NHS Forth Valley Assurance Board minutes: 22 February 2023

Attendees and apologies

Members

• Christine McLaughlin (Chair), Co-Director of Population Health (in-person)
• Alex McMahon, Chief Nursing Officer (virtually)
• Gregor Smith, Chief Medical Officer (virtually)
• Angie Wood, Director of Social Care Resilience and Improvement (virtually)
• Richard Foggo, Co-Director of Population Health (virtually)
• Robert Kirkwood, Head of the Office of Chief Executive (in-person)
• Tracy Slater, Head of Performance and Delivery (virtually)

Attendees – Forth Valley 

• Cathie Cowan, Chief Executive (in-person)
• Janie McCusker, Chair (in-person)
• Andrew Murray, Medical Director (in-person)
• Frances Dodd, Executive Nurse Director (in-person)
• Scott Urquhart, Finance Director (virtually)
• Robert Clark, Employee Director (in-person)
• Linda Donaldson, HR Director (in-person)
• Annemargaret Black, Chief Officer, Clackmannanshire and Stirling HSCP (in-person)
• Gillian Morton, Director of CPMO/Women and Children’s Directorate, Director of Midwifery (in-person)
• Jonathan Best, Acting Director of Acute Services (in-person)
• Jonathan Procter, Director of Estates and Infrastructure (in-person)

Attendees – SG

• Hazel Borland, Professional Advisor and External Support (in-person)
• John Harden, Deputy National Clinical Director and External Support (in-person)
• John Brown, Chair of NHS Greater Glasgow and Clyde and External Support (virtually)
• [redacted], Head of Workforce Practice Unit (in-person) 
• [redacted], Senior Policy Manager (virtually) 
• [redacted] (Secretariat), Policy Adviser (in-person)

Apologies 

• Gillian Russell, Director of Health Workforce, Scottish Government
• Patricia Cassidy, Chief Officer, Falkirk HSCP 

Items and actions

Welcome, Apologies and Introduction

The Chair welcomed members to the sixth meeting of the Assurance Board (AB), made introductions and noted apologies. 

Feedback from External Support Team

The SG External Support Team provided an update on their work, including consideration of indicators and tools to measure improved culture; and, providing feedback on the Measurement Framework. Prof Borland and Dr Harden meet weekly with the Chief Executive, Nurse Director and Medical Director, and continue to extend their support to the wider Executive Leadership team (ELT). 

John Brown provided a short update on the progress of the Governance review, which has a Terms of Reference (ToR) agreed. He outlined the three stands of work and their associated timelines: one-to-one interviews, observations of key governance meetings, and a desk-based review. The final report is expected to be shared in late June, but early findings will be fed back throughout the review to support continuous improvement.  

The Chair provided an update on her meeting with the Cabinet Secretary for Health and Social and, separately, the Area Partnership Forum (APF) on 21 February 2023. It is still the intention to update Parliament before the end of March, which will include publishing the next version of the Improvement Plan, and a full progress update against the original. NHS FV should continue to work hard to maintain momentum and drive sustainable improvements.  

Verbal Performance Update 

The ELT provided an update on challenged performance areas including: out of hours (OOH), Psychological Therapies (PT), Child and Adolescent Mental Health Services (CAMHS), and Unscheduled Care (USC). The ELT noted positive progress in CAMHS and challenged performance in PT, primarily due to workforce recruitment. USC and OOH progress has been varied.

Head of Performance and Delivery, Tracy Slater, corroborated this with intelligence from SG colleagues. The Chair asked the ELT to provide a substantive update on OOH at the next meeting. 

The ELT provided a short update on progress against the Healthcare Improvement Scotland (HIS) actions and the Chair noted good practice that could be shared with other Boards. 

Deep Dive on Integration

The Chair noted the importance of understanding the successes and challenges within the Integration space, given that delays achieving full integration in this area was a key factor underpinning Forth Valley’s escalation. 

The ELT shared a presentation which captured progress to date and outlined further work required. FV colleagues highlighted that the benefits of integration are yet to be fully realised. However, the Board is making robust progress, and the ELT recognised that doing so will impact positively on the culture of the organisation. 

FV highlighted the use of a decision-making matrix, which is supporting them to make effective and robust decisions based on clear lines of accountability. The AB and External Support Team queried the need for such a matrix, however FV reaffirmed that it is compliant with the Public Bodies (Joint Working) (Scotland) Act 2014 and will only be used in the short-term to clarify and embed roles and responsibilities. Director of Social Care Resilience & Improvement to engage with Forth Valley Chief Executive to facilitate external for Integration. 

Members also queried data sharing between different organisations within Forth Valley. The ELT confirmed that data sharing activities are underway to triangulate information between the Board and Local Authorities. Director of Estates & Infrastructure to share Forth Valley digital plan with Director of Social Care Resilience & Improvement. 

Members reaffirmed the need for Forth Valley to ensure the work they are doing goes beyond transactional actions and that time is also dedicated to working collaboratively with Local Authority partners, notably on the development of a shared strategic vision supported by joint leadership. NHS FV colleagues confirmed they have included strategic improvement work in this workstream. There was a recognition that more work needs to be taken forward and that momentum needs to be maintained. Chief Officer, Clackmannanshire & Stirling HSCP to share Public Body Act presentation with Director of Social Care Resilience & Improvement and Chair of NHS GGC. 

The Chair confirmed that the AB will next meet on Thursday 9 March, and asked NHS FV to submit a further iteration of the Improvement Plan ( incorporating additional culture, leadership and Integration actions); a progress report against the Improvement Plan; a summary report on progress against actions with a February timescale for completion; a milestones chart; and, finally, a full draft of the Measurement Framework. 

The Chair thanked everyone for their contributions and closed the meeting.