NHS Forth Valley Assurance Board minutes: 23 March 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)

• Gillian Russell, Director of Health Workforce (virtually)

• Robert Kirkwood, Head of the Office of Chief Executive (in-person)

Attendees – Forth Valley (in-person)

• Cathie Cowan, Chief Executive 

• Janie McCusker, Chair

• Frances Dodd, Executive Nurse Director

• Linda Donaldson, HR Director

• Scott Urquhart, Finance Director

• Robert Clark, Employee Director 

• Gillian Morton, Director of CPMO/Women and Children’s Directorate, Director of Midwifery

• Jonathan Procter, Director of Estates and Infrastructure

• Sally Mcintosh, Project Manager

• Kirstin Cassells, ACF Chair

• Gail Woodcock - Head of Integration, Falkirk HSCP (substituting for Patricia Cassidy) 

Attendees – Forth Valley (virtually)

• Annemargaret Black, Chief Officer, Clackmannanshire and Stirling HSCP

• Jonathan Best, Acting Director of Acute Services 

Attendees - Scottish Government

• John Harden, Deputy National Clinical Director and External Support (virtually)

• [redacted], Head of Workforce Practice Unit (in-person)

• [redacted], Head of Workforce Relations (in-person)

• [redacted] (Secretariat), Senior Policy Manager (in-person)

• [redacted] (Secretariat), Policy Adviser (in-person)

Apologies 

• Richard Foggo, Co-Director of Population Health, Scottish Government 

• Angie Wood, Director of Social Care Resilience and Improvement, Scottish Government 

• Tracy Slater, Head of Performance and Delivery, Scottish Government 

• Hazel Borland, Professional Advisor and External Support, Scottish Government 

• John Brown, Chair of NHS Greater Glasgow and Clyde and External Support Team 

• Andrew Murray, Medical Director, NHS Forth Valley

• Patricia Cassidy, Chief Officer, Falkirk HSCP

Items and actions

Welcome, Apologies and Introduction

The Chair welcomed members to the eighth meeting of the Assurance Board (AB), noted apologies and outlined the agenda. 

The Chair informed the NHS Forth Valley (FV) Executive Leadership team (ELT) that she will be providing a written update to Parliament by 31 March 2023. She has also engaged with elected members in Forth Valley and will arrange a meeting to provide them with an update on the progress against their Improvement Plan and overview of the Assurance Board. 

Performance Update 

The ELT provided an update on performance areas including: out of hours (OOH), Psychological Therapies (PT), Child and Adolescent Mental Health Services (CAMHS), and Unscheduled Care (USC).

They remain on track to meet the CAMHS standard. PT is still facing challenges, including in relation to workforce, but FV are engaging with colleagues in Scottish Government (SG) to support modelling work. USC is still very challenged, but the interim Acute Services Director is progressing a range of actions to improve performance, and is developing a workstream to reduce contingency beds. Action has been taken to develop and improve OOH services in response to the recommendations from the independent review carried out by Professor Sir Lewis Ritchie.

The ELT also provided an update on the positive progress against the actions detailed in the Healthcare Improvement Scotland (HIS) report, and will continue to progress this work once HIS conclude their support. 

Leadership and Culture Deep Dive 

The Chair acknowledged the progress made at the last meeting and was encouraged by the level of engagement from the ELT. 

The ELT shared a presentation which provided an in-depth consideration into leadership and culture in Forth Valley which included the results from a number of surveys, the learning they have taken from them, and the actions in place to mitigate concerns. They considered staff experiences and reaffirmed the need to include staff in culture programmes, pursuing actions beyond the national Whistleblowing strategy, and embedding partnership working across the organisation. There was also a recognition that staff wellbeing and patient care is interlinked.

NHS FV is learning from other Boards that have been escalated for similar issues and are engaging with a number of colleagues in SG. The ELT noted that a further Organisation Development (OD) programme would be progressed, with a self-facilitated learning session to take place prior to commencement of a structured and facilitated programme. There was a recognition that the relationships within the ELT have been improving. They provided an overview on the work they are doing alongside the Area Partnership Forum (APF). 

The Assurance Board provided some reflections on what the ELT had shared and queried whether these separate workstreams should be incorporated within the wider Improvement Plan and requested clear timeframes, and clarify on the role of the NHS FV Board in holding ultimate ownership. There was a recognition that this would be an iterative process which would evolve, and also that there are a range of different tools available e.g. iMatter results which can be used to evidence improvement.  This will all support sustainable change within Forth Valley.

The ELT were asked to consider the outcome measures in the Measurement Framework, with recognition of the overlapping measures that will be in place for the Governance and Culture sections. They were also asked to consider what other tools are available for them to measures progress e.g. internal audit processes. 

The AB also queried progress on Integration services, as support has been secured for Forth Valley to develop and embed a strategic vision for integration in Forth Valley. Members reaffirmed the overarching role the audit committee should have in the governance of this Improvement Plan and escalation. 

The ELT should publish the latest version of their Improvement Plan to support the letter from the Chair issued to MSP’s. 

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