NHS Ayrshire and Arran Assurance Board minutes: Meeting Two: 30 April 2026.

Attendees and apologies

Members

• (SG): Stephen Gallagher, Director of Assurance & Improvement – Chair
• (FB): Fiona Bennett, Chief Finance Officer (FB)

 

Attendees – NHS Ayrshire and Arran

• (LB): Lesley Bowie, Chair of NHS Ayrshire and Arran
• (GJ): Gordon James, Chief Executive
• (VC): Vicki Campbell, Director of Acute Services
• (CM): Crawford McGuffie, Medical Director
• (BS): Brian Steven, Turnaround Director
• (DS): David Stonehouse, Director of Finance
• (JW): Jenny Wilson, Director of Nursing
• (KD): Kirstin Dickson, Director of Transformation & Sustainability

 

Attendees – Scottish Government/other

• [redacted] Unit Head
• [redacted], Policy Official
• [redacted] Lynsey Brown, Policy Official
• (TS): Tracy Slater, Unit Head
• (CMcL): Christine McLaughlin, Chief Operating Officer

 

Apologies 

• (AW): Angie Wood, Director Mental Health, Social Care and NCS

 

Items and actions

1. Welcome and introductions

SG welcomed members and attendees to meeting two of the assurance board and outlined the agenda. He thanked those who have contributed to the minutes of meeting one on 02 April 2026 and asked for any final comments. There were no further comments so the minutes are accepted and will be published following the election in May 2026. The Chair thanked Kirstin Dickson (Director of Transformation & Sustainability) from A&A to attend her first meeting and noted apologies from Angie Wood.

2. Action Log

Three actions can be closed after today’s meeting:

 

Action	Update
Fiona Bennett to share information/contact relating to the Forth Valley approach to communications.	Shared 7 April 2026
Fiona Bennett to arrange for a deep dive on finances	Feedback included in item 3 of today’s agenda
Fiona Bennett to arrange a deep dive into the PMO approach to best value	Feedback included in item 3 of today’s agenda

 

Five actions remain open and are relating to future workplans and meeting agendas.

 

Action	Update
AW and GJ to meet to explore more of the detail around involvement and partnership working between the health board and integration joint boards.	Meeting has taken place. Whole system planning to be included in a future agenda.
VC to explore options around partnership working that will provide value for money and provide better care, linked to the aims of the Safe Hospital Occupancy programme, and bring a paper back to the assurance board if further support will facilitate this.	Gordon James to bring a proposal on transfer of care to the assurance board in May   Due 28 May 2026
Gordon James to develop a proposal for using the £500,000 support and bring to the assurance board in May.	Due 28 May 2026
NHS A&A to bring a paper on communications to the assurance board in mid-May	Due May 2026.
Add review of vacancy data to a future assurance board agenda	To be included on an agenda at the end of Q1 (July)

 

Item 3: Update on deep dive on finances and PMO

 

SG outlined the context for the deep dives, and stressed the need for confidence in the numbers, for a clear savings plans and evidence of impact. Whilst currently in a period of stabilisation, once through this the assurance board will expect to see service improvements and transformation to sustain financial balance

 

FB then provided an update on the deep dives into the PMO and savings programme held on 14 and 28 April 2026 respectively. The sessions acted as a critical friend review of the governance, pace and delivery confidence of the 2026/27 savings programme. Paper 3.1 was circulated in advance of the meeting which covered the PMO deep dive, and highlighted the need for a step‑change in pace and rigour at stage 4, including increased frequency of director sponsor oversight, clearer articulation of the full scale of the savings requirement, accelerated development and de‑risking of the savings pipeline, and continued momentum on the Caring for Ayrshire transformation programme. Ten actions are identified in the paper, some of which have already been started.

 

GJ confirmed that the frequency of director sponsor meetings has increased [action PM002] by adding meetings in between meetings of the best value group and performance and transformation meetings of the corporate management team.

 

FB noted that the deep dive was helpful to fully understand the saving requirements and asked if non-executive directors also fully understand the £57 million. GJ advised that integration joint board members had sought clarity on this point at Monday’s corporate management team meeting and that all members of the health board were fully sighted on the savings programme in full.

 

KD advised that a meeting with internal auditors is scheduled for next week and a finalised report on the savings audit will be shared with the assurance board. FB noted that this will be helpful evidence. GJ noted that positive discussions have been held with Audit Scotland before the start of the external audit process.

 

FB referenced the action on managing pipeline savings [PM004] and noted that these would be included within a single master tracker. KD advised that this work is evolving as things get brought on-stream, and that pipeline capture will be the focus of a meeting next week.

 

SG asked for evidence of change control. FB noted that this would be drawn out in monthly and quarterly finance review meetings. KD advised that a pathway of development would be followed, and that snapshots could be brought back to future meetings. SG noted that action updates will be requested in future assurance board meetings.

 

ACTION: Evidence of change control to be brought to future assurance board meetings.

 

FB advised that the assurance board should be viewed as a safe environment in which to test difficult ideas.

 

GJ said that his team are looking at front-door models and working with clinical teams to work up new models.

 

CMcL noted that while the fundamental point of escalation is for the health board to get into a stable financial position, a key question is what model looks best for NHS Ayrshire and Arran, and how that sits within the context of east/west planning models. She asked how existing infrastructure can be used to make space for redesign, and what a future community model might look like.

 

GJ said that “Caring for Ayrshire” will have a renewed focus on top priority areas. There is work to do on medical models including urgent care, elective and emergency models.

 

CM advised that there is a 3-year plan to improve surgical models and flow, and then align with national models in years 3 to 5.

 

CMcL said it would be helpful to get ideas from NHS Ayrshire and Arran feeding into national work. She suggested a discussion in the summer to set out plans and ideas for the future.

 

JW noted that the organisation is in a good place for this discussion as there is buy-in from clinical leaders.

 

GJ described the sub-national template to assess services. He said that some NHS Ayrshire and Arran services are Scotland-leading.

 

SG affirmed that escalation needs to be the immediate focus but must also consider the long-term future and connect to national thinking. He agreed that a discussion in the summer around developing thinking and testing ideas would be helpful.

 

LB noted that it is important to ensure that implementing changes doesn’t lead to declining performance. Sub-national planning needs to be optimised for partners.

 

Action: Meeting in the summer to consider service redesign.

 

Action A&A to provide a formal response to the actions in paper 3.1 at the next assurance board meeting (18 May 2026)

 

FB committed to sharing a similar paper covering the finance deep dive.

 

Action: Fiona Bennett to draft and share a paper summarising the finance deep dive and associated actions.

 

Item 5: Finance

It was agreed to skip ahead to this item to maintain the flow of conversation from the finance deep dive into the finance overview

DS presented the finance update, covering the year end position for 2025/26 and the forecast position for 2026/27. A paper had been circulated in advance of the meeting relating to the year end and breaking down the spend.

FB asked was delivery of recurring savings c.1.9% in 2025-26. It was confirmed yes.

FB confirmed that the deficit support funding values are the maximum a health board could receive and there is an expectation that health boards will deliver deficits under those limits to show improvement and a route to de-escalate.

DS referred to the external audit meeting scheduled for next Monday to begin work on 2025-26 accounts.

DS noted that the savings in the slides map to the £57 million headline number for 2026-27.

FB referred to the finance deep dive and asked about confidence in the savings around nursing. JW confirmed that there had been an independent review of the programme and that this was broadly in line with the comparator health boards Forth Valley and Lanarkshire.

FB asked about theatre/outpatient programmes and whether these are productivity or cash-releasing programmes. CMcL asked about impacts on waiting times.

GJ noted the use of the theatre scheduling tool Infix and that more was needed to drive out the benefits of this, a meeting was planned between NHS Ayrshire and Arran and the Infix team. Discussion would take place on any opportunities to improve performance through increased capacity vs taking cash releasing savings from productivity gains.

CMcL asked whether more could be done via national procurement. GJ said that managed services is an area of their plan. The plan for 2027-28 includes reprovision of labs-managed services, although this is a significant undertaking in a health board the size of NHS Ayrshire and Arran.

DS said that they are switched on regarding national procurement, and they will be doing a sense check with NHS Grampian colleagues. CMcL asked if it would be worth asking national procurement to do a review. BS said they will consider this.

DS said the key priority just now is the month-one review. SG said that the assurance board will consider the M1 out-turn on 18 May

action:  M1 out-turn to be considered at the next assurance board meeting (18 May).

Item 4: Risk

 

FB introduced the risk review paper which examined NHS Ayrshire and Arran’s approach to risk management and reporting following escalation to stage 4 for finance. This had been previously shared with attendees.

 

CM advised that a response had been drafted and will be shared with the assurance board. This includes documents requested. The corporate management team have discussed how risk work could be improved.

 

GJ noted that issues are surfaced with integration joint boards and social care partners. A pan-Ayrshire group has been established to address cross-cutting issues.

 

JW referred to delayed discharges and said that this issue is raised with the healthcare governance committee and the chief officers’ group. It is considered a public protection issue, and impacts on quality of care.

 

VC advised that she engages with chief officers twice weekly and recognises the need to protect positive working relationships

 

SG said the assurance board will review the response paper and feedback at the next meeting.

Action: Assurance board to feedback on the risk response paper at the next assurance board meeting (18 May).

Item 6: AOB

 

There were no items of other business raised.

 

Date of next meeting: rescheduled to 1330-1530 on Monday 18 May 2026.