NHS Chief Executives minutes: November 2021

Attendees and apologies

NHS Board Chief Executives

• Hazel Borland, 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
• Caroline Hiscox, NHS Grampian
• Jane Grant, NHS Greater Glasgow and Clyde
• Pam Dudek, NHS Highland
• Heather Knox, NHS Lanarkshire
• Calum Campbell, NHS Lothian
• Michael Dickson, NHS Orkney and Shetland
• Grant Archibald, NHS Tayside
• Gordon Jamieson, NHS Western Isles (15:30 onwards)
• Jann Gardner, NHS Golden Jubilee
• Robbie Pearson, Healthcare Improvement Scotland (Vice Chair of CEs Group)
• Jim Miller, NHS 24
• Karen Reid, NHS Education for Scotland
• 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
• Gillian Russell, Director of Health Workforce
• Richard McCallum, Director of Health Finance and Governance
• Donna Bell, Director of Mental Health and Social Care (from 15:25-15:45)
• Richard Foggo, Covid-19 Director
• Christine McLaughlin, Director of Testing
• Alex McMahon, Interim CNO
• Naureen Ahmad, Deputy Director General Practice (attending on behalf of Tim Mcdonnell)
• Jonathan Cameron, Interim Director of Digital Health and Care

In attendance

• Colin Briggs, Chair of Directors of Planning/NHS Lothian
• Alan Gray, Director of Finance, NHS Grampian
• Jacqui Jones, Director of HR, NHS National Services Scotland
• Malcolm Summers, Head of Strategic Reform (Agenda Item 5)
• Kim Walker, National Programme Director, NHS National Services Scotland (Agenda Item 5)
• Craig White, Deputy Director, Planning and Quality Division (Agenda Item 6)
• Robert Kirkwood, Office of the Chief Executive
• Laurie Whyte, Office of the Chief Executive
• Sarah Hildersley, Office of the Chief Executive
• Roz Barclay, Executive Support
• Nicola Gordon, Executive Support

Apologies

• Nick Fluck, Co-Chair of MDs/NHS Lothian
• Ann Gow, Director of NM&AHPs/DCE NHS Lothian/Chair of Send
• John Burns, Chief Operating Officer NHS Scotland 
• David Miller, Chief People Officer NHS Scotland
• Gregor Smith, Chief Medical Officer
• Dave Caesar, Deputy Chief Medical Officer
• Tim McDonnell, Director of Primary Care (Naureen Ahmad attending)
• Alison Strath, Chief Pharmaceutical Officer
• Michael Chalmers, Director of Children and Families

Items and actions

Agenda

1. Welcome, introductions and apologies for absence

2. Minutes of the previous meeting – 8 September 2021

3. Matters arising

4. System pressures (John Burns)

5. Care and wellbeing portfolio (Christine McLaughlin, Director of Test and Protect)

6. COVID-19 public inquiry (including Duty of Candour update) (Richard McCallum, Director of Health Finance and Governance)

7. Feedback from Chief Executives private meeting (Ralph Roberts)

8. Any other business

9. Date and time of next meeting

Chief Executives Business Meeting - Wednesday 12 January 2022 at 14:00 (Cabinet Secretary for Health and Social Care attending).

Minutes

Welcome, apologies for absence and attendees

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. 

Minutes of the previous meeting – 8 September 2021

The minutes of the meeting held on 8 September 2021 were approved. 

Matters arising

There were no matters arising raised.

Care and wellbeing portfolio

Richard Foggo, COVID-19 Director led the discussion relating to the Care and Wellbeing Programmes which focussed on the presentation and one page portfolio descriptions which had been circulated in advance of the meeting. The four portfolios for initial consideration were:

• preventative and proactive care
• place and wellbeing
• integrated unscheduled and urgent care
• integrated planned care

It was noted that the current system needed to be improved to meet desired outcomes. Moving to a portfolio approach from a programme approach would add value and allow critical actions to be carried out, enabling local change. 

Colleagues welcomed the update and the opportunity for greater coherence within a complex landscape. It was acknowledged that communications with the public and politicians would be a key part of enabling these changes. Portfolios need to be clearly set out, with timescales and details about what will be local, regional and national change. 

It was agreed that Regional Group Chairs, Solace and CoSLA and other Third Sector organisations should all be involved moving this work forward. 

System pressures

Caroline Lamb provided an update on current system pressures in John Burns absence. These included:

• current COVID-19 case numbers and hospital position
• four hour wait improvement at national level
• delayed discharges – the Cabinet Secretary has had discussion with a few Boards who have the highest cases

COVID-19 Public Inquiry (including Duty of Candour update)

Richard McCallum provided an update on the COVID-19 Public Inquiry. There will be two teams set up to manage the Inquiry. The Inquiry will take a person centred human rights based approach and further information will be available by the end of the year. It will be led by a Judge, as Chair, and discussions are currently taking place. 

Central Legal Office are already engaging and considering what will be required for NHS Scotland. It is likely that more staffing resource will be required to meet the tasks ahead, with key pressure around timelines.

Colleagues reflected on the current hospital inquiries in Glasgow and Lothian and it was agreed that Richard McCallum should have a discussion with Jane Grant and Calum Campbell regarding their experience of the process. It was recognised that Boards needed to prepare and support staff through the inquiry process, mindful of the potential impact from colleagues being drawn away from service delivery.

Craig White, Deputy Director provide an update on duty of candour in relation to the Inquiry. He raised four points:

• Linda Pollock’s letter in February 2021 relating to what were reasonable demands
• obligations – what will be required
• nosocomial infections
• how to support Duty of Candour leads with the process

Draft guidance is currently being prepared regarding nosocomial infection and Chief Executives would welcome a further discussion and involvement in preparing this guidance. CNO Directorate are in the lead on this piece of work and a copy of the draft as it stands would be shared, with a view to further discussion at a future meeting. 

Action: further discussion to take place with Chief Executives at a private meeting in the 1st instance regarding nosocomial infection guidance. 

Feedback from Chief Executives Private meeting

Ralph Roberts, Chair of Chief Executives Group, provided feedback from their Private Chief Executives and Strategy meeting, which included:

Mental Health and Wellbeing Action Plan for Veterans

• National Care Service
• digital roadmap
• national governance
• portfolio approach within CEs Group
• Black Start: planning for the scenario of a national power outage
• RMP4s and three year plans

Any other business

There were no items of other business.

Date and time of next meeting

Chief Executives Business Meeting - Wednesday 12 January 2022 at 14:00 to which the Cabinet Secretary for Health and Social Care will be attending.