NHS Chairs minutes: September 2022

Attendees and apologies

Health Board Chairs

• Karen Hamilton, NHS Borders
• Lesley Bryce, NHS Dumfries and Galloway, Vice Chair (on behalf of Nick Morris)
• Tricia Marwick, NHS Fife
• Allan Rennie, NHS Forth Valley, Vice Chair (on behalf of Janie McCusker)
• Ian Ritchie, NHS Greater Glasgow and Clyde, Vice Chair (on behalf of John Brown)
• Boyd Robertson. NHS Highland
• John Connaghan. NHS Lothian
• Meghan McEwen, NHS Orkney
• Natasha Cornick, NHS Shetland, Vice Chair (On behalf of Gary Robinson)
• Lorna Birse-Stewart, NHS Tayside
• Gillian McCannon, NHS Western Isles
• Linda Semple, NHS Golden Jubilee, Vice Chair (On behalf of Susan Douglas-Scott)
• Keith Redpath, NHS National Services Scotland
• Martin Cheyne, NHS 24
• Douglas Hutchens, NHS Education for Scotland, Vice Chair (On behalf of David Garbutt)
• Anne McKechin, Public Health Scotland, Vice Chair (on behalf of Angiolina Foster)
• Tom Steele, Scottish Ambulance Service
• Brian Moore, The State Hospitals Board for Scotland
• Doug Moodie, Care Inspectorate
• Suzanne Dawson, Scottish Health Council and Health Care, Improvement Scotland (on behalf of Carole Wilkinson too)

Scottish Government Officials

• Humza Yousaf, Cabinet Secretary for Health and Social Care
• Maree Todd, Minister for Public Health, Women's Health and Sport
• 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
• Gillian Russell, Director of Health Workforce
• Jason Leitch, National Clinical Director
• Linda Pollock, Interim Director, Healthcare Quality and Improvement
• Richard McCallum, Director of Health Finance and Governance and Value
• Donna Bell, Director of Social Care and NCS Development
• Hugh McAloon, Interim Director for Mental Health and Wellbeing
• Richard Foggo, Co-Director of Population Health
• Christine McLaughlin, Co-Director of Population Health
• Tim McDonnell, Director for Primary Care
• Jason Birch, Unit Head, Professional Healthcare Regulation and Healthcare Ass (on behalf of Alex McMahon)
• Derek Grieve, Head of Vaccines Division

In attendance

• Robert Kirkwood, Head of the Office of the Chief Executive
• Laurie Whyte, OCENHS Team
• Kat Dobell, OCENHS Team
• Carol Hunter, OCENHS Team
• Hannah Mackay, OCENHS Team
• Samantha Burns, Deputy Private Secretary to Cabinet Secretary for Health and Social Care
• Gerald Ellison , Private Secretary, Minister for Drugs Policy
• Roz Barclay, NHS Scotland Executive Support
• Nicole Smith, NHS Scotland Executive Support

Apologies

• Lesley Bowie, NHS Ayrshire and Arran
• Nick Morris, NHS Dumfries and Galloway, Chair of NHS Chairs Group (Lesley Bryce attending)
• Janie McCusker, NHS Forth Valley (Alan Rennie attending)
• John Brown, NHS Greater Glasgow and Clyde (Ian Ritchie attending)
• John Tomlinson, NHS Grampian
• Martin Hil, NHS Lanarkshire
• Gary Robinson, NHS Shetland (Natasha Cornick attending)
• Carole Wilkinson, Healthcare Improvement Scotland, Vice Chair of NHS Chairs Group (Suzanne Dawson attending)
• David Garbutt, NHS Education for Scotland (Douglas Hutchens attending)
• Susan Douglas-Scott, NHS Golden Jubilee (Linda Semple attending)
• Angiolina Foster, Public Health Scotland (Ann McKechin attending)
• Kevin Stewart, Minister for Mental Wellbeing and Social Care
• Caroline Lamb , DG Health & Social Care/CE NHS Scotland
• David Miller, Chief People Officer
• John Harden, Deputy National Clinical Director
• Stephen Gallagher, Director of Digital Health and Care
• Gregor Smith, Chief Medical officer
• Alex McMahon, Chief Nursing Officer (Jason Birch attending)
• Michael Chalmers, Director for Children and Families

Items and actions

Agenda

• welcome, apologies for absence and attendees
• minutes and actions from the previous meeting (27 June 2022)
• matters arising
• Cabinet Secretary remarks
• planned care targets
• national treatment centre (John Burns)
• national care service update (Donna Bell)
• feedback from Chairs private meeting
• any other business
• date and time of next meeting: NHS Chairs meeting on 24 October 2022

Welcome, apologies for absence and attendees

The Cabinet Secretary for Health and Social Care welcomed everyone to the meeting and thanked all for accommodating the late change of time. The newly appointed Chair of the Care Inspectorate Board was welcomed to their first NHS Chairs meeting, Doug Moodie took up the post on 1 September 2022.

Thanks were provided to Tricia Marwick, NHS Fife, for standing in the lead Chair for today’s meeting due to the Chair and Vice Chair of the Chairs Group being unable to attend due to pre-existing leave plans. 

The Cabinet Secretary noted the apologies and acknowledged the Vice Chairs representing their boards. A full 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 27 June 2022 were approved.

Matters arising

There were no matters arising from the previous meeting.

Cabinet Secretary remarks

The Cabinet Secretary highlighted the following:

• thanks were expressed to health boards who hosted the Cabinet Secretary and senior team visits over the summer which were exceptionally well planned. These visits provided insight to the range of issues boards are dealing with every day, from acute care to social care
• the system continues to be in a period of challenge particularly with the added pressure of the upcoming winter. Financially, this year has been extremely difficult as we recover from COVID-19 and the added pressure of the cost of living crisis
• discussions continue with health trade unions regarding the latest pay offer after the last offer was formally rejected
• the Improving Wellbeing and Culture paper will be published in autumn 2022. Thanks were given to all for contributions

Planned care targets

The Cabinet Secretary thanked Chairs for their hard work and the improvements to date in meeting planned care targets. Public Health Scotland are currently collating the statistics on the targets, which will be published in due course. The Cabinet Secretary gave assurances that his expectation was to insulate elective care through the winter pressures. 

John Burns, NHS Scotland Chief Operating Officer reiterated the good work that is being done through national collaborative working. He emphasised the collective effort that has been made in order to progress targets and connect across boards. Extra support has been provided to help resolve some issues for particular workforce specialities.

In comparison with pre-COVID-19 statistics, productivity across boards is improving. John Burns indicated that theatre utilisation was used as a critical measure and there is a need to maximise its capacity in boards. A number of boards have good examples of improvements made in day surgery and colleagues noted that it would be beneficial for those practices to be shared. He confirmed that there would be a national ‘planned care’ event held in the coming months and asked Chairs, as system leaders to offer support. Experts will be identified from each board and the event will have a key focus on collaboration.

There was a discussion about the workforce of the future, and the following was noted:

• the Cabinet Secretary confirmed the need for three year workforce projections to encourage a move away from short term thinking. Some thought should be given to training requirements and how we encourage training to take place in remote and rural areas to help retain staff.
• it was acknowledged that the workforce of the future will have different view of work and consequently there is a need to plan and think differently in order to recruit new staff. Plans are being put in place to assist with this, including:
  • NHS Golden Jubilee and NHS Education for Scotland (NES) are working jointly with youth academies to encourage Generation Z to work in health and care, helping them understand the different areas of work
  • encouraging older people back into healthcare. Work is being done around retire and return policies
  • working closely with higher education to promote Health and Social Care as a good place to work
  • Scottish Patient Safety Programme led by Healthcare Improvement Scotland (HIS) and NES working in partnership with the Centre for Sustainability and positively working in collaboration with NHS Boards
  • the Cabinet Secretary highlighted that current public messaging should be badged under winter resilience. He indicated that engagement and communication with the public would be key to get the message across that there are challenges ahead. With the focus currently being on tackling the long waits, it was acknowledged that there will be difficult decisions ahead. He encouraged Boards to think about a leaflet drop to every household, which provides people with other alternatives to accident and emergency.

Action: John Burns and Jason Leitch to consider a leaflet drop to every household, which details other avenues to seek medical assistance, other than accident and emergency.

National Treatment Centre

John Burns, NHS Scotland Chief Operating Officer, provided an update on the significant progress made by the National Treatment Centre (NTC) Programme. He confirmed that  four new NTC’s are on schedule for delivery, these are NHS Fife; NHS Forth Valley; NHS Highland; and NHS Golden Jubilee.

He indicated that work is taking place with local teams with a focus on the workforce, future modelling to assess demographic change and ensure we have the right delivery models, and finalising medium to long term plans which will maximise the opportunities which the NTCs provides including moving towards sustainable waiting lists and a sustainable workforce.

National Care Service update

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

• the Bill is currently at stage one and was introduced to Parliament. It is currently making its way through the committee process, which is likely to result in changes and additions being made to the Bill
• the framework will progress following conversations with stakeholders including social care, local government and health care. A NCS forum has been set up for this and invites should be with colleagues
• preparations are underway to launch a Lived Experience Experts panel. Opportunities to participate will be advertised via the Scottish Government website and all Scottish residents will be able to register their interest

It was noted that NHS Chairs and Chief Executives were asked by the Bill committee to provide their response to the Bill. The views expressed were joint opinions which focused on ensuring that the progress that has already been made through integration, and the learning from that, are taken into consideration when designing the NCS. 

The reality of the financial challenges of the NCS are currently being worked on. While the financial cost is significant there is a shared understanding that there would be a bigger cost by not perusing this work.

Feedback from Chairs private meeting

Tricia Marwick provided feedback from the chairs private meeting which included:

• an update on blueprint for good governance
• national strategic plans
• chairs away day in September
• national care cervice
• winter and workforce plans
• COVID-19 Inquiry paper, progress has been noted
• innovation design authority has been set up focussing on getting quick results on the most impactful projects. Tom Steele would like to provide an update on this work at a future meeting

Action: Secretariat to arrange future item on innovation design authority

Any other business

Vaccination programme

The Chief Medical Officer has emphasised the strong clinical basis for completing the winter vaccination programme by the start of December, in line with the Joint Committee on Vaccination and Immunisation’s target. Engagement and support will be provided to boards who are struggling to achieve this target.

NHS Chairs were asked to ensure that their boards issue local communications on the importance of the COVID-19 and flu vaccination to encourage the public’s uptake of the vaccination programme.

The Cabinet Secretary made Chairs aware that there was a ministerial statement due out this week on vaccinations and that there would be a Parliamentary debate on recovery and winter resilience later this month.

Action: Chairs to issue communications on the importance of the COVID-19 and flu vaccination.

Update on Hepatitis C

Maree Todd, Minister for Public Health, Women's Health and Sport provided an update on Hep C. She reminded colleagues that the Scottish Government had set a target of achieving elimination of Hep C by 2024 to 2025. It was acknowledged that while COVID-19 has caused pressure on this target, there is work to be done to determine how test and protect resources could be utilised for this work.