Health and care reform: Stakeholder Advisory Group minutes - September 2025

Attendees and apologies

Carol Harris, RCN Scotland

Carol Sinclair, SAS

Charlotte Waite, British Dental Association Scotland

Chris Provan, Royal College of General Practitioners (RCGP) Scotland

Conor Maguire, RCPE

Daphne Varveris, Royal College of Physicians

Eddie Fraser, East Ayrshire Council

Emma Currer, The Royal College of Midwives

Eric Livingston, Royal College of Physicians and Surgeons of Glasgow

Iain Kennedy, BMA Scotland

Iain Morrison, SGPC

Jaki Lambert, Director of Royal College of Midwives Scotland

Jennifer Champion, NHS Forth Valley

Jim Crombie, NHS Lothian

Jo McBain, Director of Allied Health Professionals

John Robertson, BMA

Julie Mosgrove, Optometry Scotland

Julie Rankin, Allied Health Professions Federation for Scotland/Society and College of Radiographers

Karen Hedge, Scottish Care

Katie MacGregor, Royal College of Occupational Therapists

Kenryck Lloyd-Jones, Allied Health Professions Federation Scotland

Kirstin Dickson, NHS Ayrshire & Arran

Malcolm Clubb, NHS Borders (representing Directors of Pharmacy)

Rachael King, Chair, Representative of Chairs and Vice Chairs Group - IJB

Rachel Cackett, CCPS

Robbie Pearson, Healthcare Improvement Scotland

Ross Sanderson, RCN Scotland

Sara Redmond, The Health and Social Care Alliance Scotland

Sharon Wiener-Ogilvie, AHPFs

Susan Webb, Scottish Directors of Public Health

Chris Williams, Royal College of Physicians

Items and actions

Welcome and update on reform - Neil Gray MSP, Cabinet Secretary for Health and Social Care and Caroline Lamb, Chief Executive NHS Scotland/DG Health and Social Care

The Director General welcomed members to the fifth Stakeholder Advisory Group (StAG). 

The Cabinet Secretary:

• welcomed members, noting that StAG is a space for members to offer insights on how we work through challenge and make the most of the transformational opportunities that are before us
• commented on our common belief in the value of our public services and the need to move up stream to support preventative activity, further utilising digital and innovation opportunities coming through the system

Reform portfolio update 

Richard Foggo, Director for Population Health, provided an update on reform delivery across the Health and Social Care portfolio:

• since publication of our two long term reform frameworks in June, our joint national and local long-term policy landscape is clear
• there are huge connections between the products – establishing a baseline for the 10 year journey. We need to use the platform these frameworks give us to drive forward implementation
• the focus at reform portfolio level has been putting in place the conditions for successful delivery, being clear on leadership and resourcing of actions, the contribution of government, the NHS and local authorities and other key partners, and making sure the governance is in place to oversee and drive delivery
• systematic engagement is vital and – this StAG group remains key in that
• we are also putting in place programme governance. Linda Bauld and Richard Foggo will chair the reform board bringing together people accountable for delivery
• throughout July and August 2025, work has continued to map the actions under each driver within both the PHF and SRF. This has been conducted in collaboration with COSLA, Public Health Scotland (PHS) and NHS Board Directors of Public Health to determine accountability and identify the most effective delivery approach for each action
• mapping the 30 PHF actions now provides a baseline for delivery and two initial evidence-based priorities have been selected to support delivery of the aim of the PHF: embedding prevention in our systems and improving healthy weight
• following the mapping of actions, individual Programme Boards are being established for each programme to oversee and drive the delivery of initial actions
• we are already developing a new alcohol and drugs approach with a focus on key high risk/dependent areas and have kicked off work on preventative spend
• in parallel, dependencies and strategic alignment between the PHF and SRF have been identified to maximise synergies across both programmes
• both frameworks are being mapped against wider strategic planning, including the Public Service Reform Strategy, to ensure alignment of key objectives, strengthen coherence, and promote collaboration across the broader reform agenda

Donna Bell, Director for Social Care and NCS Development, provided an update on the Service Renewal Framework (SRF):

• highlighted connections with PHF, commenting that the fundamental shifts in SRF require involvement of StAG members, so making sure the right engagement plans are in place is of key importance
• the SRF is linked up to the aspiration of PHF with how we deliver our services
• in terms of the role StAG can play in facilitating engagement, it was thought that deep dive sessions might be of benefit and  members were asked to recommend areas of interest
• areas of interest for deep dives and comments offered from members were as follows: 
• a deep dive on data and how data is collected to help guide and inform  our actions. Regarding data (relating to social care) ambition appears limited and system driven rather than person driven. 
• our response to the highest needs individuals (eg. prisons) and safeguarding
• preventative spending work 
• mapping and specifically dependencies mapping
• how we are taking into account interdependencies on reform with public service reform [Richard Foggo suggested inviting Mary McAllan to a future StAG meeting focussing on risk and PSR]
• sector viability work integrating into risk registers for reform
• worth exploring how central programme-level risk registers are reflected in stakeholder corporate risk registers

Operational Improvement Plan (OIP)

Derek Grieve, Head of Social Care Response, provided an update on the OIP, highlighting:

• an OIP programme structure is now in place
• OIP is seeking to try and deliver a range of actions that start to move us on journey of reform 
• many of these services delivering better outcomes and cost effective
• at a programme level there are four workstreams – waiting times, improving flow, digital / innovation and prevention 
• a programme board reviews progress
• OIP recognises a whole system approach

Jim Crombie from NHS Lothian presented how NHS Lothian is taking a whole system approach to shifting the balance of care. He highlighted:

• how leadership across the system has contributed to this work
• Lothian was in a challenging place with high waiting times and has a history of improvement. Usual response to open more beds was not resilient approach
• unscheduled care improvement programme goals to deliver prevailing national standards for performance (95) and an occupancy bed model (85)
• priorities to reduce ED attendance, length of stay and admissions - key workstreams to improve performance
• data was a central pillar of the programme. Data pack developed as a single source of truth
• governance structure was important - board and executive level significant commitment
• the aim is to roll out methodology of pilot across Lothians
• utilise real time information flows to inform decision making
• working closely with Primary Care to ensure seamless integration with HSCP teams and acute
• utilising ambitious digital initiatives and decision making capability

Comments and questions from members relating to the presentation related to the following:

• resource and cost
• quality and safety improvements 
• GP involvement 
• data as key enabler and system leadership approach
• results from 'moving rehab into community'
• Inclusive decision making, leadership and workforce planning

Closing remarks

The Cabinet Secretary thanked colleagues for their contributions, highlighting that Jim Crombie’s presentation was very helpful, and colleagues are learning from the experience in Lothian and replicating in other NHS boards.