Health inequalities: Place and Wellbeing Programme Board minutes - March 2025

Attendees and apologies

• Chik Collins, Director, The Glasgow Centre for Population Health
• Calum Irving, Deputy Director, Strategic Third Sector and Public Service Leadership, Scottish Government
• Dona Milne, Director of Public Health, NHS Lothian
• Eddie Follan, Chief Officer Health and Social Care , COSLA
• Gerard McCormack, Head of Transformation, Performance, and Improvement     Improvement Service
• Kerri Todd, Head of Health Improvement, NHS Lanarkshire
• Linda Bauld, (Chair), Chief Social Policy Advisor, Scottish Government
• Lynne Nicol, Deputy Director Planning and Quality, Scottish Government
• Marion Bain, Deputy Chief Medical Officer, Scottish Government
• Marie Burns, Councillor Marie Burns, Leader of North Ayrshire Council, North Ayrshire Council
• Sheila McCole, Non-Executive Member, NHS Tayside
• Rebecca Hunter (Speaker), Anchors Workforce Policy Manager, Scottish Government
• Mathew Lowther (Deputy), Head of Service (Health Equity), Public Health Scotland
• Neil Cardwell (Deputy for Ellie Crawford), Team Lead, Primary Care Strategy unit, Scottish Government

Apologies

• Angela Davidson, Deputy Director for Improving Mental Health and Wellbeing, Scottish Government
• Caitlin Frickleton, Communities Lead, Scottish Government
• Carol Potter, Chief Executive, NHS Fife
• David Cowan, Head of Regeneration, Architecture and Place Unit, Scottish Government
• Ellie Crawford, Primary Care, Scottish Government
• Gordon Paterson, Director of Social Care, NHS Education for Scotland
• Lynn MacMillan, Head of Health Inequalities Unit, Scottish Government
• Niamh O'Connor, Deputy Director, Strategic Capability Division    Scottish Government
• Ruth Glassborow, Director Place and Wellbeing , Public Health Scotland
• Susan Gallacher, Deputy Director GP practice, Scottish Government
• Sam Martens, Policy and Business Analyst, NHS National Services Scotland
• Susan Paxton, Acting Director, Scottish Community Development Centre
• Wendy MacEwan, Project Support Officer, NHS National Services Scotland

Items and actions

Welcome and Apologies - Linda Bauld

Linda Bauld provided an outline of the meeting and noted apologies. Towards the end of the meeting there will be a substantial update on the Population Health Framework (PHF) from Chris Stothart. The meeting will finish with an update on the agenda for the next meeting in June.

Minutes from previous Board meeting (Paper 1) – Linda Bauld

Minutes from the previous meeting were circulated on the 19th December 2024. Linda Bauld invited members to make any amendments not already communicated by email. Members finalised and agreed the minutes.

Programme update – Emma Wylie

Emma Wylie offered a high-level update on each of the workstreams and relevant programme risk.

Enabling Local Change – there are two remaining deliverables – wider engagement event and developing activities for workstream to progress, which have been put on hold until the PHF is published. Once published, a review will be held on how the objectives are taken forward in light of actions with the PHF. Due to this delay, the Enabling Local Change workstream has been given an Amber RAG rating.

Anchors – overall outputs for the workstream are on track, and the RAG rating remains at green. A new lead for NHS NSS has been put forward for the Procurement workstream, Leanne Lyons, who is National Procurement Planning Manager.

Communities – Kimi Smith has returned as Communities workstream lead. The current focus of the workstream is around the Communications Strategy, which will be discussed later in the meeting. The RAG rating for the workstream has moved from Green to Amber, due to a number of areas for action are dependent on the Population Health Framework being published in Spring 2025.

High risks persist for the Programme around resource and fiscal position. The high risks are largely outside control of the Programme, and are not currently affecting the work, but may hinder longer-term implementation.

Programme Governance will also be changing over the coming months. The Health and Social Care Reform Portfolio is replacing the Care and Wellbeing Portfolio, following First Minister’s speech in 2025, outlining what the focus of Health and Social Care Reform will be, which goes beyond the current scope of Care and Wellbeing Portfolio. There is currently no impact on the Place and Wellbeing Programme until the scope and governance of the PHF has been finalised and published.

Anchors – Workforce Progress and Stage 2 Plan (Paper 2) – Rebecca Hunter

Rebecca Hunter sits within the Health Workforce Strategic Reform Unit, supporting the Anchors Workforce strand. Rebecca Hunter provided an update on achievements and next steps of the workstream, setting out how the workforce strand will continue to drive national enablers of local Anchors Workforce actions, with a particular focus on leveraging NHS employability potential towards anchor priority groups and tackling child poverty.

Rebecca Hunter and her team have been working closely with PHS and NHS Scotland to build fair work opportunities, supporting the Anchor Workforce objective.

Rebecca Hunter outlined the findings from stage 1 of the workstream, and associated work progressed for both Anchors Applicant Experience and optimised entry requirements into NHS Scotland, reducing barriers for people applying for jobs from key groups. This also included local partnership working which was identified as an important means of achieving the objectives. An Engagement Framework and menu of options for Health Boards to engage with Local Employability Programmes was developed to support engagement between Health boards and Local Employability Partnerships.

Scottish Government officials are working in collaboration with NHS Education for Scotland (NES) mapping current skills and apprenticeships pathways, assess use of apprenticeship, and convene a health summit to assist in the development of recommendations.

Rebecca Hunter outlined next steps as part of stage two of the delivery of the Anchors Workforce strand. This included: the implementation of Anchor Applicant Experience Recommendations; the development of a report on entry requirements for NHS Careers; the roll out of recruitment job description and person specification guidance; publishing and embedding the Local Employability Partnership – Health Board engagement framework & menu of options; evaluating existing practice and develop evidence based, scalable, adaptable model(s) for parental employability; developing a report with analysis on existing earn as you learn qualifications (including apprenticeships) and prioritised skills needs; and developing detailed workplan for establishing diversified earn as you learn training pipelines, providing progressive opportunities for new and existing staff.

Rebecca Hunter also provided an initial draft of the intended benefits of stage two, building upon the findings and achievements of stage one to show the link to achieving the overall Anchors Workforce strategic objective.

Linda Bauld invited members to note and comment on findings and planned action for the Anchors Workforce Workstream.

Marie Burns commented on how helpful this work is, particularly through the lens of Local Employability Partnerships, noting the greatest benefit is the willingness of local managers to adapt roles to suit potential recruits, for example part-time posts that don’t align with school hours. There are lots of barriers to consider, but recruiting managers have a prominent role to play. Marie Burns also noted funding has been provided to local authorities in the past for training, but the restriction in place to not fund other public sector training is a barrier, something that should be looked at for future consideration.

Kerri Todd found the Anchor Delivery Group presentation helpful in January and noted good progress to date. The key from this point is implementation of findings. Local discussions highlighted a few things. Firstly, there is an assumption people want a job in the public sector, but feedback suggests NHS jobs are not as attractive as we might think. Additionally, assumptions are made about IT competency skills and we should be wary of additional training required. Finally, noted flexible posts would also be a challenge locally, and are not always possible, so important to recognise how best to adapt roles.

Dona Milne highlighted the strong relationship with Local Employability Partnerships (LEPs) and NHS Lothian. NHS Lothian have an identified member of staff to engage LEPs which has proved to be very beneficial. To support the work with LEP’s, Public Health can offer the broader view on the requirement, and HR can work to support bringing people into employment on a more technical level. A 6-month employment pilot from NHS Lothian has supported people from the furthest to reach groups to be on placements, where some have been redeployed into permanent NHS contracts already. This could provide a useful model of a successful approach. After an initial unsuccessful pilot, this programme worked closely with Hiring Managers to avoid previous issues and has seen improved success for placements.

Shelia McCole highlighted the logistical issue of getting to-and-from work and how access to public transport can affect this, especially in rural areas, such as rural Tayside. Noted the work with colleagues to address engagement with young people and potential careers within the NHS. There was some concern that young people do not fully understand the career progression available in NHS employment outside of clinical roles, and if they were aware might be more likely to tailor their choices in education around NHS / Public Sector employment. Early engagement remains key to support this kind of engagement.

Rebecca Hunter welcomed the comments and noted that a lot of what members discussed has been within the focus of the workforce workstream. Úna Bartley also agreed it would be helpful to hear more from Dona Milne on the NHS Lothian employability pilot, and how they were able to overcome barriers around resource.

Action 26

• Rebecca Hunter to contact NHS Lothian colleagues to discuss further details on the 6-month employability pilot.

Rebecca Hunter noted the LEP and Health Board meeting, which discussed the importance of reliable transport to support the workforce, particularly in rural areas. Noted the importance of partnership working to help address the barriers as many solutions do not sit within health’s gift. Noted other areas for learning such as the Nursing and Midwifery review and the adoption applying more flexible working for roles that might provide opportunities to link.

Rebecca Hunter also noted NHS youth academy and social media engagement are both being taken forward to bring younger people into the workforce, but more work is needed. Partnership working will also be required here as the aspect of careers sits with another team. In the meantime, Rebecca Hunter is working with NES colleagues on attraction and careers.

Eddie Follan noted the Local Government work on 3rd Sector fair work and would like to hear more on the partnership working. Would be good to link in with team in COSLA and offered support to strengthen ties to Local Authorities.

Action 27

• Rebecca Hunter to reach out to Eddie Follan at COSLA, to meet with the Fair Work team and discuss how COSLA can support work around local employability teams.

Úna Bartley shared thanks with Rebecca Hunter for her work and appreciated comments from colleagues. Much of what has been reflected here was mentioned in feedback on the Anchor Strategic Plan.

The Programme will be sharing an updated workplan for the coming financial year, and we will have finalised dates for the deliverables that are yet to be confirmed.

Communities – Communications Strategy (Paper 3) – Úna Bartley

Úna Bartley provided a recap of the aim of the Communities workstream to provide the context for the communications strategy and highlighted the focus of engagement will be with system leaders and decision makers in Scottish Government, NHS, Local Government, and those leading on actions within the Population Health Framework.

Lots of engagement has taken place with community organisations which identified a number of barriers preventing community and voluntary organisations from being able to do more towards reducing health inequalities. A key finding was many community organisations do not feel valued or treated as an equal partner within local decision-making processes that affect the health and wellbeing of their community.

The strategy is aimed at system leaders and decision makers to strengthen their understanding of the community and voluntary sector’s contribution to population health. Further work is ongoing to refine the audience and forums appropriate to engage once the Population Health Framework is published.

Identified ‘champions’ from academia, think tanks, the NHS, and the community and voluntary sector who are well respected will amplify the strategy’s key messages and challenge system leaders to identify opportunities for community organisations to support the delivery of Population Health Framework actions.

Next steps include identifying champions; refining audience; identifying forums; and developing content.

Úna Bartley invited colleagues to comment on the strategy and share recommendations for potential champions.

Matthew Lowther reminded the board that Public Health Scotland is rolling out a series of health inequalities focussed programmes in three local authority area (Aberdeen City, South Lanarkshire, North Ayrshire) working with Michael Marmot through the Collaboration for Health Equity in Scotland. There is a potential opportunity to identify leaders and share learning from these three areas. He also noted that Scottish Government Place Directors could be an option as they provide a strong role in bridging between local government and Scottish Government. Finally, he suggested Professor Kat Smith from the University of Strathclyde, Scottish Health Equity Research Unit, as a potential academic champion.

Calum Irving welcomed the use of champions and noted that in the barriers section of the document it is worth mentioning that the current decline in volunteering is a pressure impacting on the community sector’s capacity. He also highlighted existing infrastructure that would be worth linking with to advise and connect with the sector.

Marie Burns agreed with Calum Irving’s point on volunteering and stated it would be great to equip people with the means to demonstrate how this work can have a positive economic impact to strengthen it.

Kerri Todd commented whether there is value in identifying champions from COSLA / Local Authorities, to extend over the broader public sector.

Action 28

• Úna Bartley to organise a meeting between Place and Wellbeing colleagues and Eddie Follan from COSLA, to discuss possible champions and forums.

Dona Milne flagged a risk to the work, regarding the credibility of the messages given the current state of funding within the sector, for example, many organisations are still waiting on confirmation of funding for next year. Though the value of the work is recognised among members, it is extremely important to ensure these barriers are addressed to maintain credibility.

Shelia McCole agreed with Kerri Todd on local authority involvement and clarified that all third sector groups should not be considered the same, given they all provide distinct functions. She also echoed concern regarding funding and noted a possible champion could be from individuals to provide lived experience, as the strategy currently feels ‘top down.’

Úna Bartley thanked colleagues for comments and noted the importance to highlight the valuable contribution of community organisations including their economic benefits. She noted the value of champions with lived experience, and the work of Common Health Assets group in raising the voices of those with lived experience. She reiterated that the hope is to convince those with policy levers, that some of these longstanding challenges can be addressed.

Linda Bauld highlighted the next steps and appreciated the caveats and comments from colleagues.

Population Health Framework Progress and Publication – Chris Stothart

Chris Stothart highlighted that the PHF will now sit within a suite of three key health and social care reform and renewal products, followed by a brief outline of the purpose, audience, and development of the Framework for 2025 – 2035. The development of proposed aims, actions, and priorities for the framework has been completed over the last 18 months and have now been reviewed by a range of stakeholders and key partners. Following this, advice was shared with ministers and COSLA leaders in February 2025.

Board members were provided with an overview and outline of the priorities, initial actions, long-term focus, and guiding principles for the Population Health Framework. There are approximately 30 actions within the framework, which are currently being drafted. The next steps consist of drafting the framework in the coming weeks, with Ministerial and COSLA sign off to follow.

Linda Bauld thanked Chris Stothart and invited colleagues to note and provide comment on the progress to date and proposed content and next steps for the developing the PHF.

Shelia McCole highlighted that many of the actions will be taken forward by Local Authorities, and their role will be crucial. Asked for this to be clearer and more explicit so that local authorities fully know their role. Noted that 10 years is an ambitious timeline to make real impact. There was agreement with the action regarding food and food environment given the importance of diet and nutrition.

Eddie Follan noted that there has been support on the direction of travel and content with the PHF being discussed at all appropriate COSLA boards and with SOLACE. The feedback from elected members has been around resource issues, and how there is no specific resource attached to support the implementation of the framework.

Shelia McCole highlighted the potential for making Health in All Policies mandatory alongside Equality and Environmental, noting how beneficial it would be for all policies and help shift the focus to health, using the PHF implementation as a catalyst.

Dona Milne found the progress promising, and felt the further detail is helpful. One issue was flagged around the Marmot Places reference, wherein there is a lack of reflection of the place-based work that has been progressed over many years including with the involvement of local public health teams. To avoid making contributors feel undervalued, DM requested that this long standing work is noted alongside reference to Marmot in the framework.

Kerri Todd wanted to echo support for Dona Milne’s point, also noted that there were initial concerns the Framework was too broad so welcomed the focus of the two initial priority areas. Added to Shelia McCole’s point on Heath in all Policies, there remains anxiety on the resource required to implement a Health in All Policies approach and what impact this might have on other areas.

Linda Bauld thanked members for their contributions.