NHS Chief Executives Meeting: September 2023

Attendees and apologies

NHS Boards

• Claire Burden, NHS Ayrshire and Arran
• Ralph Roberts, NHS Borders
• Jeff Ace, NHS Dumfries and Galloway
• Carol Potter, NHS Fife
• Adam Coldwells, NHS Grampian, Interim Chief Executive
• Jane Grant, NHS Greater Glasgow and Clyde
• David Park, NHS Highland, Deputy Chief Executive
• Judith Park, NHS Lanarkshire, Director of Acute Services and Deputy Chief Executive
• Calum Campbell, NHS Lothian
• Laura Skaife-Knight, NHS Orkney
• Gordon Jamieson, NHS Western

Special Health Boards

• Robbie Pearson, Healthcare Improvement Scotland (Chair of CEs)
• Jacqui Hepburn, NHS 24, Deputy Chief Executive and Director of Workforce (V)
• Karen Reid,    NHS Education for Scotland
• Gordon James,    NHS Golden Jubilee (V)
• Mary Morgan,    NHS National Services Scotland
• Michael Dickson,    Scottish Ambulance Service
• Gary Jenkins,    The State Hospitals Board for Scotland (V)

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
• Douglas McLaren, Deputy Chief Operating Officer - Performance and Delivery
• Jason Leitch, National Clinical Director
• Richard McCallum, Director of Health Finance and Governance
• Saira Kapasi, Head of Support for DG H&SC and CE NHS Scotland
• Gillian Russell,  Director of Health Workforce
• Fiona Hogg, Chief People Officer
• Christine McLaughlin, Co-Director of Population Health
• Angie Wood, Director of Social Care Resilience and Improvement
• Tim McDonnell, Director of Primary Care
• Gavin Gray, Deputy Director, Improving Mental Health Services (on behalf of Hugh McAloon)
• Gregor Smith, Chief Medical Officer 
• Alex McMahon, Chief Nursing Officer
• Alison Strath, Chief Pharmaceutical Officer
• Robert Henderson, Unit Head, Intergovernmental and International Relations
• Ann Pullar, Team Leader – HIS and NSD Sponsorship 
• Robert Kirkwood, Head of the Office of the Chief Executive

Secretariat

• Laurie Whyte,Head of Board Governance and Appointments Team (V)
• Kat Dobell,    Board Governance and Appointments Team
• Sarah Hildersley,    Board Governance and Appointments Team
• Carol Hunter,    Board Governance and Appointments Team
• Fraser McJannett,    Executive Support to NHS Board Chairs and Chief Executives

Other Attendees

• Kirstin Dickson,    Chair of Directors of Planning/Director of Planning, NHS Ayrshire and Arran (V)
• Boyd Peters,    Co-Chair of Medical Directors/Medical Director, NHS Highland (V)
• Dona Milne,     Director of Public Health, NHS Lothian (on behalf of Susan Webb, Chair of Directors of Public Health) (V)
• Jacqui Jones,   Chair of HRDs/Director of HR, NHS Lanarkshire
• Claire Pearce,    Chair of SEND/NMAHP Director and Deputy Chief Executive, NHS Tayside (V)

Apologies

• Amanda Croft, NHS Forth Valley
• Caroline Hiscox, NHS Grampian (Adam Coldwells attending)
• Pamela Dudek, NHS Highland (David Park attending)
• Jann Gardner, NHS Lanarkshire (Judith Park attending)
• Jim Miller, NHS 24 (Jacqui Hepburn attending)
• Paul Johnston, Public Health Scotland
• Susan Webb, NHS Grampian, Director of Public Health (Dona Milne attending)
• Julie Carter, Scottish Ambulance Service, Director of Finance
• Richard Foggo, Co-Director of Population Health
• Donna Bell, Director of Social Care and NCS Development
• Hugh McAloon, Interim Director of Mental Health and Wellbeing (Gavin Gray attending)
• Stephen Gallagher, Director of Digital Health and Care
• Tom Ferris, Chief Dental Officer
• John Harden, Deputy National Clinical Director
• Andrew Watson, Director for Children and Families 
• David Plews, Head of NHS Service Development

Items and actions

Welcome, apologies for absence and attendees

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

Caroline extended additional welcomes to Michael Dickson to his first meeting as Chief Executive of the Scottish Ambulance Service and Brian Chittick to his first meeting as Chief Executive of NHS Shetland. 

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

Minutes of the previous meeting – 14 June 2023 – NHSCE/23/24/10

The Minutes of the meeting held on 14 June 2023 were approved. 

Four actions noted from the previous meeting have been completed. 

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. This included discussion on:

• dental services. 
• general medical services (GMS) and primary care
• Scottish medicines consortium (SMC)
• business systems 
• unscheduled care
• access to medication data

Alison Strath, Chief Pharmaceutical Officer advised that work is being undertaken on access to medication data through the cancer medications outcome programme.

Patient safety in the wake of Lucy Letby verdict – NHSCE/23/24/11

Caroline Lamb invited Alex McMahon, Chief Nursing Officer to give an update to colleagues following the announcement of a public inquiry into the circumstances behind the murders and attempted murders of babies at the Countess of Chester Hospital. Discussion included: 

• the Cabinet Secretary issued a letter to board Chairs and Chief Executives on 26th August asking for assurance on matters relating to clinical and corporate governance. A subsequent email from the Cabinet Secretary’s office asked for verbal updates at this meeting, followed by initial findings in writing to the Cabinet Secretary by 15 September.
• in terms of the work that Scottish Government will progress, it has been agreed to look at current processes and programmes around:
  • corporate and clinical governance
  • patient safety
  • leadership, culture and performanc
  • performance 
  • how the sharing intelligence network functions and its governance
  • SG has therefore established a Quality Assurance Oversight group: this group will look at the initial board replies but the set of actions listed above, as well as a forward planner. It will not look at individual patient cases and will report to the Health and Social Care Management Board, Audit and Risk Committee and then the Cabinet Secretary.

Action: NHS Boards to submit initial findings in writing from patient safety reviews in the wake of the Lucy Letby verdict within boards by 15 September 2023

Mary Morgan, NHS National Services Scotland raised questions about the judicial review, incidents not being reported and the length of time for whistleblowing complaints to be investigated. 

Winter planning update - NHSCE/23/24/12

Paula Speirs, Deputy Chief Operating Officer – Health Planning, provided colleagues with an update on winter planning for 2023. This covered:

• winter priorities and winter plan
• lessons from winter 2022/2023
• winter summit
• winter checklist
• resilience framework and target operating model
• reporting and modelling
• communications
• priorities and actions

Drawing assurance from things already in play, discussion followed highlighting current quarterly self-assessments on delayed discharges and the need to ensure triangulation with the winter checklist, noting that boards/partnerships have been asked to submit joint returns. It was noted that there will be no additional funding for winter 2023/24.

Action: For 2023/24, NHS boards to complete the winter checklist in collaboration with associated health and social care partnerships with return date of 22 September.

National and regional planning SLWG - NHSCE/23/24/13

Paula Speirs, Deputy Chief Operating Officer – Health Planning provided colleagues with an update on the National and Regional Planning Short-life Working Group (SLWG). This covered:

• the aim to strengthen coherence of planning and delivery of health services across NHS Scotland in accord with existing legislation
• enhanced coordination between NHS boundaries and regions will be evidenced by greater collaboration and proactivity
• key recommendations from the SLWG

Chief Executives were asked to consider the paper and presentation and return comments to Paula by late September noting that the final meeting of the SLWG would take place on 02 October 2023.

Action: Chief Executives to consider and provide comments to Paula Speirs on the National and Regional Planning Short Life Working Group (SLWG), prior to it being finalised at the SLWG’s final meeting on Monday 2 October

There was a discussion on the importance of the principles on how planning is done and acknowledgement that the updated workplan needs to align with what is currently in place. It was noted that there needs to be further work undertaken to develop a rural and urban model for Scotland. 

NCS update – NHSCE/23/24/14

Angie Wood, Co-Director Social Care and NCS Development provided colleagues with a progress update on the National Care Service (NCS). This covered:

• NCS bill
• shared accountability
• co-design

Caroline Lamb indicated that discussions with partners were ongoing and noted that NHS Chief Executives were keen to be engaged in discussions. NHS Chief Executives asked for clarity on timescales to be shared as soon as practicable. 

Action: Angie Wood to provide clarity to Chief Executives on timescales as soon as practicable

Vaccination programme and Covid update – NHSCE/23/24/15

Gregor Smith, Chief Medical Officer provided colleagues with an update on Covid. He indicated that whilst there are no general Covid-19 restrictions in place, the advice to the public remained that individuals should take up the offer of vaccination when it becomes available and try to stay at home if unwell. He added that, in Scotland, the purpose of COVID-19 testing has shifted from population-wide testing to reduce transmission, to targeted testing and surveillance. 

Action: NHS Chief Executives to ensure implementation of person-centred visiting practices

Christine McLaughlin, Co-Director of Population Health directorate provided colleagues with a written update on this year’s vaccination programme. She indicated that the programme began on 4 September 2023, and that most of the programme will be completed by 11 December 2023. The programme will run until 31 March 2024. 

Christine expressed thanks to vaccine teams in boards who have worked hard to bring forward, where possible, covid vaccinations for those at highest risk.

Any other business

There were no other items of business.

Date and time of next meeting

NHS Chief Executives Business meeting – Wednesday 15 November 2023 at 14:00.