NHS Chief Executives minutes: September 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
• Margo McGurk, NHS Fife
• Cathie Cowan, NHS Forth Valley
• Adam Coldwells, NHS Grampian
• Jane Grant, NHS Greater Glasgow and Clyde
• Pam Dudek, NHS Highland
• Laura Ace, NHS Lanarkshire
• Grant Archibald, NHS Tayside
• Jann Gardner, NHS Golden Jubilee
• Robbie Pearson, Healthcare Improvement Scotland (Vice Chair of CEs     Group)
• Steph Phillips, NHS 24
• Karen Wilson, 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:

• Leslie Evans, Permanent Secretary 
• Caroline Lamb, DG Health and Social Care/Chief Executive NHS Scotland
• John Burns, Chief Operating Officer NHS Scotland  
• Gillian Russell, Director of Health Workforce
• Gillian Russell, Director of Health Workforce
• Richard McCallum, Director of Health Finance and Governance
• Donna Bell, Director of Mental Health and Social Care
• Richard Foggo, Covid-19 Director
• Christine McLaughlin, Director of Testing
• Dave Caesar, Interim Deputy Chief Medical Officer
• Anne Armstrong, DCNO Designate (attending on behalf of Amanda Croft)
• Michael Kellet, Director of Population Health
• Heather Campbell, Deputy Director of Primary Care (attending on behalf of Tim Mcdonnell)

In attendance:

• Alan Gray, Director of Finance 
• Nicholas Fluck, Co-Chair of MDs/NHS Lothian 
• Jennifer Nye, Health Workforce (Observer)
• Robert Kirkwoodt, Office of the Chief Executive
• Laurie Whyte, Office of the Chief Executive
• Hannah Mackay, Office of the Chief Executive
• Roz Barclay, Executive Support
• Nicola Gordon, Executive Support
• Nicole Smith, NHS Scotland Executive Support

Apologies:

• Carol Potter, NHS Fife (Margo McGurk attending)
• Caroline Hiscox, NHS Grampian (Adam Coldwells attending)
• Heather Knox, NHS Lanarkshire (Laura Ace attending)
• Calum Campbel, NHS Lothian
• Michael Dickson, NHS Orkney and NHS Shetland
• Gordon Jamieson, NHS Western Isles
• Karen Reid, NHS Education for Scotland (Karen Wilson attending)
• Jim Miller, NHS 24 (Steph Phillips attending)
• Colin Briggs, Chair of Directors of Planning/NHS Lothian
• Tim McDonnell, Director of Primary Care (Heather Campbell attending)
• Jason Leitch, National Clinical Director (John Harden attending)
• Tom Ferris, Chief Dental Officer

Items and actions

Agenda

• welcome, introductions and apologies for absence
• minutes of the previous meeting – 18 August 2021 NHSCE/21/22/17
• matters arising
• Permanent Secretary remarks    
• update on the outputs of the System Pressures Group - (Caroline Lamb and Ralph Roberts)
• feedback from Chief Executives private meeting - (Ralph Roberts)
• any other business    
• date and time of next meeting - Chief Executives business meeting - Wednesday 10 November 2021 at 14:00 

Minutes

Welcome, apologies for absence and attendees

Caroline Lamb, DG Health and Social Care/Chief Executive NHS Scotland, welcomed everyone to the meeting. The welcome was extended to the Permanent Secretary, Leslie Evans, who joined the first part of today’s meeting.  

A list of attendees and apologies for absence are provided at Annex A.  

Minutes of the previous meeting – 18 August 2021 – NHSCE/21/22/17

The minutes of the meeting held on 18 August 2021 were approved.  

Matters arising 

There were no matters arising raised.

Permanent Secretary remarks 

Thanks were expressed to Chief Executives and all those working across health and social care for their tireless work during the pandemic: standing up increased ICU capacity, maintaining urgent care at the same time as dealing with Covid patients, providing leadership to Test and Protect and vaccinations. It was recognised that the system continued to be under significant pressure and the Permanent Secretary expressed that she was looking forward to hear directly from Chief Executives about the challenges being faced during the System Response Group item.

Update on the outputs of the System Response Group

Caroline Lamb, outlined that there was a number of presentations provided at the System Response Group (SRG) which included:

• Golden Jubilee supporting Boards with additional capacity
• primary care – mpact on the change of distancing rules
• care at home
• social care
• workforce

John Burns, Chief Operating Officer for NHS Scotland, highlighted that SRG was an action focused group. During that morning’s strategy group meeting with Chief Executives, a number of actions had emerged that would now be linked in to the work of the SRG – with clear leadership identified for each action. In addition, the strategy group had highlighted the importance of system leadership at this time, recognising that all areas of the health and care system were being impacted by pressures.

Ralph Roberts, Chair of Chief Executives Group, emphasised how critical the SRG was due to the significant pressures being experienced across the system.  

Gillian Russell, Director of Workforce, provided an update on workforce, which included:

• staff absences had recently slightly deteriorated
• policies on annual leave ‘buy back’
• ongoing work on increasing the overtime rate
• ongoing engagement with military with the potential to assist in a range of ways
• emergency deployment of Healthcare students would not be appropriate at this stage but potentially could be an option in spring

Chief Executives requested that the military offer was flexible at a local level to make arrangements which would best suit individual Boards. It was also highlighted that it would be helpful to know timescales of these actions and what the impact would be. It was agreed that the System Response Group would discuss this at their next meeting and feedback.

The Permanent Secretary was keen to hear how Chief Executives manage the current pressures while also looking at future improvements and reform. Caroline Lamb reflected that the system now faced significant pressures across health and social care and Chief Executives continued to move resources and ensure that priority services were protected. Being open with stakeholders and the public was important in dealing with the current pressures, but it also allowed the opportunity to identify reform and work differently in the future.

The Permanent Secretary thanked Chief Executives for their time today and highlighted that there was a real opportunity for change in the system.

Action:  

• System Response Group to discuss actions, timescales and impact

Feedback from Chief Executives Private meeting

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

• financial planning update
• remobilisation plans
• recovery plan
• ongoing work on GMS
• COP26
• National Care Service consultation
• integrated and unscheduled care

Donna Bell, Director of Mental Health and Social Care, highlighted that she was keen to discuss NCS in more depth with Chief Executives at future sessions.

John Burns, Chief Operating Officer for NHS Scotland, updated that conversations had taken place on the Delivery Plan and he would welcome a discussion with Directors of Planning to co-produce guidance. John would return to a strategic meeting of the Chief Executives in the future for a further discussion on the Recovery Plan.

The importance of clarity on key objectives for NHS Boards was highlighted. This would support colleagues in achieving a balance around the current pressures as well as planning for the future.

Action:  

• John Burns to return to a future srategic meeting to discuss the Recovery Plan

Any other business

Christine McLaughlin, Director of Test and Protect, provided an update on the Care and Wellbeing Programmes. It was outlined that work was progressing in each of the 4 Care and Wellbeing Programmes, which now needed to be progressed with putting in place the Portfolio infrastructure. This would require Director leadership and Christine McLaughlin and Richard Foggo, Covid-19 Director would take on this role jointly. Analysis work was ongoing on the enabling Workstreams and working towards a session with Ministers on 27 September. Chief Executives were asked to consider how best to engage with Christine and Richard on this work and support the programmes.

Alison Strath, Chief Pharmaceutical Officer, outlined that a response to the Pharmacy Committee enquiry letter had been issued to Chief Executives. A paper would be shared with Chief Executives in due course to outline what could be done with current legislation, in relation to Pharmacy.

Date and time of next meeting

Chief Executives business meeting - Wednesday 10 November 2021 at 14:00