NHS Ayrshire and Arran Assurance Board minutes: 28 May 2026

Attendees and apologies

Members

• (FB): Fiona Bennett, Chief Finance Officer – Chair, Scottish Government
• (FH): Fiona Hogg, Chief People Officer, Scottish Government
• (AW): Angie Wood, Director Mental Health, Social Care and NCS, Scottish Government

 

Attendees – NHS Ayrshire and Arran

• (LB): Lesley Bowie, Chair of NHS Ayrshire and Arran
• (GJ): Gordon James, Chief Executive
• (CC): Caroline Cameron, Chief Officer, North Ayrshire Integration Joint Board
• (VC): Vicki Campbell, Director of Acute Services
• (CMcG): Crawford McGuffie, Medical Director
• (BS): Brian Steven, Turnaround Director
• (DS): David Stonehouse, Director of Finance
• (KD): Kirstin Dickson, Director of Transformation & Sustainability
• (MI): Mark Inglis, Chief Officer, South Ayrshire Integration Joint Board

 

Attendees – Scottish Government/other

• [redacted], Unit Head
• (CN): Colin Neil, Professional Advisor to NHS Ayrshire & Arran Assurance Board
• (PT): Phil Tydeman, Interim Director of Improvement NHS Grampian

 

Apologies 

• (SG): Stephen Gallagher, Director of Assurance & Improvement
• (CMcA): Craig McArthur, Chief Officer, East Ayrshire Integration Joint Board
• (JW): Jenny Wilson, Director of Nursing

 

Items and actions

1. Welcome and introductions

FB welcomed members and attendees to meeting four of the assurance board and outlined the agenda. She invited comments on the last meeting’s minutes. LB advised of an amendment required to page 5 regarding board awareness. This will be amended. No further comments so the minutes are accepted.

2. Action Log

Most outstanding AB actions will be addressed in the course of the agenda

 

Item 3a: Sustainability funding This item relates to action AB012

The submitted paper was taken as read.

FB asked for detail around elements of workforce spend and what was inclued. CM confirmed that medical agency bank spend and all supplementary medical spend is included.

KD and DS both highlighted the importance of e-rostering going forward.

CN asked about tracking of mobilised elements against the baseline position. GJ confirmed that this is tracked and shows a positive trend against agency spend.

KD advised that monthly data can be shared. DS noted that two-to-three months’ data would be needed to identify any trends.

FB asked about reduction in WLI expenditure. DS advised that this needs to be considered in the context of throughput vs cash out.

GJ advised that there are ongoing discussions about other elements of the £500,000 sustainability funding; there is need for strong HR advice and support, as well as support around systems and the digital delivery plan. He will come back on this and acute leadership capacity.

FB confirmed that NHS Ayrshire and Arran do not need to wait for assurance board approval in order to spend the sustainability funding, but the assurance board would expect to be made aware of how it is being used.

Item 3b: Operational Improvement Plan (OIP) funding

FB sought confirmation of the split between planned care and unscheduled care spending.

DS provided context from last year. £4 million was carried forward from unscheduled care; £5.1million had been allocated for this year which was apportioned on a pro rata basis in line with last year, meaning £3.2 million was apportioned to unscheduled care and £1.9 million to planned care; combined with the carry over, this totals £7.2 million for unscheduled care in 2026-27.

CN asked about the mix of recurring and non-recurring and slippage. DS confirmed that slippage was not being planned for, and that the aim was for all spend to be recurring.

Item 3c: Internal audit

FB acknowledged that the audit report was reviewed by the health board at their meeting on 19 May 2026, and that this is not a function of the assurance board but is part of core business.

DS advised that the headline message of the report is that substantial improvement is required. It notes that previous recommendations have been addressed, but there is under-delivery of recurrent savings.

LB advised that the current report has a more positive tone that the previous year’s report

FB asked whether the 2026-27 audit plan has been signed off, noting it would be helpful for the assurance board to have sight of the plan.

GJ noted that the draft annual report will be published to align with the publication of the annual accounts; as draft went to the audit risk committee last week who noted they are content with the process.

Item 4: Closing the gap

KD presented slides on the best value plan, which demonstrated some stretch opportunities. The gap between savings required and identified now stands closer to £5 million.

CMcG noted that some deep dives are scheduled starting on Wednesday, included one into non-delay length of stay, and one on digital optimisation.

FB highlighted the risk of savings value diminishing if delivery is delayed. KD noted that slippage is factored in.

FB noted that when moving into a delivery phase it would be useful to see an additional ‘delivered’ amount in the plan. DS advised the intent to move to a delivery risk dashboard.

FB advised that it would be helpful to see the recurring vs non-recurring split. CN added that it would help to see the distinction between current and full-year effects.

Item 5: Transfer of care This item relates to action AB002/AB003.

GJ noted that this builds on the Operational Improvement Plan (OIP) item and links with the flow assurance board. The paper will be presented to the flow assurance board, and then go through health board and integration joint board governance processes.

VC noted the importance of sustainability in approach, noting that improvements brought about by quick transfer of care often don’t last.

GJ noted the importance of doing more to improve quality of care over the summer in order to be better placed to sustain improvements over the winter.

FB noted that discussions of proposals can take place outwith formal assurance board meetings, and that a more operational update would be appropriate following the improving flow meeting.

Action: Ayrshire & Arran to advise when ready to have a further discussion on this topic, and this can be outwith established assurance board agenda.

Item 6: Vacancy control This item relates to action AB004.

The supporting paper was taken as read.

FB asked whether the control process led to front-line delays. DS advised that some requests are for pass-through posts. CMcG gave the example of posts related to care of the elderly.

BS noted that the number of posts going to panel has slowed down. GJ noted that recruitment activity has halved, with the period from October to March seeing 30 posts a month while April to May saw 25 in total.

FB asked about seeing monthly data, suggesting a format could be agreed for this. BS noted that there is a tracking database for this.

CN asked about vacancy factors. BS advised that the panel don’t see this. DS suggested vacancy factors aren’t useful  and that check and challenge is what is needed.

GJ noted that some areas may need to do more recruitment to avoid using agency. BS noted that nursing recruitment is carried out in cohorts.

FB referenced the Viridian analytics and noted that a discussion of workforce could be had outwith the assurance board in order to be clear about ongoing asks.

Item 7: PMO change control This item relates to action AB013.

The supporting paper was taken as read.

FB noted that it was useful to see the process, and asked whether in practice this was helpful or onerous. KD advised that it was a helpful process and that it is easy to go back through the tracker to answer questions on how decisions have been made.

CN asked if subgroups operate in a culture of partnership. GJ noted that the employee director sits on the group.

Item 8: AOB

FB advised that the assurance board would give consideration to the scheduling of meetings over the summer period with possible reduced frequency and agenda set in advance to facilitate forward planning.

 

LB asked about reporting to NPPOG as referenced in the terms of the escalation. FB advised that NPPOG would be meeting in June and would get an update on stage 4 escalations, which would be essentially a summary of the work and meetings carried out to date.

BS asked about de-escalation criteria as this is also cited in the terms of reference. FB confirmed that NPPOG would also be considering de-escalation in their next meeting; there will be an opportunity to discuss more fully in due course but the anticipated criteria will be framed around the reasons for escalation.

Date of next meeting is 11 June 2026.