NHS Chief Executives Meeting: June 2023

Attendees and apologies

NHS Boards

• Claire Burden, NHS Ayrshire and Arran
• Jeff Ace, NHS Dumfries and Galloway
• Margo McGurk, NHS Fife, Director of Finance and Strategy/Deputy Chief Executive
• Cathie Cowan, NHS Forth Valley 
• Caroline Hiscox, NHS Grampian (VC of CEs)
• Jane Grant, NHS Greater Glasgow and Clyde
• Pamela Dudek, NHS Highland
• Calum Campbell, NHS Lothian
• Laura Skaife-Knight, NHS Orkney
• Michael Dickson, NHS Shetland
• Brian Chittick, NHS Shetland
• Grant Archibald, NHS Tayside
• Gordon Jamieson. NHS Western

Special Health Boards

• Robbie Pearson, Healthcare Improvement Scotland (Chair of CEs) 
• Jim Miller, NHS 24 
• Karen Reid, NHS Education for Scotland
• Gordon James, NHS Golden Jubilee 
• Mary Morgan, NHS National Services Scotland
• Pauline Howie, Scottish Ambulance Service
• Gary Jenkins, The State Hospitals Board for Scotland
• Scott Heald, Public Health Scotland (on behalf of Paul Johnston)

Scottish Government

• Caroline Lamb, DG HSC/CE NHS Scotland
• John Burns, NHS Scotland Chief Operating Officer
• Paula Speirs, Deputy Chief Operating Officer - Planning and Sponsorship
• Jason Leitch, National Clinical Director
• Richard McCallum, Director of Health Finance and Governance
• Steven Lea-Ross, Deputy Director of Health Workforce (on behalf of Gillian Russell) 
• Fiona Hogg, Chief People Officer
• Angie Wood, Director of Social Care Resilience and Improvement
• Gavin Gray, Deputy Director, Improving Mental Health Services (on behalf of Hugh McAloon
• Richard Foggo, Co-Director of Population Health
• Siobhan Mackay, Interim DD, Sponsorship, Operational Capability and Transformation (on behalf of Tim McDonnell)
• Alison Strath, Chief Pharmaceutical Officer
• Andrew Watson, Director for Children and Families
• Lyndsey Saki, Embedding Children’s Rights in Public Services Programme Lead
• Louise Mayes, Programme Manager, National Workforce Strategy Implementation
• Robert Kirkwood, Head of the Office of the Chief Executive 
• Kat Dobell, Board Governance and Appointments
• Sarah Hildersley, Board Governance and Appointments Team
• Carol Hunter, Board Governance and Appointments Team

Other Attendees

• Kirstin Dickson, Chair of Directors of Planning/Director of Planning (NHS Ayrshire and Arran
• Crawford McGuffie, Medical Director (NHS Ayrshire and Arran)/Co-Chair of Medical Directors
• Dona Milne, Director of Public Health, NHS Lothian (on behalf of Susan Webb, Chair of Directors of Public Health)
• Julie Carter, Director of Finance (SAS)
• Claire Pearce, Chair of SEND/NMAHP Director and Deputy Chief Executive (NHS Tayside)
• Fraser McJannett, Executive Support to NHS Board Chairs and Chief Executives
• Hayley Barnett, Executive Team Observing
• Boyd Peters, Medical Director, NHS Highland

Apologies

• Ralph Roberts, NHS Borders
• Carol Potter, NHS Fife 
• Jann Gardner, NHS Lanarkshire
• Paul Johnston, Public Health Scotland
• Colin Briggs, Director of Planning
• Nick Fluck, Medical Director (NHS Dumfries and Galloway)/ Co-Chair of Medical Directors
• Susan Webb, Director of Public Health (NHS Grampian)
• Jacqui Jones, Director of HR (NHS National Services Scotland)
• Gillian Russell, Director of Health Workforce 
• Christine McLaughlin, Co-Director of Population Health
• Donna Bell, Director of Social Care and NCS Development
• Tom Ferris, Chief Dental Officer
• Alex McMahon, Chief Nursing Officer
• Douglas McLaren, Deputy Chief Operating Officer - Performance and Delivery
• Hugh McAloon, Interim Director of Mental Health and Wellbeing
• Tim McDonnell, Director of Primary Care
• Stephen Gallagher, Director of Digital Health and Care
• John Harden, Deputy National Clinical Director
• Linda Pollock, Interim Director of Healthcare Quality and Improvement
• Graham Ellis, Deputy Chief Medical Officer
• Saira Kapasi, Head of Support for DG H&SC and CE NHS Scotland
• David Plews, Head of NHS Service Development
• Laurie Whyte, Head of Board Governance and Appointments Team

Items and actions

Minutes

Welcome, apologies for absence and attendees

Caroline Lamb, DG Health and Social Care and Chief Executive NHS Scotland, welcomed everyone to the meeting. 

Caroline thanked Pauline Howie for her 15 years of service as Chief Executive of the Scottish Ambulance Service (SAS) (1 year Acting CE and 14 as CE) ahead of her early retirement at the end of June. 

She also thanked Michael Dickson for his tenure as Chief Executive of NHS Shetland ahead of him moving to SAS as Chief Executive on 1 July 2023. 

Caroline welcomed Brian Chittick to the meeting, who will take up the role of Chief Executive, NHS Shetland from 01 July 2023. 

A list of attendees and apologies for absence are provided in Annex A. 

Minutes of the previous meeting – 3 May 2023 – NHSCE/23/24/06

The minutes of the meeting held on 3 May 2023 were approved. Three actions noted from the previous meeting have been completed. 

• Paula Speirs to arrange meeting with colleagues from Board Appointments and Governance Unit to discuss plans to create a framework agreement for territorial health boards by September – Paula Spiers is picking this work up with board secretaries
• Caroline Lamb to investigate the use of the public cloud to assist NES in “lift and shift” of data for care homes – this work is being picked up as part of the demand and capacity workstream within the winter planning project
• Executive support team to identify contacts in boards for the Good Food Nation team – Executive team working with officials

Matters arising

There were no matters arising.

Feedback from Chief Executives private meeting

Robbie Pearson, Chief Executive Healthcare Improvement Scotland/Chair of NHS Chief Executives Group provided feedback from the private meeting. These included topics on:

• junior doctors ballot result
• NHS dental service review has been commissioned by BCEs
• development of an NHS Scotland position statement with a focus on public health and the wider system which describes current context, challenges and opportunities

United Nations Convention on the Rights of the Child (UNCRC) incorporation and implementation – NHSCE/23/24/08

Caroline Lamb introduced Andrew Watson, newly appointed Director for Children and Families, who shared a presentation covering an update on the UNCRC incorporation and available support for NHS Chief Executives preparing for their duties under the UNCRC Bill. The presentation included:

• key provisions: 
  • compatibility duty
  • interpretation duty
  • strike down power
  • incompatibility declarator power
• supreme court judgement
• commencement of the substantive provisions of the Bill will come into force after 6 months beginning with the day of Royal Ascent
• existing UNCRC resources – including useful links to some of the resources and support available from the Scottish Government’s Children’s Rights Unit
• UNCRC Innovation Fund – £500,000 worth of funding to support pieces of innovation from across the public sector which embeds children’s rights. Bids should be in by end of June 2023
• upcoming UNCRC resources
• considerations for the health sector including targeted support and identifying a manager to lead on UNCRC implementation to consider impact on 16/17 year olds moving from the child to adult setting

Action: Chief Executives to consider assigning a senior manager to lead on UNCRC implementation

Andrew Watson indicated that boards should progress with recommendations ahead of the judgement on the Bill. Once Royal Ascent is granted the process will move quickly, so implementation will need to be swift and will need to have strong foundations in health and other parts of legislation around children’s rights. Andrew and his team would be happy to offer further guidance on wider priorities relating to children and family policies if Chief Executives would find this helpful. 

Karen Reid, NHS Education Scotland (NES) thanked Andrew for the presentation and queried whether work was being done to have training hosted on TURAS. Lyndsey Saki, Embedding Children’s Rights in Public Services Programme Lead, confirmed the team was in discussions with colleagues at NES and looking at the practicalities of hosting training on TURAS.

Dona Milne, NHS Lothian Public Health Director, confirmed Child Health Commissioner Champions in local councils have been working on this however would be helpful to bring to National Public Health rroup. Lyndsey Saki, is happy to involve other networks and groups in this work.

Action: Lyndsey Saki to contact Dona Milne for information on the National Public Health group

Andrew Watson confirmed he would write a paper to Chief Executives once a conclusion has been reached regarding the Bill.

Action: Andrew Watson to write to Chief Executives regarding the Bill once it has reached a conclusion

National Health and Social Care workforce Strategy Implementation programme - NHSCE/23/24/09

Stephen Lea-Ross, Deputy Director, Health Workforce shared a presentation which focused on:

• rationale and objectives
• refreshed governance – ensuring alignment and accountability
• organogram of workstreams and projects
• PMO progress to date
• project dashboard
• risks and issues – monitoring and mitigation
• next steps:
  • assessment to go to HSCMB and risk workshops re safe staffing
  • further advice to minister required
  • sub groups and Agenda for Change (AfC) workstreams to engage over the summer

Stephen Lea-Ross advised recommendations regarding implementation would be going to ministers in September. A suite of risk and governance workshops will be delivered over the summer, before final guidance on compliance in the autumn.

Calum Campbell, NHS Lothian questioned current modelling on workforce as Chief Executives have not seen it. There are risks on balancing the non-pay changes and safe staffing implementation, it requires a 3 prong approach including safe staffing, cost and service reform. 

Stephen Lea-Ross advised the current modelling needs refinement. He suggested holding a session with Chief Executives to look at the modelling and what next steps would look like would be valuable.

Action: Stephen Lea-Ross to arrange a session with Chief Executives to share modelling and discuss next steps

Mary Morgan, NHS National Services Scotland queried how we understand staff shortages across different disciplines not only midwifery and nursing. Staff shortages are proportionate in different services and staffing legislation applies to a broader space. There needs to be integrated an integrated response with a focus on staff engagement. 

John Burns, Chief Operating Officer stated it is important we understand where there are higher risk staffing issues, high risk discipline and vulnerability of service. Finding a solution will require looking at different service models, and looking at performance modelling and workforce modelling together.

Stephen Lea-Ross concluded that the input from Chief Executives has been constructive and work will continue to alignment dependencies and outcomes. There is a clear focus on risks and mitigations and there will be further discussions with Chief Executives as this progresses. 

Any other business

Caroline Lamb advised a letter would issue to NHS territorial board Chief Executives from Richard McCallum in relation to 2023-24 funding, which should be reflected in updated financial plans due later this month.

Date and time of next meeting

NHS Chief Executives Business meeting – Wednesday 13 September at 14:00.