NHS Forth Valley Assurance Board minutes: 27 September2023

Attendees and apologies

Members

• Christine McLaughlin, Co-Director of Population Health (Chair) (in-person) 
• Fiona Hogg, Chief People Officer (in-person)
• Angie Wood, Director of Social Care Resilience and Improvement (in-person)
• Robert Kirkwood, Head of the Office of Chief Executive (in-person)

Attendees – Forth Valley 

• Amanda Croft, Interim Chief Executive (in-person)
• Janie McCusker, Chair (in-person)

Attendees – SG/Other

• [redacted] (Secretariat), Executive Support Officer (in-person)

Items and actions

Welcome, apologies and introductions

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

This is the first AB meeting with Amanda as interim Chief Executive. It was noted that  the membership of AB had been reduced and meetings will focus more sharply on the three areas of escalation: governance, Leadership and Culture. NHS Forth Valley attendees are now the Chair and Chief Executive with additional attendees as appropriate. Updates on performance will be included for noting. 

NHS Forth Valley improvement plan

Amanda Croft provided a progress update on the improvement plan and advised that the next iteration will broaden out to focus on Assurance and Improvement and will be available for review at the following Assurance Board.   

In relation to the measurement framework, Amanda indicated that there were numerous ways to measure impact, which included:

• current evidence and goals to increase performance
• use of the Well Led Framework as a starting point with the whole system unscheduled care team. This can then be developed as a methodology in a cascading effect for delivery teams at all levels
• measurement of a high performing team. Look at IHI work and Kings Fund methodology. With a view for a baseline measure mid to end of October and review again at the end of March, with check ins in between

The next iteration of the assurance and improvement plan will have three key sections: governance, leadership and culture with members agreeing five key high-level priorities, with supporting actions, along with agreed timeframes and progress reports they will be accountable for. The plan will cover the next six months, in the first instance, with a review and refresh with pipeline priorities added. The Executive Leadership Team (ELT) will develop the content and take ownership of the plan. The Programme Management Office (PMO) team will be the narrators of the plan.

In discussion, Amanda confirmed that that the full ELT are engaged in the development of the plan, as they have a sense of ownership through their role in its creation. Having actions assigned to individuals was helpful as this fostered closer working across the ELT to deliver a shared objective. It was highlighted that this was about building on the good work already completed within previous versions of plans. 

There was a clear sense of vision and direction from the interim Chief Executive, despite being relatively new into the role . However, significant challenges remained to be addressed and the AB underlined the importance of focussing on outcomes, rather than process and on delivering sustained improvement. This would be key to provide the evidence required to support de-escalation in due course.

​​​​​​​The support provided by the Board Secretary to this work was acknowledged.

​​​​​​​The range of performance data available to the board was highlighted but there was concern that it did not, in itself, provide the insight required to drive improvement. The board’s current performance position caused concern with winter approaching. Angie Wood,  Director of Social Care Resilience and Improvement, highlighted the action plan which the unscheduled care team have developed previously should be re-visited. Jim Cannon was now the Executive leading on the four-hour target, with a clear focus on driving improvements in this area that had remained stubbornly challenging for the Board.

​​​​​​​Healthcare in prisons was highlighted as a concern due to the potential increase in the overall population. This would be picked up separately with Christine McLaughlin and Amanda Croft.

​​​​​​​Action: as part of the next iteration of assurance and improvement plan, a summary of what has been completed to date should be provided in order to be able to move over to the new plan.

Update on board development, governance review and Audit Scotland S.22 report

​​​​​​​Janie McCusker, Chair, indicated that board development has been on her agenda since taking up post and was an ongoing piece of work.  Seminars with the board are held every two months with a different focus at each session. 

​​​​​​​​​​​​​​The initial draft of the governance review is expected shortly and once concluded, will form part of the governance self-assessment on the Blueprint for Good Governance to be completed by board members.

​​​​​​​Amanda Croft updated that Audit Scotland have indicated publication of the report by end of December. 

AOB/prep for next meeting

​​​​​​​The Chair of AB indicated that the next meeting at the end of October and should include: the closure of the current Improvement Plan; the new Assurance and Improvement Plan; and, papers on performance should be condensed to provide update on key areas.

​​​​​​​It was highlighted that John Harden, Deputy National Clinical Director, and Hazel Borland, Professional Adviser, were content to join meetings with the ELT, on occasion, and it may be useful to have their perspective on the changes made, so far. Amanda Croft would consider when it may be beneficial for them to attend. 

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

27 September 2023​​​​​​​