NHS Chief Executives minutes: March 2021

Attendees and apologies

NHS Board Chief Executives:

• John Burns, NHS Ayrshire and Arran
• Ralph Roberts, NHS Borders (Vice Chair of CEs Group)
• Jeff Ace, NHS Dumfries and Galloway 
• Carol Potter, NHS Fife, Interim Chief Executive
• Cathie Cowan, NHS Forth Valley
• Caroline Hiscox, NHS Grampian
• Jane Grant, NHS Greater Glasgow and Clyde
• David Park, NHS Highland
• Heather Knox, NHS Lanarkshire, Interim Chief Executive
• Calum Campbell, NHS Lothian 
• Michael Dickson, NHS Orkney and Shetland
• Gordon Jamieson, NHS Western Isles 
• Jann Gardner, NHS Golden Jubilee
• Robbie Pearson, Healthcare Improvement Scotland
• Angiolina Foster, NHS 24
• Jim Miller, NHS 24
• Karen Reid, NHS Education for Scotland
• Jill Young, NHS Louisa Jordan
• Colin Sinclair, NHS National Services Scotland
• Mary Morgan, NHS National Services Scotland
• Angela Leitch, Public Health Scotland
• Pauline Howie, Scottish Ambulance Service (Chair of the CEs Group)
• Gary Jenkins, State Hospital

Scottish Government:

• Caroline Lamb, DG Health and Social Care/Chief Executive NHS Scotland
• John Connaghan, Interim Chief Executive NHS Scotland
• Jason Leitch, National Clinical Director
• Gillian Russell, Director of Health Workforce
• Sean Neill, Interim Director of Health Workforce 
• Richard McCallum, Interim Director of Health Finance
• Donna Bell, Director of Mental Health and Social Care
• Irene Barkby, Chief Nursing Directorate
• Aidan Grisewood, Interim Director of Primary Care
• Heather Campbell, Deputy Director of Primary Care
• Michael Kellet, Interim Director of Population Health
• Dave Caesar, Deputy Chief Medical Officer
• David Williams, Director of Delivery, Health and Social Care Integration
• Robert Kirkwood, Office of the Chief Executive
• Laurie Whyte, Office of the Chief Executive
• Hannah Mackay, Office of the Chief Executive

In attendance

• Ken Donaldson, Co-chair of MDs/NHS Dumfries and Galloway MD
• Alan Gray, Chair of Directors of Finance/NHS Grampian DoF
• Graham Foster, Chair of Directors of Public Health/NHS Forth Valley DoPH
• Jacqui Jones, Chairs of HRDs/National Services Scotland HRD
• Colin Briggs, Chair of Directors of Planning/NHS Lothian
• Andrew Fleming, Head of NHS Board Sponsorship
• Ruth Yates, Scottish Clinical Leadership Fellow    
• Lucy Hetherington, Scottish Clinical Leadership Fellow
• Alison Crooks, Scottish Pharmacy Clinical Leadership Fellows
• Jaxon Parish, Policy Officer (Observer)
• Laura Zeballos, Deputy Director, Pay, Practice and Engagement (Item 5)
• Yvonne Summers, Head of Operational Planning and Performance (Item 6)
• Lyndsay Turner, Policy Team Leader - Elective and Cancer Access (Item 7)
• Andrew Chapman, Interim Unit Head – GP Policy Division (Item 9)
• Nicola Gordon, Executive Support
• Roz Barclay, Executive Support

Apologies:

• Pam Dudek, NHS Highland (David Park attending)
• Grant Archibald, NHS Tayside
• Richard Foggo, Covid Director
• John Harden, Deputy National Clinical Director
• Amanda Croft, Chief Nursing Officer (Irene Barkby attending)
• Christine McLaughlin, Director of Testing

Items and actions

Agenda

• Welcome, introductions and apologies for absence (13:00)
• Minutes of the previous meeting – 11 November 2020 NHSCE/20/21/05
• Matters arising
• Feedback from Chief Executives Private Meeting (Pauline Howie)
• Finance (13:15-13:45)

1. Budget (Richard McCallum)
2. Pay (Laura Zeballos)

• Remobilisation Plans (13:45-14:05) (Yvonne Summers)
• Performance Management Framework (14:05-14:25) (John Connaghan)
• COVID-19 Road Map Service Implications (14:25-14:40) (Dave Caesar) Primary Care: Implementing the Contract and Beyond (14:40-14:55) (Aidan Grisewood and Ralph Roberts)
• Any Other Business (14:55-15:00)
• Date and Time of Next Meetings
• Chief Executives COVID-19 Meeting – Friday 26 March 2021 – 12:00-13:00
• Chief Executives Business Meeting – Wednesday 05 May 2021 - 13:00

NHSCE/20/21/06 – an update from SAH

Minutes

Welcome, apologies for absence and attendees

John Connaghan, Chief Operating Officer NHS Scotland, welcomed everyone to the meeting. A list of attendees and apologies for absence are provided at Annex A. 

John Connaghan, on behalf of the Scottish Government and Chief Executives, expressed his appreciation and thanks to Angiolina Foster, as this was her last meeting as Chief Executive of NHS 24.

He also thanked Pauline Howie, for her work as Chair of the Chief Executives Group over the last 2 years. The current Vice-Chair, Ralph Roberts, Chief Executive, NHS Borders, will take over as Chair on 1 April 2021, and Robbie Pearson, Chief Executive, Healthcare Improvement Scotland, will become Vice Chair.

 Caroline Lamb, DG Health and Social Care/Chief Executive NHS Scotland, provided opening remarks and thanked Boards for submitting their remobilisation plans. She reaffirmed that the key priority for all Boards was the Vaccination Programme.

Minutes of the previous meeting – 11 November 2020 – NHSCE/20/21/05

The minutes of the meeting held on 11 November 2020 were previously approved at the Chief Executives COVID-19 Meeting on Friday 5 February 2021. 

Matters arising

Scottish Parliament Election Guidance for the 6 May 2021 has been issued to Boards. Whilst the Guidance is similar to previous years, it was highlighted that given the unique nature of the pandemic, Boards can, if they choose to do so, continue to brief MSPs on factual matters related to COVID-19.

Feedback from chief executives' private meeting – 9 March 2021

Pauline Howie provided feedback on topics discussed at the Chief Executives Private Meeting which included:

• Vaccination supply
• Developing a strategic vision and framework of supporting principles
• Forensic mental health review
• Independent review of adult social care
• COVID-19 legacy opportunities: maximising on new infrastructure that has been created;
• Gypsy travellers' health;
• Scottish access collaborative; and,
• SPSO: whistleblowing

COVID-19 road map service implications

Dave Caesar, Deputy Chief Medical Officer, provided an overview of the service implications from social distancing and shielding. He highlighted ongoing work to prioritise those who need to attend appointments in person and how to manage waiting lists and prioritisation.

Finance

Budget

Richard McCallum, Interim Director of Health Finance, provided an update on the Budget, highlighting that a fuller update on longer term planning would be provided at the next Chief Executives meeting in April. The update included:

• 1.5% uplift for boards
• Public sector policy pay had been agreed
• £120 million for mental health
• £60 million for waiting times recovery
• capital funding
• savings programmes
• £870 million additional COVID funds

Pay

Laura Zeballos, Interim Deputy Director, Health and Social Care Workforce Pay, Practice and Engagement, provided an update on pay, which covered:

• Agenda for Change (AfC) pay
• pay award 2021/22 medical staff
• contractual reform for specialty doctors

Laura Zeballos advised that formal negotiations on the pay award for AfC staff will conclude in summer 2021 and that the Scottish Government has committed to Scottish Pay bargaining from 2022 onwards. It is expected that the Doctors and Dentists Pay Review Body will publish its recommendations on the 2021/22 pay award for medical staff in summer 2021. She also confirmed that new contractual and pay arrangements for Speciality Doctors have been agreed across the UK for implementation on 1 April 2021.

In discussion, Chief Executives welcomed the shared approach to reform. It was agreed that Sean Neill, Director of Health Workforce, would respond separately to the query from Chief Executives on the role of employers for 2020/2021.

Action: Sean Neill to provide a response to the query on the role of employers for 2020/2021.

Remobilisation plans

Yvonne Summers, Head of Operational Planning and Performance, expressed her thanks to Chief Executives for submitting their Remobilisation Plans, acknowledging the short time scales involved. Initial, high level, feedback that covered the Strategic Framework Timeline and key emerging themes was provided:

• good coverage of priorities as set out in commissioning letter; encompassing acute, primary, community and social care
• whole system approaches to mental health from forensic and emergency services to community and virtual provision
• importance of looking after staff wellbeing
• the need to retain the capacity to respond to possible future demands on the health and care services
• expanded role of public health
• workforce sustainability
• continuing need for robust IPC and impact on service capacity
• pace of remobilisation and expansion of services

Chief Executives indicated their commitment to doing things differently and building on lessons learned during the pandemic. They highlighted the importance of working in partnership with public and third sector partners, staff and clinical colleagues, and, with local communities.

Performance management framework

John Connaghan, Chief Operating Officer NHS Scotland gave a presentation and provided an update on the Performance Management Framework, which included an overview of Waiting Times and Activity. There then followed a discussion on measuring and targets and what should be put in place going forward. 

It was noted that this was being discussed at the joint Chairs and Chief Executives meeting on 22 March 2021, but that it should also be included as an Agenda Item at a future Chief Executives Business Meeting, once the new administration is in place.

Action: secretariat to include measuring and targets on future Chief Executives' business meeting agenda.

Primary care: implementing the contract and beyond

Aidan Grisewood, Director of Primary Care and Ralph Roberts, Chief Executive, NHS Borders, provided an update on Primary Care. They thanked Chief Executives for their feedback and engagement on the Revised MoU Commitments for the GP Contract.

Any other business

No other items of business were raised.

Date and time of next meeting

• Joint Ministerial Session with NHS Chairs and Chief Executives – Monday 22 March - 14:00-16:00
• Chief Executives COVID-19 Meeting – Friday 26 March 2021 – 12:00‑13:00
• Chief Executives Business Meeting - Wednesday 14 April 2021 - 13:00