Health and Social Care Service Renewal Framework Programme Board minutes: December 2025

Attendees and apologies

• Donna Bell, Scottish Government (Chair)
• Eddie Folan, CoSLA
• Evan Beswick, Argyll and Bute Health and Social Care Partnership 
• Gary Jenkins, the State Hospitals Board for Scotland Board
• Gavin Reid, Scottish Government
• Henry Acres, Scottish Government
• Holly Abercrombie, Scottish Government 
• Jill Laspa, CoSLA
• Karen Reid, NES
• Malcolm Summers, Scottish Government
• Nicky Waters, NHS NSS
• Rachel Cackett, Coalition of Care and Support Providers in Scotland (CCPS)
• Sara Redmond, Health and Social Care Alliance
• Stephen Gallagher, Scottish Government
• Tim McDonnell, Scottish Government
   

Items and actions

Welcome and apologies

DB welcomed attendees to the first Service Renewal Framework (SRF) Programme Board and initiated introductions. 

Introduction SRF background and structure

HA presented slides on SRF and referenced the papers distributed prior to the meeting and outlined a number of key points, including:

• SRF is committed to a ten-year transition towards preventive healthcare, increased community support, and the strategic integration of technology
• the health and social care vision is guided by four core values: prevention, access, quality, and person-centred care. Five key principles inform its approach: a focus on prevention, person-led service delivery, community orientation, responsiveness to population needs, and digital enablement
• the program’s structure involves significant changes overseen by Senior Responsible Officers (SROs), supported by major change and enabling shift leads. Internally we have a director’s group, a delivery board, and a reform executive. Externally this board and the oversight board provide shared accountability
• that there is a need to enhance external engagement and collaboration beyond the Scottish Government. Current participation plans include an initial pilot for Major Change 4 Shifting the Balance of Care. The strategy prioritizes leveraging existing teams for implementation rather than establishing new entities

DB recognized the complexity of the situation and emphasized the importance of engaging with partners and encouraging feedback.
EF highlighted concerns regarding the scale of the internal structure, which could not be replicated in local government. He reflected that these are joint documents but noted the absence of the COSLA logo. EF also raised a query about joint political ownership and oversight and inquired about the composition of the delivery board and recommended collaborative efforts to strengthen joint governance. Emphasized the importance of local delivery and bridging gaps between national and local implementation. 
DB confirmed that the delivery board is an internal Scottish Government group, focusing on defining workstreams, but expressed openness to co-chairing or rotating chair arrangements for the Programme Board. 
SR emphasised the need for robust local oversight to manage change alongside existing priorities and stressed the value of effective communications for member engagement. SR inquired about the dissemination of deep dive findings and sought clarification on references to the third sector in social care discussions.
DB agreed on the necessity of cohesive local reform frameworks and improved connections between local and national planning, as well as recognising the complexity of establishing a singular model for local oversight.
RC acknowledged the comprehensive nature of the papers but noted they may be overwhelming for those external to government. RC identified the omission of sustainability as a risk and called for increased attention to funding flows and workforce considerations. RC also requested that future documents minimise the use of acronyms.
TM clarified that the programme handbook is intended to outline local engagement strategies for each major change and reiterated the centrality of joint governance and local engagement in programme development.
GJ noted challenges in understanding complex structures and requested clarification between strategic and specific requests directed to chief executives and the NHS executive group. GJ suggested regular status reports to facilitate engagement with executive groups.
DB agreed that input requirements may vary across different stages of the programme and emphasised patience as the group establishes its processes.
EB sought clarity around the board’s purpose, particularly in monitoring delivery and outcomes and stressed the significance of joint strategic plans as a lever for local delivery. EB advocated for national collaboration with local strategic planning cycles and cautioned against replicating intricate programme structures locally. EB proposed engaging the public at the national level to support local change and recommended piloting the framework with live local examples.
DB agreed to test the framework in real-world settings and noted that strategic planning and needs assessment are incorporated into the SRF, though further work is required.
KR expressed support for the programme approach and raised several points:

• digital capabilities should underpin all significant changes
• greater focus is needed on data, evidence, and intelligence
• risk thresholds and the political appetite for risk should be clearly defined
• a communications plan is essential
• integration of SRF commitments into NHS and integration authority delivery plans is critical
• shared executive delivery plans could aid performance triangulation

DB supported the strategic application of digital solutions across key changes and endorsed the emphasis on risk, data, and alignment.
EF reinforced the importance of testing the framework within ongoing local and national initiatives. Stressed the need for transparent expectations for local areas, especially given current operational pressures. Opposed top-down approaches, advocating for facilitative support to enable successful reform at the local level.
DB recognized the necessity of developing a communication strategy for staff and the public and welcomed input on shaping these efforts.

Programme Reporting and Risks

KC outlined the process for collation of the status report, which provides a summary of progress against SRF commitments using RAG ratings for milestones and escalates risks/issues from the delivery board or major change leads. KC highlighted that the current overall RAG rating is amber-green, indicating ongoing work and areas requiring additional development. One deliverable (digital health and care record) is red due to funding constraints. Amber-red milestones include dependencies on strategic needs assessment/planning and legislative factors affecting major change 7 (NHS delivery).
HA emphasized the need to capture escalations and challenges across the broader system beyond the Scottish Government. Early actions focus on establishing foundational delivery elements. 
RC requested more detailed reporting and assurance mechanisms. Proposed that delivery leads present key priorities for each major change and noted that assessing RAG status is difficult without clear definitions of success.
HA committed to sharing delivery plans for each major change area and acknowledged the complexities of evaluating long-term actions.
SR called for an honest appraisal of the system’s capacity and capability to deliver reform and highlighted funding risks at the local level and recommended that the risk register reflect wider issues around capability and capacity.
HA invited board members to review and propose additions to the risk register, including risks relating to sustainability, workforce, and capacity.

Terms of reference and membership

KR recommended incorporating innovation into roles and responsibilities and suggested explicitly listing NHS and integration authorities as key stakeholders. KR also requested the inclusion of the SRO for major change 7 in the membership list.
RC requested a review of her membership description to ensure accuracy, specifically regarding her status as a non-public sector representative.
SR sought clarity on communications responsibilities and timely dissemination of information to members. Requested provision of evidence packs and comprehensive reporting for meetings.
HA agreed to develop key messages and a communications plan and to update the terms of reference in line with feedback received.
EF endorsed the idea of workshops for local and national partners to move beyond programme management discussions and focus on practical implementation.
RC stressed the importance of considering all age groups within the framework, not just adults, particularly in commissioning and procurement.
HA confirmed the framework encompasses all age ranges and undertook to ensure appropriate links to children's services are included.

Actions:

• SRF Coordination team to investigate options for joint ownership and co-chairing of governance
• SRF PMO Team to update the Terms of Reference to clarify roles, responsibilities, innovation, and representation
• SRF PMO Team to create and distribute a glossary of acronyms and key terms
• SRF PMO Team to share detailed delivery plans for each major change area
• SRF Coordination Team to develop a strategy and key messages for internal and external communications
• SRF PMO Team to refine status reports to provide greater clarity and granularity
• SRF PMO Team to arrange a follow-up session prior to the next quarterly cycle
• All board members to review the risk register and suggest any additions