NHS Chairs Meeting Minutes: January 2025

Attendees and apologies

NHS boards – Chairs

• Lesley Bowie, NHS Ayrshire and Arran
• Karen Hamilton, NHS Borders
• Marsali Caig, NHS Dumfries and Galloway
• Patricia Kilpatrick, NHS Fife
• Neena Mahal. 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
• Lorna Birse-Stewart, NHS Tayside
• Gillian McCannon, NHS Western Isles
• Carole Wilkinson, Healthcare Improvement Scotland (Chair of Chairs)
• 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, The State Hospitals Board for Scotland
• Suzanne Dawson, Scottish Health Council

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 Social Care, Mental Wellbeing and Sport 
• Christina McKelvie, Minister for Drugs and Alcohol Policy
• Paula Speirs, Deputy Chief Operating Officer - Planning and Sponsorship
• Douglas McLaren, Deputy Chief Operating Officer - Performance and Delivery
• Amy Wilson, Director of Health Workforce
• Fiona Hogg, Chief People Officer
• John Hard, Deputy National Clinical Director
• Richard Foggo, Co-Director of Population Health
• Christine McLaughlin, Co-Director of Population Health
• Anne Armstrong, Deputy Chief Nursing Officer
• Alison Strath, Chief Pharmaceutical Officer
• Angie Wood, Interim Director, Social Care Resilience and Improvement
• Robert Kirkwood, OCENHS Team

 
Other Attendees

• Stephanie Knight, Head of Financial Planning, Reporting and Data (on behalf of Alan Gray/Fiona Bennett)
• Aislinn Ni Ghrainne, NHS Scotland Corporate Communications
• Matthew Downie, Cabinet Secretary for Health and Social Care Private Office
• Rachael Patterson, Minister for Drugs and Alcohol Policy Private Office
• Lauryn Adie, Minister for Social Care, Mental Wellbeing and Sport Private Office

Secretariat

• Laurie Whyte, Board Governance and Appointments Team
• Sarah Hobkirk, Board Governance and Appointments Team
• Carol Hunter, Board Governance and Appointments Team
• Fraser McJannett, Executive Support to NHS Board Chairs and Chairs

Apologies

• Tom Steele, Scottish Ambulance Service
• Caroline Lamb, DG HSC/CE NHS Scotland
• John Burns, NHS Scotland Chief Operating Officer
• Alan Gray, Director of Health and Social Care Finance and Governance
• Fiona Bennett, Interim Deputy Director NHS Scotland Finance
• Gregor Smith, Chief Medical Officer
• Tim Mcdonnell, Director of Primary Care
• Andrew Watson, Director for Children and Families

Items and actions

Welcome, apologies for absence and attendees

Neil Gray, Cabinet Secretary for Health and Social Care welcomed the group, thanking everyone for attending the meeting, noting his apologies for having to leave the meeting at 10:45, due to parliamentary business.

The minutes from the previous meeting held on 11 December 2024, were approved.

The two actions below, raised at the previous meeting, were now complete with papers circulated to NHS Chairs for information.

• Angie Wood to engage with NHS Chairs to discuss how to provide support around improvement for social care services
• Tom Steele to share Scottish Ambulance Service data relating to responding to cases due to lack of primary care options

Caroline Lamb, DGHSC/CE NHS Scotland and John Burns, Chief Operating Officer were unable to attend the as they were attending the public audit committee.

A full list of attendees and apologies is noted in annex a.

There were no matters arising.

Cabinet Secretary’s opening remarks

The Cabinet Secretary thanked Chairs for their efforts over the festive period, coping with storm eowyn and the impact of flu on the entire system. His opening remarks focussed on two main areas, the National Care Service (NCS) and renewal and reform.

The Cabinet Secretary referred to the announcement that the First Minister made to parliament last week with the decision to proceed with the NCS without enacting structural reform legislation, opting for alternative methods through an advisory board to achieve the service’s objectives. He added that the Scottish Government remained committed to strengthening and improving the NHS to better serve patients across Scotland.

It was noted that this could have implications for NHS Highland who are in discussion with local authorities around the model of integration for their board. The Cabinet Secretary recognised local sensitivities and offered support to help maintain smooth progress.

The Cabinet Secretary summarised the vision that the First Minister set out on Monday 27 January 2025, and the actions that would be taken forward to deliver a more accessible, more person-centred NHS, with three clear purposes:

• reducing the immediate pressures across the NHS
• shifting the balance of care from acute services to the community
• using digital innovation to improve access to care

He informed Chairs that the actions have been built following extensive engagement with NHS Chief Executives and that officials were continuing to engage with local government, the community, voluntary sector and businesses to create a long-term approach to primary prevention. He advised that over the coming weeks, the government would set out for parliament, what the different elements of our approach would mean in practice. Members of parliament would also be reminded that the delivery of this stronger NHS depends on the safe progress of the draft budget currently being considered by parliament.

The Cabinet Secretary stated that there had been a vast amount of work undertaken through the collaborative response and assurance group, which had been shared with Chairs. He added that it was essential to build on improvement and expand this year and asked NHS Chairs to continue to work alongside Scottish Government colleagues and put forward new ideas and initiatives that will bring about this positive change.

Update from NHS Chairs private meeting

Carole Wilkinson, Chair, Healthcare Improvement Scotland, provided feedback on the discussions from the NHS Chairs private meeting, held on Monday. The discussion centred around 3 key areas:

• finance – a financial update was given which enabled the discussion around financial challenges; workforce and the impact of pay awards. All agreed any future discussion around pay and work conditions should be a 2-way process
• centre for sustainable delivery (CfSD) presentation and discussion on reform. An update was provided on work being done with good examples of working with boards and staff, especially clinicians and GPs. This was a positive and timely agenda item, and Chairs were asked to think about what could be done differently.
• single authority model – Chairs were committed to partnership working and integration however were looking for clarity around the direction and policy intentions and the place of the NHS in the discussions and the expected timescales.

Susan Douglas-Scott advised that CfSD had worked through what each board’s focus was and were ready to take things forward, offering her support.

The Cabinet Secretary acknowledged that Chairs would like to be more engaged in discussions around the single authority model and welcomed that they would be meeting with Paula Speirs, Deputy Chief Operating Officer, Planning and Sponsorship, who was leading on this work.

Gillian McCannon, Chair, NHS Western Isles highlighted the importance of having evidence-based outcomes and a need to make clear the implications for clinical governance. Gary Robinson, Chair, NHS Shetland shared an account of the discussions about integration that have taken place and potential structures.

The Cabinet Secretary stressed that governance arrangements need to be clear and agreed to meet with Chairs separately if concerns were raised. It was noted that that this meeting had originally included a discussion on the single authority model as a main agenda item, and that this has been postponed for discussion at a future meeting.

Action: CfSD to ensure all Chairs and boards understood the joint work being undertaken with CfSD in their board areas and then possible future actions/initiatives

NHS reform

The Cabinet Secretary invited Christine McLaughlin and Richard Foggo, Co-Directors of Population Health, to provide an update on NHS reform. A presentation was shared in advance whish illustrated the 3 core reform products highlighted in the vision presented by the First Minister. These were:

• operational improvement plan
• population health framework (PHF)
• HSC service reform framework

It was noted that NHS Chairs had already engaged in this work through their population health sub-group and that an initial discussion had taken place between SG reform leads and Carole Wilkinson, as Chair of Chairs group, to reflect support for reform in Chairs’ sub group structure. It was reiterated that the health and social care service reform framework was still in the early development stage and therefore the presentation focussed more heavily on the operational improvement plan and broader themes for action.

Richard Foggo described the approach which had been taken to develop the products which was inclusive, collaborative and built on a foundation of prevention. He explained the five maxims, based on the getting it right for every child (GIRFEC) model, that would guide our approach were:

• prevention first
• people first
• community first
• digital first
• planning for the population

There was a discussion which focussed on governance and what boards would put in place to provide assurance on delivery of actions, the contribution of board members (Executive and non-executive), and collaboration through existing structures and relationships such as integrated joint boards, community planning partnerships, local government and the Scottish Government.

Patricial Kilpatrick, Chair, NHS Fife commented on the situation with dental services in Fife and that the aspiration to increase the number of dentists by 7% would be unlikely to have any impact on services in Fife. Jenni Minto, Minister for Public Health and Women’s Health indicated that she would be happy to discuss this further outwith the meeting.

NHS Chairs were asked to provide views about the operational improvement plan to help Christine and Richard ascertain what they wanted to do individually.

Action: NHS Chairs to provide views on the operational improvement plan.

Douglas McLaren, Deputy Chief Operating Officer - Performance and Delivery, commented on the need for a clear delivery plan, with NHS Chairs’ support to help ensure that there was the capacity and capability to deliver, a focus on innovation and good systems of governance in place to support collaborative working as well as the specifics of the plan.

Action: NHS Chairs to consider the support that will be required and discuss with Scottish Government colleagues as required.

A weekly co-ordination group has been set up with NHS Chief Executives. Although informal, there are representatives from north, south, east and west boards.

Any other business

A paper on performance was distributed to colleagues, for information, outlining current performance statistics across Scotland. Any questions should be directed to the health performance team, contacts provided in the paper.

There was no other business raised.

Date and time of next meeting

The next NHS Chairs meeting will take place on 19 March 2025.

Board Governance and Appointments Team