NHS Chief Executives minutes: May 2021

Attendees and apologies

NHS Board Chief Executives

• John Burns, NHS Ayrshire and Arran
• Ralph Roberts, NHS Borders (Chair of CEs Group)
• Jeff Ace, NHS Dumfries and Galloway
• Carol Potter, NHS Fife
• Cathie Cowan, NHS Forth Valley
• Adam Coldwells, NHS Grampian, Deputy Chief Executive
• Jane Grant, NHS Greater Glasgow and Clyde
• Katherine Sutton, NHS Highland, Chief Officer NHS Highland Acute Services
• Heather Knox, NHS Lanarkshire
• Calum Campbell, NHS Lothian
• Michael Dickson, NHS Orkney and Shetland
• Grant Archibald, NHS Tayside
• Gordon Jamieson, NHS Western Isles
• Robbie Pearson, Healthcare Improvement Scotland
• Jim Miller, NHS 24
• Stewart Irvine, NHS Education for Scotland, Deputy Chief Executive
• Jann Gardner, NHS Golden Jubilee
• Mary Morgan, NHS National Services Scotland
• Angela Leitch, Public Health Scotland
• Pauline Howie, Scottish Ambulance Service
• Gary Jenkins, State Hospital

Scottish Government

• Caroline Lamb, DG Health and Social Care/Chief Executive NHS Scotland
• John Connaghan, Chief Operating Officer NHS Scotland
• Jason Leitch, National Clinical Director
• Gillian Russell, Director of Health Workforce
• David Miller, Chief People Officer NHS Scotland
• Richard McCallum, Director of Health Finance and Governance
• Donna Bell, Director of Mental Health and Social Care
• Tim Mcdonnell, Director of Primary Care
• Michael Kellet, Interim Director of Population Health
• Christine McLaughlin, Director of Testing
• Amanda Croft, Chief Nursing Officer
• Alison Strath, Chief Pharmaceutical Officer
• David Williams, Director of Delivery, Health and Social Care Integration

In Attendance

• Tracey Gillies, Co-Chair of MDs/NHS Lothian MD
• Alan Gray, Chair of Directors of Finance/NHS Grampian DoF
• Hazel Borland, NHS Ayrshire and Arran, Nurse Director
• Andrew Fleming, Head of NHS Board Sponsorship
• Heather Campbell, Interim Deputy Director Primary Care
• Jonathan Cameron, Head of Digital Health and Care (Agenda Item 5 and 6)
• Alastair Hodgson, Head of Strategy and Policy (Agenda Item 5 and 6)
• Linda Pollock, Interim Director of Healthcare Quality and Improvement (Agenda Item 7)
• Gregor Mcnie, Team Leader – Cancer Policy (Agenda Item 7)
• Robert Kirkwood, Office of the Chief Executive
• Sarah Hildersley, Office of the Chief Executive
• Roz Barclay, Executive Support
• Nicola Gordon, Executive Support

Apologies

• Caroline Hiscox, NHS Grampian (Adam Coldwells attending)
• Pam Dudek, NHS Highland (Katherine Sutton attending)
• Jill Young, NHS Louisa Jordan
• Jacqui Jones, Chairs of HRDs/National Services Scotland HRD
• John Harden, Deputy National Clinical Director
• Colin Sinclair, Director of Covid Vaccination Programme

Items and actions

Welcome, Apologies for Absence and Attendees

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

2. Tim Mcdonnell who recently took on the role as Director of Primary Care received a warm welcome.

Minutes of the Previous Meeting – 14 April 2021 – NHSCE/21/22/03

3. The minutes of the meeting held on 14 April 2021 were approved.  All actions had been completed.

Matters Arising

4. Healthcare workforce testing was raised by SG colleagues who are looking at ways of increasing the uptake of this service.  Meetings have been arranged over the next couple of weeks with individual boards to discuss any barriers or issues that currently exist in the process.  Chief Executives highlighted issues with the registration portal and this would be discussed further during the arranged meetings. 

Feedback from Chief Executives Private Meeting – 4 May 2021

5. Ralph Roberts, Chair of Chief Executives Group, provided feedback on topics discussed at the Chief Executives Private Meeting which included:

• SOLACE Meeting
• MSG – Scottish pay negotiations
• UK Counter Terrorism Strategy
• NHS Scotland Assure
• Elective Workforce
• UK Infected Blood Inquiry
• Quality Framework
• Wellbeing Vision
• National Performance Framework.

Action: Gillian Russell to pick up the discussion on MSG following the election with Chief Executives.

Action: Chief Executives Group to keep Michael Kellet updated on the UK Infected Blood Inquiry.

Action: SG Secretariat to arrange a discussion at a future meeting regarding the National Performance Framework.

Digital Infrastructure (including Office 365) and Cyber Security

6. Agenda items 5 and 6 relating to Digital Infrastructure and Cyber Security were combined and a paper had been circulated in advance covering both items.  Jonathan Cameron, Head of Digital Health and Care for the Scottish Government led on this item and provided an update by sharing slides, which included:

• the refreshed digital health and care strategy;
• priorities for 2021/22 and beyond;
• business systems;
• the need for increased specialist digital leadership and skills; and
• NIS regulations. 

7. Chief Executives welcomed the update on Digital Infrastructure.  The complexity of the landscape and systems were recognised as was the need for links to social care systems to be established.  It was recognised there was slippage in the GP IT programme, however good progress was now being made on the development of the replacement Vision system for GP practises with the hope of full availability for deployment later this year, although no Boards are yet ready to take it.  The new EMIS system has faced some further challenges with summer 2022 now looking likely for implementation; the new entry to the Framework, EVA system, wouldn’t be available until later than 2022 posing questions for the market viability of the product. 

8. It was agreed that it would be helpful to have a Roadmap for the next few years setting out the key challenges and completion dates, factoring in finance and workforce issues.  It was also important to reflect on lessons learned from the roll out of Office 365, including in approach to licencing.  Any new systems should be on a Once for Scotland basis and good governance would be essential in establishing the roles that SG and the NHS would play, while also helping to drive improvement.  Significant additional investment would be required but it would also be important to identify and quantify the cash releasing savings that would be made by moving away from legacy systems. 

9. It was also recognised that there was no eHealth/Digital representation at the Chief Executives Business Meeting and this should be remedied.  Chief Executives queried the level of eHealth/Digital leads within boards, noting the findings of the Digital Maturity assessments which suggested significant variation, and welcomed a further discussion on this. 

10. There was agreement that further discussion on the above points be taken forward collectively, recognising the work of NES. 

Action: Digital Health and Care Team to produce a collaborative Roadmap for the next 5 years. 

Action: Chief Executives to consider representation of eHealth/Digital at their meetings.

Action: Executive Support Team to arrange a time for Chief Executives to discuss Digital Leadership within their Boards, linking in with Digital Health and Care Team. 

11. Chief Executives welcomed the update on Cyber Security.  The Covid‑19 Pandemic had heightened the risk of cyber threat with reduced capacity both nationally and locally to deal with any threat. 

12. The Network and Information Systems (NIS) audit would review Scotland wide resilience over a 3 year period, with year 1 being audit and years 2 and 3 being review periods. 

13. A new UK wide strategy to be published later in 2021 will help drive the NHS Scotland strategy.  The strategic and collaborative approach to this was welcomed and Chief Executives looked forward to the opportunity to participate in the SG/cross public sector strategy group being established. 

14. As part of the current Business Case, a pilot exercise is to be carried out with North of Scotland Boards which has funding for one year.  Chief Executives had heard from SEPA following a recent attack and learning from this was not how it happened, but how to respond and recover. 

15. Infrastructure for cyber security would be key to this work and this should be implemented on a Once for Scotland basis, working collaboratively across Boards and include the Tay Cities Deal, which brings a range of expertise from beyond health.

Action: Digital Health and Care Team to seek NHS Scotland participation in the SG/cross public sector strategy group when this is being established.

Cancer Recovery Plan

16. Jason Leitch, National Clinical Director, shared a few slides providing an update on the Cancer Recovery Plan and a paper had been shared ahead of the meeting.  Key points from the slides and paper were 4 “flagship actions”:

• early cancer diagnostic centres
• Single Point of Contact Framework
• prehabilitation
• a dedicated national resource for cancer (Scottish Cancer Network). 

17. £17 million new additional funds were agreed as part of the National Cancer Plan.  A bidding process for some of the additional funds concluded in March and some bids are still under discussion.  Any remaining money will then be used over the next 2 years against other priorities. 

18. Chief Executives welcomed the update and highlighted lessons learned from England and Wales and that workforce is a key part in implementation.  Some NHS Boards are already having regional discussions and this was recognised as a key step in the process and will help progress the plan in an effective way. 

19. A strong governance system is required for this and an ask from Chief Executives was to minimise sub‑groups to allow focus on key actions.  There needs to be transparency in the approach taken and this work needs to form part of Boards Annual Operating Plans factoring in finance, workforce and future infrastructure.  Medical and Nurse Directors need to be involved in any Group relating to this work. 

20. The approach taken will need to remain iterative and agile but commonality is required across Boards.  If any colleagues have any further comments or would like to discuss further, Grant Archibald, NHS Tayside Chief Executive would be happy to discuss. 

Feedback from SOLACE and Chief Executives Session

21. Ralph Roberts provided feedback from the SOLACE and Chief Executives joint session.  The session focussed on 2 topics, the Independent Review of Adult Social Care (IRASC) and Population Health/Inequalities.  Ralph invited Chief Executives who had led the topics to provide further feedback. 

22. Cathie Cowan, NHS Forth Valley Chief Executive led on IRASC.  The session reflected on progress in integration and how the pandemic had enabled closer working relationships, which was also recognised as an opportunity for change. 

23. Any new model should have a balanced quality system working collaboratively with HIS, SOLACE and the Improvement Service.  Something to consider is the development of a “citizen record”, rather than a “patient record”, which could be utilised across public services.. 

24. Colleagues welcomed the constructive and collaborative session and agreed to continue working together to focus on the key messages of the Review and continue to improve outcomes. 

25. Angela Leitch, Public Health Scotland led on Population Health/Inequalities.  The pandemic has strengthened communities and we need to build on this, while recognising that this was done at pace. 

26. Three areas were agreed for future discussion, and these were:

• families (in support of young people, intergenerational health and wellbeing, focusing on the 10% group);
• mental health and wellbeing (suicide prevention, drugs); and
• community wealth building (as employers and commissioners).

27. Colleagues welcomed and were supportive of the 3 areas for future discussion and SG colleagues were keen to work with boards, other partners and across Government to take this forward. 

Chief Executives Cabinet Secretary Briefing

28. Ralph Roberts provided an overview of the draft briefing which had been prepared by Chairs and Chief Executives for the information of an incoming Cabinet Secretary.  A copy of this had been shared ahead of the meeting. 

29. Scottish Government colleagues welcomed the paper and John Connaghan, Chief Operating Officer would work as conduit with Ralph to finalise the paper.  This would then be submitted to incoming Ministers as part of the wider health briefing which is being prepared.  John and Ralph agreed to meet on Friday a view to having a finalised document early week beginning 10 May 2021.  SG colleagues should submit any comments to John and Chief Executives to Ralph. 

30. An early engagement meeting between the DG/Chief Executive and Chief Operating Officer along with the Chair and Vice-Chair of Chief Executives Group should be arranged with the new Cabinet Secretary.  The new Cabinet Secretary should also be invited to meet with the collection Chief Executives at an appropriate opportunity. 

31. The meeting was advised of the likely timetable for the establishment of the new Government including swearing in MSPs, the Presiding Officer, Deputy Presiding Officer(s), First Minister and subsequently Cabinet.  This would be a slower process than usual due to Covid restrictions on Parliamentary business. 

Action: Colleagues to submit any comments on the Cabinet Secretary briefing paper to John Connaghan (for SG) and Ralph Roberts (for CEs) asap. 

Action: SG Secretariat with Executive Support Team to arrange early engagement meetings as outlined at paragraph 30 above. 

Any Other Business

32. The NHS Event this year was taking place virtually from Tuesday 22 to Thursday 24 June.  Jason Leitch would share further details with Chief Executives. 

Date and Time of Next Meeting

• Chief Executives Business Meeting - Wednesday 2 June 2021 - 14:00