening remarks

The Cabinet Secretary thanked NHS Chairs and their teams for their ongoing commitment to delivering safe, effective, and high-quality care to the people of Scotland. He made NHS Chairs aware of the new approach and working arrangements between Scottish Government and NHS Chief Executives and indicated that a meeting had been arranged for the 5th November for Caroline to discuss this with NHS Chairs.

The Cabinet Secretary noted that the winter preparedness plan, was published last month. The plan sets out the key actions’ services are expected to undertake to prepare for the months ahead.

The Cabinet Secretary highlighted that Ministers have committed in the programme for government to transform the approach to innovation across health and social care by building a new partnership between government, the NHS, academic institutions, and industry. He indicated that the Accelerated National Innovation Adoption (ANIA) pathway has been established to work in partnership with boards to deliver on this ambition.

ANIA is governed by the innovation design authority which brings government and the NHS together to make collective decisions around which technologies should be prioritised for adoption. He advised that the first flow through this pathway was digital dermatology. Consideration needs to be given to, how we can empower the innovation design authority to enable multi-year funding commitments.

Update on NHS reform

The Cabinet Secretary invited Paula Speirs, Deputy Chief Operating Officer - Planning and Sponsorship to update colleagues on the engagement required to take forward transformative reform for NHS Scotland. Paula updated on the development of a plan to meaningfully engage on reform at national and local levels. The paper provided set out four principal areas of engagement:

• engagement with the public on reform through the ALLIANCE and citizen panels
• engagement with other stakeholders including royal colleges and third sector
• engagement with the public on sustainable services through HIS-CE
• engaging with staff led by the strategic communications group

NHS Chairs were asked to note this update and consider how Scottish Government officials also meaningfully engage with NHS Chairs on reform, nationally and in connection with local engagement activity.

The Cabinet Secretary highlighted the challenge of communicating how we move to a more effective and sustainable system and the difficult choices that will need to be made around prioritisation.

Update from Chairs private meeting

Carole Wilkinson, NHS Chair, Healthcare Improvement Scotland updated on the NHS Chairs meeting on the 22 October 2024. Key items were:

• Whistleblowing and how this is embedded into Boards. Rosemary Agnew, Scottish Public Services Ombudsman and Elaine Cameron, Head of Investigations, Scottish Public Services Ombudsman had attended to provide an update. NHS Chairs asked whether there would be an opportunity to create a centralised resource to draw on qualified investigators with regards to complex cases. It was also noted that Whistleblowing was not well represented in Primary Care.
• Away Day: Action plan – a follow up conversation on how to take further key topics together and how to extend and develop strategic insight input from the NHS Chairs.
• Value based care would be discussed at next meeting with Chief Medical Officer

Any other business

There was no other business raised.

Date and time of next meeting

NHS Chairs meeting 11 December – 10:30 – 12:30.

People, Governance and Appointments Team
31 October 2024