NHS Chief Executives minutes: March 2020

Attendees and apologies

NHS Board Chief Executives

• John Burns, NHS Ayrshire and Arran
• Ralph Robert, NHS Borders
• Jeff Ace, NHS Dumfries and Galloway (by VC)
• Carol Potter, NHS Fife, Interim Chief Executive
• Cathie Cowan, NHS Forth Valley
• Amanda Croft, NHS Grampian
• Jane Grant, NHS Greater Glasgow and Clyde
• Paul Hawkins, NHS Highland (Vice Chair of CEs Group)
• Heather Knox, NHS Lanarkshire, Acting Chief Executive
• Tim Davison, NHS Lothian
• Iain Stewart, NHS Orkney, Chief Executive Designate
• Michael Dickson, NHS Shetland
• Grant Archibald, NHS Tayside
• Gordon Jamieson, NHS Western Isles (by VC)
• June Rogers, Golden Jubilee Foundation, Director of Operations/Deputy CE (by VC)
• Maggie Waterston, Healthcare Improvement Scotland, Director of Finance
• Angiolina Foster, NHS 24
• Audrey McColl, NHS Education for Scotland, Director of Finance
• Gerry McLaughlin, NHS Health Scotland
• Colin Sinclair, NHS National Services Scotland
• Angela Leitch, Public Health Scotland
• Julie Carter, Scottish Ambulance Service, Director of Finance
• Robin McNaught, State Hospital, Finance Director

Scottish Government

• Jeane Freeman, Cabinet Secretary for Health and Sport
• Malcolm Wright, Director General Health and Social Care/Chief Executive, NHS Scotland
• Shirley Rogers, Director of EU Exit and Transition, Chief People Officer, NHS Scotland and Director of Health Workforce, Leadership and Reform
• John Connaghan, Chief Performance Officer NHS Scotland and Director of Delivery and Resilience
• Jason Leitch, National Clinical Director Scotland
• Elinor Mitchell, Director for Community Health and Social Care
• Donna Bell, Director of Mental Health
• Richard Foggo, Director of Population Health
• Caroline Lamb, Director of Digital Reform and Service Engagement
• Catherine Calderwood, Chief Medical Officer Scotland
• Richard McCallum, Deputy Director of Health Finance, Corporate Governance and Value
• David Williams, Director of Delivery, Health and Social Care Integration
• Robert Kirkwood, Office of the Chief Executive
• Laurie Whyte, Office of the Chief Executive
• Sarah Hildersley, Office of the Chief Executive
• Jack Downie, Deputy Private Secretary

In attendance

• Tracey Gillies, Co-Chair of SAMDs
• Colin Briggs, Chair of Directors of Planning
• Gabe Docherty, Chair of Directors of Public Health
• Alan Cooper, NHS Scotland Executive Support
• Yvonne Summers, Head of Operational Planning and Performance

Apologies

• Calum Campbell, NHS Lanarkshire
• Gerry O’Brien, NHS Orkney
• Jann Gardner, Golden Jubilee Foundation
• Robbie Pearson, Healthcare Improvement Scotland
• Stewart Irvine, NHS Education for Scotland
• Pauline Howie, Scottish Ambulance Service (Chair of CEs Group)
• Gary Jenkins, State Hospital
• Fiona McQueen, Chief Nursing Officer Scotland
• Gregor Smith, Deputy Chief Medical Officer
• Michael Chalmers, Director for Children and Families
• Tom Ferris, Chief Dental Officer

Items and actions

Agenda

• welcome, apologies for absence and attendees
• Cabinet Secretary opening remarks
• Cabinet Secretary discussion items: Coronavirus disease – COVID-19
• minutes of the previous meeting – 15 January 2020 – NHSCE/19/20/32
• matters arising
• feedback from the Chief Executives private meeting
• EU withdrawal – NHSCE/19/20/36
• implementing best practice: delayed discharges – NHSCE/19/20/34; good practice emerging from the Independent Review of Mental Health Services in Tayside – NHSCE/19/20/35
• any other business
• date and time of next meeting

Welcome, apologies for absence and attendees

Malcolm Wright, DG Health and Social Care and Chief Executive NHS Scotland welcomed everyone to the meeting. A list of attendees and apologies for absence are provided at Annex A.

Malcolm Wright thanked Shirley Rogers, Director of EU Exit and Transition, Chief People Officer NHS Scotland and Director of Health Workforce, Leadership and Reform for her time and commitment over the years and wished her well in her new role.

He also thanked Gerry McLaughlin for his role as Chief Executive in NHS Health Scotland and his support in the transition to Public Health Scotland.

Agenda Items 4, 5, 6, 7 and part of 8 were then discussed ahead of the Cabinet Secretary’s arrival.

Cabinet Secretary opening remarks

The Cabinet Secretary extended her thanks to Chief Executives and staff in NHS Boards and social care who have been working extremely hard to ensure system preparedness for the impact of COVID-19. The Cabinet Secretary highlighted the importance of working together and the need to focus on caring for the population, especially the most vulnerable. The Cabinet Secretary set out the importance of scientific and clinical evidence in supporting the preparation and response to COVID-19 but emphasised that this must be overlaid with judgement. She then led discussion on number of key areas.

Cabinet Secretary discussion items - Coronavirus – COVID-19

Phasing

The UK is still in the ‘containment phase’, the first stage of the four part plan to respond to COVID 19. CMO confirmed that decisions to move to the next phase, ‘delay’, will be made based on clinical and scientific evidence. The 4 UK CMO’s are meeting regularly to consider the measures that will be put in place to slow down the spread of the uptake of the virus.

Capacity

John Connaghan, Chief Performance Officer, NHS Scotland and Director of Delivery and Resilience gave an overview of the modelling which has been carried out with regards to both current and surge capacity. He outlined some of the key things that Chief Executives should include in Local Mobilisation Plans and advised that he would write out to ask for them to be returned by Wednesday 18 March 2020.

He advised Chief Executives that he would seek to finalise current Annual Operating Plans within the next two weeks. This will provide the basis of a recovery plan later in the year. Local Mobilisation Plans will form an addendum to the AOPs for 2020-2021.

National Boards were asked to also consider their resilience arrangements and how they can support the whole system in providing services over this period.

Action: John Connaghan to e-mail Chief Executives asking them to prepare and submit their local mobilisation plans by close of play Wednesday 18 March 2020.

There was a discussion about the capacity of private hospitals. John Connaghan agreed to pick this up with Jane Grant, Chief Executive, NHS Greater Glasgow and Clyde and Tim Davison, Chief Executive, NHS Lothian after the meeting.

Action: John Connaghan to have a conversation with Jane Grant and Tim Davison regarding utilising private sector capacity by Friday 13 March 2020.

Elinor Mitchell, Director of Community Health and Social Care provided an overview of the national work being done to support Boards to reduce delayed discharges and free up capacity. There will be an initial focus on supporting 5 key Health and Social Care Partnerships to reduce their numbers. The Cabinet Secretary emphasised the importance of working with local authorities on these issues but also on supporting social care that many vulnerable individuals rely upon.

Communication

Jason Leitch, National Clinical Director is working closely with Communications Healthier and other colleagues to ensure that information is communicated sensibly to the public in an accurate and helpful way. It was noted that the messaging needs to be aligned with information provided on digital platforms, for example NHS Inform and by NHS 24. Jason Leitch confirmed that a core script and Q and A are being developed and will be issued as soon as possible.

Digital technology

Caroline Lamb, Director of Digital Reform and Service Engagement advised that the ‘Attend Anywhere’ platform has been branded ‘Near Me’ in Scotland. The platform enables video consultations between patients and GPs and can be scaled up relatively easily. Guidance is already available for use in primary care, outpatient and inpatient settings.

Caroline Lamb will write to all Chief Executives to ask for a key point of contact in NHS Boards. Weekly calls with eHealth leads will be put in place to provide support to Boards on future usage, technology and bandwidths etc.

Action: Caroline Lamb to write to Chief Executives seeking key point of contact in NHS Boards regarding the use of ‘Near Me’ Staffing.

There was a discussion about the workforce and how staff providing frontline services can be mobilised and the arrangements for supporting bank and agency staff.

Other 

Colin Sinclair provided assurance around supplies of equipment, including protective masks and home oxygen supplies.

It was noted that there may be issues with mortuary capacity, but that local resilience arrangements would already be covered in NHS Board mass casualty plans. Elinor Mitchell agreed to liaise with other parts of Scottish Government regarding mortuary capacity and crematoriums.

Action: Elinor Mitchell to liaise with other parts of Scottish Government regarding mortuary capacity and crematoriums.

The Cabinet Secretary left the meeting after agenda item 3.

Minutes of the previous meeting – 15 January 2020 – NHSCE/19/20/32

The minutes of the meeting held on 15 January 2020 were approved.

Matters arising

There were no matters arising.

Feedback from the Chief Executives private meeting

Paul Hawkins, Vice-Chair of the Chief Executives Group gave an update on the discussions from the private meetings. This included:

• annual operating plans
• finance
• Independent Review of Transvaginal Mesh
• COVID-19

EU withdrawal – NHSCE/19/20/36

Shirley Rogers, Director of EU Exit and Transition, Chief People Officer NHS Scotland and Director of Health Workforce, Leadership and Reform gave a verbal update to the Group on EU withdrawal. The UK is currently in the transition phase and negotiations will end on 31 December 2020. Chief Executives will be kept informed of progress.

Implementing best practice

Delayed discharges – NHSCE/19/20/34

This was discussed under COVID 19. A paper had been circulated to Chief Executives in advance outlining areas of good practice across NHS Scotland. 

Good practice emerging from the Independent Review of Mental Health Services in Tayside – NHSCE/19/20/35

A paper was circulated to Chief Executives in advance of the meeting which identified 5 cross-cutting themes from the 51 recommendations outlined in the Strang Report.

In the absence of Donna Bell, Director of Mental Health, Malcolm Wright commended Grant Archibald for the work that had been carried out in NHS Tayside and acknowledged the support provided by NHS Lanarkshire.

Any other business

There were no items of other business.

Date and time of next meeting

The next NHS Chief Executives Business Meeting will take place on Wednesday 6 May 2020 at 13:00. Consideration would be given as to how this meeting would take place, either in the Fettes Suite, Scottish Health Service Centre, Crewe Road South, Edinburgh EH4 2LF or by teleconference or other method.

Action: SG Secretariat and Executive Support to liaise regarding arrangements for next meeting on 6 May 2020.

Office of the Chief Executive NHS Scotland

12 March 2020

Other papers issued were:

• NHSCE/19/20/33 – An Update from St Andrew’s House

NHS Chief Executives minutes: March 2020

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