NHS Ayrshire and Arran Assurance Board minutes: 23 July 2026

Attendees and apologies

Members Scottish Government

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

 

Attendees – 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
• (KD): Kirstin Dickson, Director of Transformation & Sustainability
• (MI): Mark Inglis, Chief Officer, South Ayrshire Integration Joint Board
• (CM): Crawford McGuffie, Medical Director
• (DS): David Stonehouse, Director of Finance
• (ES): Erik Sutherland, Chief Officer, East Ayrshire Integration Joint
• (JW): Jenny Wilson, Director of Nursing

 

Attendees – Scottish Government/other

• (GD): Glen Deakin, Unit Head
• (CN): Colin Neil, Professional Advisor to NHS Ayrshire & Arran Assurance Board
• (TS): Tracy Slater, Head of Assurance & Performance
• (PT): Phil Tydeman, Turnaround Director, NHS Ayrshire & Arran

Apologies 

• (LB): Lesley Bowie, Chair of NHS Ayrshire and Arran
• (SG): Stephen Gallagher, Director of Assurance & Improvement

Items and actions

Item 1. Welcome and introductions

FB welcomed members and attendees to meeting six of the assurance board and invited comments on the last meeting’s minutes.

CN asked for clarification of the forecasting wording so they distinguish formal FPR forecasting from wider board forecasting practice, rather than implying other boards do not forecast before month 3.

Action: Minutes of the 25 June 2026 meeting to be amended ahead of publication.

JW provided feedback on the recent unannounced inspection, noting that feedback was broadly positive: patients were reported as receiving the fundamentals of care despite sustained pressure, and the emergency department was described as calm and organised. Positive feedback also reflected a sense that staff were working as part of a good team, while the main improvement areas remained feedback loops to staff, some hand hygiene practice, PVC bundles, and parts of the ageing estate.

Item 2. Action Log

Outstanding actions are being addressed outwith the meeting. There were no areas of concern to note.

Item 3: 2026-27 Month 3 review

The submitted papers were taken as read, and a detailed discussion followed. Key points:

The month 3 position is on track but remains high risk: The assurance board welcomed the forward-looking financial reporting, including a clearer forecasting direction, however acute savings delivery is behind plan. This links to the transfer of care business case discussed later in the agenda. Slippage in savings has been offset to an extent by positive movements in other areas.

Recurring impact needs clearer visibility: CN pressed for the savings programme to show its full-year effect, not just the in-year number, so the assurance board can judge whether structural deficit reduction is genuinely happening. Monthly reporting needs to make clearer how recurring delivery in-year translates into a more sustainable position in the following year.

Action: Add a monthly full-year-effect view of recurring savings to the financial reporting after month 4. 

Pipeline delivery now matters more than identification: The organisation has identified new areas of savings opportunities, but the assurance board’s main concern is whether operational teams and programme management office capacity can convert those opportunities into delivered schemes at pace. Delivery capacity was recognised as a material risk, given the competing pressures of operational performance, inspections, planned care activity, and wider improvement priorities.

IJB reporting needs a fuller system view: Members asked for future papers to confirm, rather than assume, that Integration Joint Board (IJB) savings are on track and to show health and social care pressures together so underspends or overspends are not read in isolation. The discussion highlighted that seeing only the health-funded element gives an incomplete picture of whole-system risk and flow.

Workforce pressures are easing unevenly: Agency use is reducing and recruitment activity is helping, but medical overspends, sustainability of multidisciplinary workforce models, and the impact of intakes of new staff still need close attention.

It was noted that that late circulation of papers limits proper scrutiny, so the current sequence of finance review and assurance board meetings needs to change. The intention is to move the meeting later in the cycle so finance discussions and quality assurance can happen first and papers can be reviewed properly in advance.

Action: Reschedule future assurance board meetings later in the monthly cycle so finance discussions can happen first and papers can be circulated with enough time for scrutiny and quality assurance.

Item 5: Invest to Save Proposals

It was agreed to take item 5 ahead of item 4, in line with the flow of the conversation.

FB noted that seven of the submitted invest-to-save schemes received early support, including diagnostics, home care capacity, procurement, remote attendance coordination, 3D printing, and one advanced practice scheme.

Action: Fiona Bennett to provide formal written confirmation of the seven approved schemes.

Action: Arrange follow-up discussions on the amber proposals that need more detail.

Item 4: Transfer of Care / Operational Improvement

The papers were taken as read.

The assurance board supported the direction of travel and stressed that delay now creates more risk if we wait for further work to be done on the business case, because winter timing, delayed discharge pressures, and stranded costs all make inaction more expensive. Mobilisation was treated as necessary to begin in parallel with continued refinement of the business case. 

TS and others were supportive of the bed-related proposal but emphasised that it will only hold if work on frailty, hospital at home, discharge processes, front-door performance, and SAS interfaces progresses alongside it. Bed changes alone were not presented as sufficient without the wider enabling work needed to sustain flow.

The IJB chief officers confirmed support for the plan and explained that delegated authority was tied to strategic fit, a return to IJBs after summer, and complete underwriting of recurring financial risk. Recurring funding support was presented as important for recruitment, mobilisation, and delivery confidence.

Action: Fiona Bennett to issue a formal letter confirming the assurance board‘s support for the balance of care proposal and clarifying the underwriting position and maximum financial risk being supported so the governance basis for mobilisation is explicit.

Item 5: AOB

No other items of business were raised.

Date of next meeting will be confirmed, in line with the action above.