NHS Chairs Meeting: May 2025

Attendees and apologies

NHS Boards – Chairs

• Lesley Bowie, NHS Ayrshire and Arran
• Karen Hamilton, NHS Borders
• Marsali Caig, NHS Dumfries and Galloway
• Alistair Morris, NHS Fife, Vice Chair (on behalf of Patricia Kilpatrick)
• Neena Maha, NHS Forth Valley
• Alison Evison, NHS Grampian (Vice-Chair of Chairs)
• Lesley Thomson, NHS Greater Glasgow and Clyde
• Sarah Compton-Bishop, NHS Highland
• Martin Hill, NHS Lanarkshire
• John Connaghan, NHS Lothian
• Meghan McEwen, NHS Orkney
• Gary Robinson , NHS Shetland
• Carole Wilkinson, NHS Tayside (Chair of Chairs)
• Gillian McCannon, NHS Western Isles
• Annie Gunner-Logan, NHS Education for Scotland, Vice Chair (on behalf of David Garbutt)
• Susan Douglas-Scott, NHS Golden Jubilee
• Keith Redpath, NHS National Services Scotland
• Angiolina Foster, Public Health Scotland
• Tom Steele, Scottish Ambulance Service
• Brian Moore, The State Hospitals Board for Scotland
• Suzanne Dawson, Scottish Health Council

Scottish Government

• Maree Todd, Minister for Social Care, Mental Wellbeing and Sport 
• Caroline Lamb, DG HSC/CE NHS Scotland
• John Burns , NHS Scotland Chief Operating Officer
• Paula Speirs, Deputy Chief Operating Officer - Planning and Sponsorship
• Gillian Russell, Director of Health Workforce
• Fiona Hogg, Chief People Officer
• Alan Gray, Director of Health and Social Care Finance and Governance
• John Harden, Deputy National Clinical Director
• Stephen Gallagher, Director of Mental Health
• Richard Foggo, Co-Director of Population Health
• Tim Mcdonnell, Director of Primary Care
• Anne Armstrong, Deputy Chief Nursing Officer
• Alison Strath, Chief Pharmaceutical Officer
• Angie Wood, Interim Director, Social Care Resilience, and Improvement
• Robert Kirkwoo, OCENHS Team
• Aislinn Ní Ghráinne, Health Communications

Aspiring Chairs

• Paul Buchanan, NHS National Services Scotland
• Liz Humphreys, Non-Executive Director and Whistleblowing Champion for the SAS and Public Health Scotland

Secretariat

• Laurie Whyte, Board Governance and Appointments Team
• Kat Dobell, Board Governance and Appointments Team
• Carol Hunter, Board Governance and Appointments Team
• Rhea Crighton, Executive Support to NHS Board Chairs and Chairs

Apologies

• Pat Kilpatrick, NHS Fife (Alistair Morris attending)
• David Garbutt, NHS Education for Scotland
• Martin Cheyne, NHS 24
• Evelyn McPhail, Healthcare Improvement Scotland
• Neil Gray, Cabinet Secretary for NHS Recovery Health and Social Care
• Jenni Minto, Minister for Public Health and Women’s Health
• Christine McLaughlin, Co-Director of Population Health
• Fiona Bennett, Interim Deputy Director NHS Scotland Finance
• Douglas McLaren, Deputy Chief Operating Officer - Performance and Delivery
• Donna Bell, Director of Social Care and NCS Development
• Fiona Bennett, Interim Deputy Director NHS Scotland Finance
• Gregor Smith, Chief Medical Officer
• Andrew Watson, Director for Children and Families
• Karen Duffy, Delivery Director

Items and actions

Welcome, apologies for absence and attendees

Maree Todd, Minister for Social Care, Mental Wellbeing and Sport welcomed colleagues to the meeting and advised that she would be chairing the meeting due to the Cabinet Secretary needing to address other commitments. 

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

Minutes and actions from the previous meeting

The minutes from the previous meeting held on 19 March 2025 were approved and it was noted there were no overdue actions.

Matters arising

There were no matters arising from the previous meeting.

Opening remarks/discussion

Ms Todd opened the discussion noting that the programme for government (PfG) which sets out the actions that the Scottish Government will take in the coming year, was published on 6 May 2025. The PfG highlights the continued focus on delivery, whilst remaining committed to four priorities: eradicating child poverty; growing the economy; tackling the climate emergency; and delivering high quality and sustainable public services. The early publication of the PfG this year, will help to align the policy programme with budget processes and ensure that the country is as prepared as possible to face global challenges. 

Colleagues shared their concerns around the UK Government’s recent statement on immigration and the impact on social care. Social care sustainability represents a significant challenge and considering the recent announcement it was acknowledged that this may be expounded. Colleagues also reflected on the impact of this statement on students and the ability of them to stay in the UK after studying. Chairs agreed that it was imperative for them as system leaders to ensure the safety and security of staff and patients from diverse backgrounds. NHS Scotland has a clear role as anchor institutions to advocate for diversity and inclusion and NHS Chairs have a role in championing this culture in their boards. 

Chairs raised the importance of making social care an attractive career opportunity which includes consistent outreach to young people as well as changing the rhetoric on social care as an investment for communities. Colleagues highlighted the importance of this in remote and rural areas and the impact social care has on delayed discharge and hospital capacity. Colleagues also indicated the need for a whole societal look at the issue as lack of housing, childcare and wages all played a part into retaining and attracting care staff. It was highlighted that more work needed to be done relating to pay and conditions for care workers. Ms Todd indicated that this is an ongoing conversation, and she will continue to take forward. 

Chairs agreed that the PfG was ambitious, and it was good to see increased emphasis on prevention, which would pay dividends. The relationship between NHS services and the population would need to change and hopefully the population health framework would help to develop and recognise deliverables in the health service, allowing the whole system to hold itself to account to make tangible improvements. 

Colleagues raised issues regarding GPs and the British medical association’s (BMA) indication that there may be balloting for strike action. Tim Mcdonnell, Director for Primary Care clarified that the BMA issues identified in the parliamentary and media spaces were ongoing. Although funding has helped and moved some work outside the GP domain, there is still considerable risk and challenge. 

Chairs reflected positively on this open forum discussion and having the opportunity to discuss the emotional and social impacts not only performance that are interlinked with health and care. 

Operational improvement plans – NHSC-25-07

John Burns, NHS Chief Operating Officer, advised that the operational improvement plan (OIP) is a part of a suite of documents to bring about short-, medium- and long-term change. John thanked boards for their efforts over the past year regarding target levels of activity in diagnostics and outpatient appointments which were exceeded, he indicated that this needs to continue into this year with a clear focus on delivery.

John confirmed he had spoken with Chief Executives to ensure they were working together at national and regional level to optimise opportunities in the system to deliver improvements which were set out in the plan. 

Performance slides which were issued prior to the meeting and these highlighted need for further focus on the following areas:

• planned care – Chief Executives are currently undertaking discussions on validation on waitlists to ensure patients are treated in a timely fashion. Chairs were asked  to ensure that progress was being made to deliver on implementing the theatre scheduling system
• cancer – aspects are performing well, however there is a need to focus on the 62 days standard. Chief Executives are ensuring learning from the work at NHS Lanarkshire which saw performance move to 95%
• John noted that digital dermatology should be on the radar of every board. Good work has been done with NECU around dermatology, helping with backlogs however all boards needed to assure this was being taken forward

Caroline Lamb, DG Health and Social Care, stated that there were now clear targets set as a system which were challenging and backed by financial investment, and it was important to be able to deliver against this. There is a clear remit to drive forward improvement in the short term to boost morale and bring about wider change over the medium and long term.

Ms Todd added that Jenni Minto, Minister for Public Health, and Women’s Health launched the framework for specialist nursing in cardiology yesterday which was about specialist clinical skills, a collaboration amongst boards supported by NHS education for Scotland (NES). 

Service renewal framework – NHSC-25-08

John Burns introduced the context on the service renewal framework (SRF), how this links to the OIP and noted the positive collaborative input from Chairs and Chief Executives on this work. The SRF looks at 10 years and sets a clear direction and focus on prevention, people, community, digital and population-based healthcare. 

John presented slides to the group which highlighted the following key aspects of change:

• service planning for population
• collaboration
• supporting accountable and collective leadership
• Strengthening primary care and community health teams
• flow navigation and 
• virtual wards
• person centred discharge planning

The focus of discussion was on ensuring central and local communication is consistent and that there is a clear joint ownership through integrated joint boards (IJB). Caroline Lamb advised that the framework is a guide only and that these conversations will be centrally driven but need to be locally lead through Chairs and Chief Executives as system leaders. 

John concluded that the framework would challenge how the system has been working but create a powerful framework that will help generate change and engage people across the system to work together differently. 

Update from NHS Chairs private meeting

Ms Todd invited Carole Wilkinson, Interim Chair of NHS Tayside to provide feedback on the discussion from the Chairs private meeting. Carole noted that the content of the meeting held on 28 April which included sessions with Neil Gray, Cabinet Secretary for Health and Social Care and John Burns linked with today’s conversation. 

The following was discussed:

• the role of Chairs in the performance space at board and national level including what support was needed to bring about the required changes
• the importance of including communities to understand why changes to services are being made to ensure best quality and safety of care
• joint Chairs and Chief Executives meeting in June will pick up issues on primary care and workforce
• the leadership role of Chairs with communities and partnerships. All agreed there was a need to work together across the system to deliver change

Any other business

A paper on NHS recovery and performance was circulated for knowledge prior to this meeting. No questions were raised.

Ms Todd informed the group that this was John Burns last meeting with NHS Chairs before his retirement. She thanked him for all his work and leadership across the system and wished him well.

There was no other business raised.

Date and time of next meeting

The next NHS Chairs meeting will take place on 23 July 2025.