Interim National Care Service Advisory Board: Advice to Scottish Ministers and Council Leaders - Composition of the final National Care Service Advisory Board

Risks/challenges associated with advice

Risk/challenge: If the final Board composition does not include the right membership:

• The reputation and credibility of the Board may be damaged
• The health and social care sector might perceive a hierarchy of value placed on different groups
• The Board may not access all necessary information and perspectives to ensure it fully understands issues and proposed solutions
• The implementation gap between intention and reality may not be prevented

Response/mitigation: The interim Board recognises the importance of ensuring the right people have member positions on the Board. The voice of non-public sector providers is clearly an essential one in the successful delivery of improvements in health and social care–the options presented all offer at least one seat.

Co-design recognised that it would never be possible to include every unique perspective through Board membership. The terms and conditions of all Board members include within members’ expected activities the gathering of wider views. The interim Board’s Ways of Working also highlights the importance of collaboration and sharing learning. It highlights the need to work with supporting infrastructure priority groups and stakeholders from the integrated health and social care sector, particularly those with lived experience, to inform the Board’s recommendations.

Risk/challenge: If the final Board’s composition is not in line with co-design recommendations, the process of embedding lived experience in decision making will be undermined.

Response/mitigation: The interim Board recognises the importance of the work undertaken by the co-design group, notwithstanding the views were sought on a statutory body. The value of lived experience perspectives are central to the Board’s purpose. The majority of the co-design insights have been acted on, when arriving at the final composition of the Board – including chairing arrangements and key groups for inclusion. All but one of the options now proposed allows for a membership which falls within the maximum of 15 recommended by co-design.

Risk/challenge: If the Board is too large discussions will become harder to manage and progress harder to achieve

Response/mitigation: The interim Board recognises that meeting agendas are often very busy. Ensuring all members have the opportunity to contribute meaningfully to discussions can lead to meetings overrunning or business being curtailed.

Risk/challenge: If there is a need to establish too many supporting structures in order to ensure the Board can access the right expertise, these could become difficult to support from within existing resources and might undermine the value of the Board itself

Response/mitigation: The interim Board is keen to draw views and contributions from existing groups where they exist – so that it is building on what is already known and minimising any unnecessary duplication. Co-design findings recognised that it would not be possible to have all interests included on the Board. It will be important for the final Board to find the right balance in reaching out to wider interests and expertise to inform its thinking; and ensuring that key decisions are made by the Board itself.

Risk/challenge: If statutory delivery partners (local authorities, health boards, integration authorities) are included on the Board as core members, there may be a conflict of interest for them in contributing to advice which affects their peers.

Response/mitigation: All members are invited to join the Board to share their experiences and knowledge and serve in the best interests of the people of Scotland. Members are not appointed to represent their roles in partner organisations. This is, quite deliberately, a new way of working, and one it is recognised might take some time for all members to feel comfortable with. It will be important for the final Board to ensure it establishes an understanding of this way of working within the health and social care sector. The inclusion of both system leaders and lived experience on the Board as equal partners is essential to ensuring a deep understanding of both problems, and the implications and feasibility of solutions.