NHS Chair minutes: December 2021

Attendees and apologies

Scottish Ministers

• Humza Yousaf, Cabinet Secretary for Health and Social Care
• Maree Todd, Minister for Public Health, Women's Health and Sport

Health Board Chairs

• Lesley Bowie, NHS Ayrshire and Arran
• Karen Hamilton, NHS Borders
• Nick Morris, NHS Dumfries and Galloway (Vice Chair of Chairs Group)
• Tricia Marwick, NHS Fife
• Janie McCusker, NHS Forth Valley
• John Tomlinson, NHS Grampian, Vice Chair
• John Brown, NHS Greater Glasgow and Clyde
• Boyd Robertson, NHS Highland
• Neena Mahal, NHS Lanarkshire
• John Connaghan, NHS Lothian
• Meghan McEwen, NHS Orkney
• Gary Robinson, NHS Shetland
• Lorna Birse-Stewart, NHS Tayside
• Gillian McCannon, NHS Western Isles
• Carole Wilkinson, Healthcare Improvement Scotland (Vice Chair of NHS Chairs group)
• Martin Cheyne, NHS 24
• David Garbutt, NHS Education for Scotland
• Susan Douglas Scott, NHS Golden Jubilee
• Keith Redpath, NHS National Services Scotland
• Angiolina Foster, Public Health Scotland
• Brian Moore, State Hospital Board
• Tom Steele, Scottish Ambulance Service
• Suzanne Dawson, Scottish Health Council
• Paul Edie, Care Inspectorate

Scottish Government officials

• Caroline Lamb, Director General HSC and Chief Executive of NHS Scotland
• John Burns, NHS Scotland Chief Operating Officer
• Richard McCallum, Director Health Finance, Governance and Value
• Jonathan Cameron, Interim Director, Digital Health and Care
• Gillian Russell, Director of Health Workforce
• Jason Leitch, National Clinical Director
• Donna Bell, Director for Mental and Social Care
• Tim McDonnell, Director for Primary Care
• Alex McMahon, Chief Nursing Officer
• Michael Kellet, Director of Population Health
• Richard Foggo, COVID-19 Director
• Christine McLaughlin, Director for Testing

In attendance

• Derek Grieve, Head of Operational Vaccines Division
• Anna Kynaston, Deputy Director, NCS, Engagement and Workforce
• Roz Barclay, NHS Scotland Executive Support
• Nicola Gordon, NHS Scotland Executive Support
• Nicole Smith, NHS Scotland Executive Support
• Rachel Nicholson, APS Cabinet Secretary for Health and Sport
• Robert Kirkwood, Corporate Business Management Team
• Laurie Whyte, Corporate Business Management Team
• Carol Hunter, Corporate Business Management Team

Apologies

• Kevin Stewart, Minister for Mental Wellbeing and Social Care
• Lynda Lynch, NHS Grampian (John Tomlinson attending)

Items and actions

Agenda

• welcome, apologies for absence and attendees
• minutes and actions from the previous meeting (25 October 2021)
• matters arising
• Cabinet Secretary remarks
• updates on:
  • system pressures (John Burns)
  • management of Delta and Omicron variants (Jason Leitch)
  • vaccinations (Stephen Gallacher)

• Population Health/Place and Wellbeing Programme (Maree Todd, Minister for Public Health, Women’s Health and Sport and Michael Kellet, Director of Population Health
• National Care Service (Anna Kynaston)
• feedback from Chairs private meeting
• any other business
•  date and time of next meeting
• NHS Chairs meeting on 24 January 2022

Welcome, apologies for absence and attendees

The Cabinet Secretary for Health and Social Care welcomed everyone to the meeting. He expressed thanks to Lynda Lynch, Chair of NHS Grampian and Neena Mahal, Chair of NHS Lanarkshire, for the dedication that they have shown to their roles and wished them well for the future. They both stand down at the end of the year.

He informed Chairs that, for NHS Grampian, John Tomlinson, the current Vice-Chair, will take on the role as Interim Chair, until a new Chair has been recruited. The recruitment round for NHS Lanarkshire has now concluded and a public announcement about the new Chair, will be made shortly.

A list of those present and apologies is provided at annex A.

Minutes and actions from the previous meeting

The minutes of the meeting held on 25 October 2021 were approved.

Matters arising

There were no matters arising from the previous meeting.

Cabinet Secretary remarks

The Cabinet Secretary thanked Chairs for their continued effort in leading their Boards to reduce the numbers of delayed discharges. Numbers have gone down, but there remains significant work to ensure that improvements are sustainable. He also expressed his gratitude to Boards for their response to the request to accelerate the vaccinations programme for COVID-19.

The Cabinet Secretary advised that Cabinet are closely monitoring the impact and spread of the new Omicron variant and noted concerns around staffing numbers should they need to self-isolate following the implementation of enhanced contact tracing. 

Updates

System pressures

John Burns, Chief Operating Officer NHS Scotland, provided an outline of priorities over the next two to three weeks. This included, a focus on:

• understanding the new variant

• maximising hospital capacity and reducing delayed discharges

• recruitment of support workers

• minimising harms around electives/maximising use of the Golden Jubilee

• use of third and voluntary sector/community response to support people at home

• redesign of urgent care and support to SAS

He explained that discussions would be taking place daily to review actions and a plan for taking forward medium term issues will be developed during January and February 2022. 

Management of Delta and Omicron variants

 Jason Leitch, National Clinical Advisor, provided an update on the management of Delta and the new Omicron variant of COVID-19. He advised that they would be dealing with two pandemics simultaneously, until scientists learned more about the new variant. He asked NHS Chairs to:

• check in with their public health teams and ask about staff wellbeing

• continue to enhance messaging to staff and public around testing, vaccination and hand-washing

• encourage uptake of vaccination boosters for health and care staff

He indicated that current restrictions and measures which might be required to protect vulnerable people would be discussed by Cabinet on 7 December 2021.

There was some discussion about the impact of enhanced contact tracing and the numbers of health and social care staff recording the results of lateral flow tests. Gillian Russell, Director, Health Workforce said that discussions would take place with staff-side about boosters and lateral flow testing, but asked that Chairs consider what might work locally to increase reporting of test results.

Action: NHS Chairs to consider local actions to increase numbers of staff reporting lateral flow test results.

Vaccinations

Stephen Gallacher, Director of Vaccine Policy and Strategy gave a presentation on the Vaccination Programme. From the 6 September, over 4.6 million vaccination doses have been delivered for COVID-19 and Flu, with a total of 1,889,285 boosters. He updated Chairs on the JCVI advice in response to the Omicron variant, which included expanding the booster offer to include all adults aged 18 to 39 years old. He underlined the importance of ensuring that workforce availability matched demand in terms of uptake of appointments offered.

Going forward, a portfolio board has been set up to oversee the establishment of a new national vaccination and immunisation service for Scotland. Driven by the Vaccine Transformation Programme and the COVID-19 pandemic, there is now an opportunity to improve uptake of all immunisation programmes and put in place supporting sustainable workforce and finance. The aim being to develop a new service which is led by public health principles and helps to reduce inequalities in addition to preventing serious illness and disease.

Gillian McCannon, Chair, NHS Western Isles informed Stephen Gallagher that different arrangements were in place for booking appointments due to the rurality of some of the communities in the Islands. Stephen Gallagher agreed to discuss further outside of the meeting.

Action: Stephen Gallagher to discuss booking systems with Gillian McCannon, Chair, NHS Western Isles.

Population Health/Place and Wellbeing Care Programme

Maree Todd, Minister for Public Health, Women’s Health and Sport introduced the discussion on Population Health/Place and Wellbeing Care Programme. She indicated that she had three main asks of NHS Chairs:

• to improve the collection and use of ethnicity data across the NHS

• to support local providers to become effective anchor institutions

• to have a stronger focus in Boards on health inequalities, public health and prevention

NHS Chairs welcomed the opportunity to focus on longer term strategic planning and the chance to get involved in discussions. Lorna Birse-Stewart, Chair, NHS Tayside confirmed that she was representing NHS Chairs in this area and sought clarity on how NHS Chairs could influence and support work going forward.

National Care Service consultation

Anna Kynaston, Deputy Director, NCS, Engagement and Workforce provided a verbal update on the National Care Service, following the consultation closing on 3 November 2021. She advised that the findings of the consultation will be published early 2022 and then discussed at the next NHS Chairs meeting on 24 January 2022. She also agreed to send details of a design workshop scheduled to take place on 10 January 2022 will be circulated to NHS Chairs.

Action: Anna Kynaston to circulate to NHS Chairs, the details of the design workshop scheduled to take place on 10 January 2022.

Feedback from NHS Chairs private meeting

Nick Morris, Chair of NHS Chairs Group, highlighted that the agenda for the private meeting has been aligned to the Chairs meeting in the afternoon and therefore there was no further feedback to provide. 

Any other business

Nick Morris advised that Boards would provide a response to the Cabinet Secretary following receipt of a letter sent from Scottish Government to the whistleblowing non-executives. The Cabinet Secretary said that he would like to meet Whistleblowing Non-Executives in the New Year.

Date and time of next meeting

The next NHS Chairs meeting will take place on Monday 24 January 2022.