NHS Chairs Meeting: February 2026

Attendees and apologies

NHS boards – chairs

• Lesley Bowie, NHS Ayrshire and Arran
• Fiona Sandford, NHS Borders
• Mark Cook, NHS Dumfries and Galloway
• Patricia Kilpatrick, NHS Fife
• Neena Mahal, NHS Forth Valley
• Alison Evison, NHS Grampian
• Lesley Thomson, NHS Greater Glasgow and Clyde
• Sarah Compton-Bishop, NHS Highland
• Katharina Kasper, NHS Lanarkshire
• John Connaghan, NHS Lothian
• Gary Robinson, NHS Shetland
• Carole Wilkinson, NHS Tayside (Interim)
• Gillian McCannon, NHS Western Isles
• Susan Douglas-Scott NHS Golden Jubilee
• Evelyn McPhail, Healthcare Improvement Scotland
• David Garbutt, NHS Education for Scotland
• Keith Redpath, NHS National Services Scotland
• Ally Boyle, Public Health Scotland
• Tom Steele, Scottish Ambulance Service
• Brian Moore, The State Hospitals Board for Scotland
• Suzanne Dawson, Scottish Health Council Board for Scotland

Scottish government

 

• Neil Gray, Cabinet Secretary for NHS Recovery Health and Social Care
• Jenni Minto, Minister for Public Health and Women's Health
• Maree Todd, Minister for Drugs and Alcohol Policy and Sport
• Tom Arthur, Minister for Social Care and Mental Wellbeing
• Caroline Lamb, DG HSC/CE NHS Scotland
• Christine McLaughlin, NHS Scotland Chief Operating Officer
• Paula Speirs, Deputy Chief Operating Officer - Planning and Sponsorship
• Derek Grieve, Director For Health and Social Care Performance and Delivery
• Fiona Bennett, Interim Deputy Director NHS Scotland Finance
• Gillian Russell, Director of Health Workforce
• Fiona Hogg, Chief People Officer
• Donna Bell, Director of Social Care and NCS Development
• Stephen Gallagher, Director of Mental Health (on behalf of DG)
• Richard Foggo, Co-Director of Population Health
• Aisha Hollway, Chief Nursing Officer
• Tim Mcdonnell, Director of Primary Care
• Anne Armstrong, Deputy Chief Nursing Officer
• Angie Wood, Interim Director, Social Care Resilience and Improvement
• Neil Harrison, Strategic Communications Lead
• Robert Kirkwood, OCENHS Team

Other attendees

 

• Mark Stirton, Head of Financial Planning and Reporting
• Susan Webb, Director of PH, NHS Lothian (Observing)
• Daniel McDonald, Head of NHS Pay
• Robbie Pearson, Chief Executive, Healthcare Improvement Scotland

Secretariat

 

• Laurie Whyte, Board Governance and Appointments Team
• Dom Ellice-Freeman, Board Governance and Appointments Team
• Carol Hunter, Board Governance and Appointments Team
• Sam Martens, NSS Scotland Chairs

Apologies

 

• Martin Cheyne, NHS 24
• Doug Moodie, Care Commission
• Gregor Smith, Chief Medical Officer
• Graham Ellis, Deputy Chief Medical Officer

Items and actions

Welcome, apologies for absence and attendees

Neil Gray, Cabinet Secretary for NHS Health and Social Care welcomed colleagues to the meeting. Noting that this was the first meeting attended by Katharina Kasper, Chair of NHS Lanarkshire, and formally welcomed her to the NHS Chairs Group.

Thanks were given to David Garbutt for his service as Chair of NHS Education for Scotland over the past eight years, and previously as Chair of the Scottish Ambulance Service, noting that this would be his final meeting before stepping down.

Apologies were noted, and a full list is provided at annex a. 

Minutes, actions and matters arising from the previous meeting

The minutes from the previous meeting held on 03 December 2025 were approved and it was noted there were 2 actions from the previous meeting:

• mycare to come to the Chairs as a substantive agenda item in the future. update: this will return at future meeting
• reduced working week to be discussed at the next meeting: update: this was on today’s agenda

There were no matters arising. 

Cabinet Secretary’s remarks

The Cabinet Secretary acknowledged the continued leadership of NHS Chairs during a period of sustained pressure and highlighted the high level of public and parliamentary scrutiny, including the Scottish hospitals inquiry, whose interim findings raise important issues around governance, decision making and risk management. He reaffirmed full support for the inquiry and the need for system wide learning.

He noted the ongoing work of the Eljamel inquiry and emphasised the importance of embedding lessons from the independent clinical review on clinical governance, professional accountability and whistleblowing across NHS Scotland. Progress was recognised in reducing the longest waits for planned care and in elective recovery, diagnostics and flow, though significant pressures remain in unscheduled care, delayed discharge and workforce capacity. The Cabinet Secretary reinforced CRAG’s role in supporting assurance and improving flow, including in accident and emergency.

Reflecting on wider health and social care reform, he welcomed continued digital progress, including preparations for the population level launch of mycare in April. As this was the final meeting of the parliamentary session, he stressed the need to maintain momentum and looked forward to receiving sub-national plans by the end of March, highlighting the importance of strengthened cooperation across the system.

Finally, the Cabinet Secretary noted the forthcoming launch of public service delivery Scotland on 1 April, welcoming Karen Reid as Chief Executive, and thanking Mary Morgan for her service. This transition aims to strengthen national support, reduce duplication and improve coherence across workforce, digital, data and shared services.

Matters arising

Gary Robinson (NHS Shetland) reported that the board had recently been recognised by INWO for good practice in a whistleblowing case. He noted increasing challenges as a result of complainants escalating concerns directly to senior executives, creating conflicts of interest and requiring external investigators to be engaged to review complaints.

Gillian McCannon (NHS Western Isles) advised that the national guidance for NHS staff Speaking up in Scotland draft is out now. This helps look at processes involved and she urged Chairs to provide feedback.

The Cabinet Secretary spoke to the new national whistleblowing officer last week and they agreed to look at sharing a best practice approach to whistleblowing in order to support boards and staff.

Operational improvement plan (OIP)

The Cabinet Secretary invited Mark Cook (NHS Dumfries and Galloway) and Susan Douglas Scott (NHS Golden Jubilee) to provide updates to support discussion on the OIP. 

Winter pressures have eased, but strong oversight remains essential to ensure delivery of the OIP. Significant progress has been made, including the rollout of front door frailty services across all Boards, expanded hospital at home capacity, wider uptake of the discharge without delay collaborative, and substantial reductions in both new outpatient and inpatient/day case 52 week waits. The overall OIP RAG rating remains amber, with steady advancement across workstreams.

Long waits have improved, and boards are working through processes to communicate with patients who will be waiting over 52 weeks by 31 March. Workforce shortages, diagnostic bottlenecks, increasing cancer demand and fragility in the independent sector continue to create pressure, with particular risks in urology, orthopaedics, spinal, ophthalmology and gynaecology. Boards were reminded to maximise the use of NHS Golden Jubilee capacity and continue sub-national planning for orthopaedic elective services.

The Cabinet Secretary welcomed progress on planned care and requested a clear landing position at 31 March 2026 and a robust handling plan for those waiting over 52 weeks. He welcomed improvements in cancer waiting times and  emphasised the need to strengthen diagnostic capacity, particularly in imaging and scopes. Board Chairs were encouraged to engage with local royal college of emergency medicine representatives on potential solutions.

Reduced working week

The Cabinet Secretary invited Ally Boyle, Chair of Public Health Scotland, and Alison Evison, Chair of NHS Grampian to provide an overview on board position, including update on measures taken to provide compliance from 1 April 2026.

Ally presented a paper from Paul Johnston (Public Health Scotland) and Tom Power (NHS Lothian), co‑chairs of the employers reference group, outlining progress on implementation of the reduced working week.

There remains a high degree of confidence that the reduction will be delivered on time. Around 70% of lost capacity will require backfill, though this varies by board. Options include increasing hours for part‑time staff, use of overtime, bank and supplementary staffing, and targeted recruitment. Some boards have already over‑recruited newly qualified nurses to mitigate the effects.

The paper highlighted the importance of the additional funding package of £300m, with an estimated £260m required for the reduced working week implementation. Risks identified include workforce availability, particularly in clinical roles, and challenges for remote and Island communities with limited ability to backfill single‑handed teams. Mitigations include service redesign, workload reprioritisation, changes to governance processes and acceptance of some service reduction.

The employers reference group continues to refine its work and is seeking further detail on job families to align need with national supply. Increased use of emerging technology is expected to contribute to improved productivity.

Chairs emphasised that the timetable for implementation is fixed and will proceed as planned. Boards are continuing risk and readiness work to 1 April, including considering necessary service changes. The greatest risk remains insufficient backfill, which would increase reliance on supplementary and agency staffing, and could have greater impact in rural and Island areas.

Chairs highlighted the importance of clear national communication from the Scottish Government and reiterated the need to prioritise staff wellbeing. From 1 April, any local issues will be managed through established processes.

Partnership involvement is essential, and SG colleagues continue to work closely with staffside and employers to support implementation.

Maternity services

Maternity Services was revisited as a standing item from the December meeting. Five HIS (Healthcare Improvement Scotland) unannounced inspection reports have now been published, the most recent relating to Crosshouse (NHS Ayrshire and Arran) on 4 February. 

The Cabinet Secretary noted the first meeting of the maternity and neonatal taskforce was held in late January and would monitor development of its workplan. HIS will inspect all acute maternity services across Scotland over the next 14 months and Chairs were encouraged to review their own systems and apply learning from inspection findings as part of ongoing improvement activity. 

Chairs received reflections from Lothian, Tayside and Forth Valley on HIS maternity inspections, highlighting recurring themes around workforce capacity, governance, safety, communication, culture, wellbeing and infrastructure. Boards have strengthened oversight, clarified responsibilities and improved escalation processes. National lessons focused on ensuring the right skills, protected learning time, an open culture for speaking up, stronger engagement with women and families, proportionate governance and robust safety systems.

Robbie Pearson, Chief Executive HIS, stressed the need for effective escalation within local systems and closing the gap between reported assurance and frontline experience. The Chief Nursing Officer emphasised the importance of understanding staff needs during inspections and referenced ongoing global work on ethical recruitment. 

The Cabinet Secretary acknowledged pressures arising from high profile inspections and asked boards to maintain strong oversight and ensure staff are supported, including advance notice of media reporting. Chairs highlighted the emotional impact of miscarriage and pregnancy loss, recommending wider bereavement support, stronger third sector involvement and better staff training.

Jenni Minto, Minister for Public Health and Women’s Health, reported that the maternity and neonatal task force has begun meeting, with priorities including miscarriage support, rural and island challenges and third sector collaboration. Acknowledging that £1.5m has been allocated this year for maternity and miscarriage services, with a commitment to co design and lived experience involvement. HIS welcomed the collaborative approach and highlighted support available through programmes such as SPSC perinatal. David Garbutt (NHS Education Scotland) drew attention to bereavement resources on TURAS and encouraged feedback and shared learning.

Reform – sub-national planning

A national oversight group has now been established to oversee sub-national planning. The group met in December to agree role, remit and membership. The Cabinet Secretary noted interest in the outcome of the group’s first formal meeting on 27 January and in the development of plans aligned with DL(2025)25. Lesley Thompson (Vice Chair of Chairs) and Christine McLaughlin, Chief Operating Officer, were invited to provide updates on discussions to date and progress on 2026/27 sub-national planning.

The oversight group has now met twice and the east and west sub-national delivery committees meeting three times. All sub groups for the four DL workstreams—orthopaedics, emergency healthcare, Once for Scotland business systems and mycare Scotland—are established.

Plans for three priorities will be submitted by 31 March and the fourth by the end of June, as required in the ministerial direction. Progress remains on track. Clinical colleagues, Board Chairs and Chief Executives are fully embedded across groups with strong cross regional links. The only remaining area of work to be concluded relates to partnership which is still under discussion.

Christine advised that work is underway to clarify expectations and timelines for the March submission. Noting that Chairs are being asked to work differently, and that the development of plans will be iterative and collaborative. The four work areas are at different levels of maturity and a check in session has been arranged with east and west teams in early March to  ensure a good understanding of what is being developed and to support alignment with wider SG policy. Further development of plans will continue from April to June, linked to next year’s operational priorities. Confidence was expressed in current progress, supported by strong infrastructure and cross board collaboration.

John Connaghan advised that, ahead of submitting the sub-national plans to the Scottish Government, all Chairs and Chief Executives will meet in the final week of March to review both east and west plans in the national context and engage with the public service delivery Scotland team. Caroline Lamb and Christine McLaughlin will attend. A key element of the agenda will be discussion of the cultural and organisational development requirements associated with this work.

Single authority models (SAMs)

The Cabinet Secretary noted that this item provided an opportunity to reflect on progress in developing the single authority models (SAMs) and their place within the wider programme of renewal. Inviting Sarah Compton Bishop (NHS Highland), David Campbell (NHS Orkney) and Gillian McCannon (NHS Western Isles) to provide an update on progress regarding SAMs.

Despite differing pressures and organisational cultures, positive progress is being made. SG feedback on outline proposals will be helpful to support alignment with wider population health goals.

Across the three areas, there is a shared focus on consistent messaging and engagement with staffside and communities. 

Local progress varies: David confirmed that he and his Chief Executive are continuing to evolve an approach but have strengthened relationships with local authority colleagues and are moving towards submitting a model and route map. Gillian emphasised prioritising improved outcomes and patient experience over structural change, with preferred options submitted and early engagement and consultation planned. HIS and COSLA continue to support this work, with SG aiming to return detailed feedback by the end of February.

Any other business

The Cabinet Secretary noted this was the final Chairs meeting before the election period. Thanks were expressed on behalf of ministers for the Chairs’ efforts. The Chairs passed on their good wishes to the Cabinet Secretary and colleagues.

Senior management pay

Caroline Lamb updated Chairs on ongoing work to review executive and senior management pay. This will focus on the current job evaluation processes to ensure a fair and consistent approach, particularly for Chief Executive roles. 

The guidance set out in HDL 2006/59 was highlighted.

Officials will begin to scope a full review of ESM pay and guidance, with Chairs, employers and partnership bodies engaged throughout. She outlined three key components of this work: 

• ensure a fair and consistent grading system. 
• provide early advice to ministers on pay scales, including overlaps at the top and bottom of the scale and the length of current grade structures. 
• clarify the scope of national evaluation and how Chairs receive assurance on decisions taken on their behalf.

Carole Wilkinson (NHS Tayside) noted that staffing related circulars are extremely old and should be added to the list of items requiring review. This was agreed

Date and time of next meeting

The next Chairs meeting will be arranged for a suitable date following the Scottish parliament elections.