NHS Chief Executives minutes: September 2020

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
• Amanda Croft, NHS Grampian
• Jane Grant, NHS Greater Glasgow and Clyde
• Paul Hawkins, NHS Highland
• Heather Knox, NHS Lanarkshire, Interim Chief Executive
• Calum Campbell, NHS Lothian 
• Michael Dickson, NHS Orkney and Shetland
• Grant Archibald, NHS Tayside
• Gordon Jamieson, NHS Western Isles 
• June Rogers, Golden Jubilee Foundation
• Robbie Pearson, Healthcare Improvement Scotland
• Steph Phillips, NHS 24
• Stewart Irvine, NHS Education for Scotland
• Mary Morgan, NHS National Services Scotland
• Angela Leitch, Public Health Scotland
• Pauline Howie, Scottish Ambulance Service (Chair of the CEs Group)

Scottish Government:

• John Connaghan, Interim Chief Executive NHS Scotland
• Elinor Mitchell, Interim Director General Health and Social Care
• Jason Leitch, National Clinical Director NHS Scotland
• Gillian Russell, Director of Health Workforce
• Sean Neill, Interim Director of Health Workforce and for Directorate of Population Health
• David Miller, Chief People Officer 
• Richard Foggo, Covid Director
• Richard McCallum, Interim Director of Health Finance
• Aidan Grisewood, Director of Primary Care
• Marion Bain, Deputy Chief Medical Officer
• Diane Murray, Deputy Chief Nursing Officer
• Alison Strath, Chief Pharmaceutical Officer
• David Williams, Director of Delivery, Health and Social Care Integration
• Christine McLaughlin, Director for NHS Planning
• Andrew Fleming, Head of NHS Board Sponsorship
• Robert Kirkwood, Office of the Chief Executive
• Laurie Whyte, Office of the Chief Executive
• Sarah Hildersley, Office of the Chief Executive
• Hannah Mackay, Office of the Chief Executive

In attendance:

• Tracey Gillies, Co-Chair of MDs/NHS Lothian MD
• Alex McMahon, Chair of SEND/Lothian DoN
• Susan Goldsmith, Chair of Directors of Finance/NHS Lothian DoF
• Jacqui Jones, Chair of HRDs/National Services Scotland HRD
• Colin Briggs, Chair of Directors of Planning 
• Vicky Irons, Chair of Chief Officer Group
• Val de Souza, Chief Officer, South Lanarkshire Council
• Stephen Lea-Ross, Deputy Director of Health Workforce
• Helen Maitland, Unscheduled Care Director
• Katie Morris, Acting Programme Director for the Scottish Access Collaborative
• Helena Jackson, Sustainability and Value Programme Director
• Nafees Ahmad, Scottish Clinical Leadership Fellow
• Roz Barclay, Executive Support
• Nicola Gordon, Executive Support
• Jenna Stone, Executive Support

Apologies:

• Jann Gardner, Golden Jubilee Foundation
• Angiolina Foster, NHS 24
• Jill Young, NHS Louisa Jordan and Director of Testing Programme
• Colin Sinclair, NHS National Services Scotland
• Gary Jenkins, State Hospital
• Donna Bell, Director of Mental Health and Social Care
• Fiona McQueen, Chief Nursing Officer
• Caroline Lamb, Director of Digital Reform and Service Engagement
• Liz Sadler, Interim Director of Population Health

Items and actions

Agenda

Welcome, apologies for absence and attendees

Minutes of the previous meeting – 10 June 2020 – NHSCE/20/21/01

Matters arising

Feedback from the Chief Executives private meeting – 8 September 2020 
(Pauline Howie) 

Integrated planning for 2021 and beyond Christine McLaughlin (introduction/setting the scene)

Programme for Government priorities:

• tackling inequalities (Sean Neill/Angela Leitch/Gabe Docherty)
• enhancing social care (Cathie Cowan/Alex McMahon/Donna Bell)
• primary care improvement (Aidan Grisewood/Chief Officer)
• sustainability (Susan Goldsmith/Richard McCallum)
• workforce development (Stewart Irvine/Gillian Russell)

Redesigning Planned Care (Paul Hawkins)

Any other business

Date and time of next meeting 

• Chief Executives Covid-19 teleconference – Friday 18 September 2020 – CANCELLED due to clash with Ministerial meeting
• Chief Executives Covid-19 teleconference – Friday 2 and 16 October 2020 – 10:00-11:00
• Chief Executives Covid-19 teleconference – Friday 30 October 2020 – 12:00-13:00 – later time due to clash with Ministerial meeting
• Chief Executives business meeting - Wednesday 11 November 2020 - 13:00

Minutes

Welcome, apologies for absence and attendees

 John Connaghan, Interim Chief Executive NHS Scotland welcomed everyone to the meeting. John thanked Paul Hawkins for his time as Chief Executive of NHS Fife and Interim Chief Executive of NHS Highland. Pam Dudek was congratulated on her upcoming appointment as Chief Executive of NHS Highland. A list of attendees and apologies for absence are provided at Annex A.  

Minutes of the previous meeting – 10 June 2020 – NHSCE/20/21/01

The minutes of the meeting held on 10 June 2020 were approved.  

Matters arising 

Stephen Lea-Ross, Deputy Director Health Workforce referred to the letter which was issued by John Connaghan to Chief Executives on 4 September 2020, relating to Test and Protect and contacts tracers. Above the ask included in the letter, it was requested that Boards identify an extra 100 contact tracers ahead of the upcoming weekend. It was agreed that this should be seen as a national resource. NHS National Services Scotland would manage the co-ordination of this and a single process would be agreed and shared with Chief Executives.  

It was emphasised Directors of Public Health would need to get involved in the co-ordination of the mutual aid agreement. As Test and Protect and contact tracing was one of the Cabinet Secretary’s current priorities, the importance of this work was highlighted.

Action:  

• Stephen Lea-Ross to issue a letter to NHS Chief Executives to request 100 additional contact tracers to be made available, ahead of the weekend
• Mary Morgan, NSS to co-ordinate the national co-ordination

On behalf of the Minister for Mental Health, John Connaghan advised colleagues that following the publication of the interim report by the Independent Review into Forensic Mental Health Services in Scotland, Chief Executives are asked to engage with their forensic mental health services and visit their Boards’ facilities if they haven’t recently done so.  

Feedback from Chief Executives private meeting – 8 September 

Pauline Howie, Chair of the Chief Executives Group provided feedback on topics discussed at the Chief Executives private meeting which included:

• adults, children and young people mental health services
• Forensic Medical Services Taskforce and
• Agenda for Change pay settlement

Integrated planning for 2021 and beyond

Christine McLaughlin, Director of Planning introduced this item which was proposed by Chief Executives. The purpose of this item was to initiate, inform and structure a wider discussion about mobilisation plans within the context of Programme for Government (PfG) priorities and what might be needed to make progress.

Programme for Government priorities

A presentation was circulated in advance of the meeting relating to the PfG priorities. The following topics were covered:

Tackling inequalities (Sean Neill/Angela Leitch)

Angela Leitch, Chief Executive, Public Health Scotland talked to the slides, which were circulated in advance. She outlined the key messages, which were the focus for tackling health inequalities:

• getting the balance right between preventing the causes of inequality (to make a long-term difference) and mitigating the harmful effects of inequality in communities currently
• poverty
• systemic exclusion and
• what role can Chief Executives, as leaders, play in creating a world class public health system?

In discussion, the following points were made:

• conversations on this topic need to stop taking place in silos and should be mindful of public health priorities
• good opportunity to review local services and look for synergy
• need to be mindful of digital exclusion
• anchor institutions should be explored

Enhancing social care (Cathie Cowan/Alex McMahon/David Williams)

Cathie Cowan, Chief Executive, NHS Forth Valley referred to the slides and outlined the future of Health and Care. Care homes were used as an example and looked at how the sector had changed.

In discussion, the following points were made:

• the changing needs of older adults and providing the right care in the right place was important
• avoid terms such as ‘old world vs new world’, as it could suggest good and bad. This is about continuing to improve and enhance services
• care homes are currently delivering in difficult circumstances and this needs to be built upon

Primary care improvement (Aidan Grisewood/Vicky Irons/Val de Souza)

Aidan Grisewood, Interim Director of Primary Care outlined the PfG commitments relating to primary care, which included:

• Pharmacy First
• GP contract
• mental health workers to key settings, including GP practices
• Near Me or telephone
• accelerate the reform programme for NHS dental services and
• accelerate the reform programme for NHS eye care services

Val de Souza, Chief Officer, South Lanarkshire shared the key themes which came from Primary Care Oversight Group:

• the need to work with a common purpose
• whole system planning and modelling
• inequalities and mental health
• relationship building – understanding the role and remit of others
• data sharing/IT infrastructure
• public messaging

Vicky Irons, Chair of the Chief Officer Group expressed that this was an opportunity for further integrated working.

It was expressed that there is a need to be bold with the use of digital technology, however need to be aware of exclusion in areas. A greater focus on what is best for patients was very welcomed.

Sustainability (Susan Goldsmith/Richard McCallum)

Richard McCallum, Interim Director of Health Finance gave an overview of the current position on funding and highlighted the incurred costs due to Covid. He highlighted that the funding available for next year was unknown at this point.

It would be helpful to make an agreement on prioritisation of services. This would assist discussions relating to funding, going forward.

Workforce development (Stewart Irvine/Gillian Russell)

Gillian Russell, Director of Health Workforce expressed that the Cabinet Secretary had made it clear that public health needed to be seen as an emergency response. Gillian outlined the priority work which related to Programme for Government.  

She highlighted:

• expanding mental health and wellbeing support for health and social care staff
• remobilising our NHS Services
• understanding workforce requirements national and locally in relation to remobilisation plans
• the Pulse Survey
• Race Equality Network and
• facilitating placements

Redesigning planned care

Paul Hawkins, Interim Chief Executive, NHS Highland provided an update on Redesigning Planned Care on behalf of Caroline Lamb. The ask of Chief Executives was whether the Scottish Access Collaborative could be the vehicle to achieve redesigning planned care.  

Following discussion, it was recognised that the Access Collaborative could work as an enabler group. Further discussions were required to look at the wider picture including elective centres, the possibility of reviewing the National Clinical Strategy and maximising current capacity of all care programmes.  

John Connaghan invited Christine McLaughlin to discuss the above further with Caroline Lamb and seek a Chief Executive to input through Pauline Howie, as Chair of Chief Executive Group.  

Action:

• Christine McLaughlin to discuss Redesigning Planned Care with Caroline Lamb and seek a Chief Executive’s involvement through Pauline Howie, to take forward the Redesigning Planned Care work

Jason Leitch, National Clinical Director would consider whether the National Clinical Strategy plan for the next five years needs to be reviewed. He reflected that the NHS needs to recapture lost ground relating to patient safety and person centred care. If a review was required, a group would be established to take this forward. 

Action:

• Jason Leitch to consider reviewing the National Clinical Strategy for the next five years and put together a group to take this forward, if required

Any other business

Jason Leitch raised the issue of chronic pain. He advised that chronic pain outpatients should be included in remobilisation plans.  

No other items of business were raised.

Date and time of next meeting

• Friday 18 September 2020 – Chief Executives Covid-19 teleconference –CANCELLED due to clash with Ministerial meeting
• Friday 2 and 16 October 2020 – Chief Executives Covid-19 teleconference –10:00-11:00
• Friday 30 October 2020 – Chief Executives Covid-19 teleconference –12:00 13:00 – later time due to clash with Ministerial meeting
• Wednesday 11 November 2020 - Chief Executives business meeting - 13:00

Office of the Chief Executive NHS Scotland
11 September 2020