NHS Chairs minutes: October 2021

Attendees and apologies

Scottish Ministers

• Humza Yousaf, Cabinet Secretary for Health and Social Care
• Kevin Stewart, Minister for Mental Wellbeing 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
• Malcolm Bell, NHS Shetland, Vice Chair (for Gary Robinson)
• 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
• Ann McKechin, Public Health Scotland (for Angiolina Foster)
• Brian Moore, State Hospital Board
• Tom Steele, Scottish Ambulance Service
• Suzanne Dawson, Scottish Health Council

Scottish Government Officials

• Caroline Lamb, Director General HSC and Chief Executive of NHS Scotland
• John Burns, NHS Scotland Chief Operating Officer
• 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

• Helen Maitland, Unscheduled Care Director (for agenda item six)
• Karen MacNee, Lead for Place and Wellbeing care Programme (for agenda item six)
• Andrew Fleming, Head of NHS Board Sponsorship
• 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
• Hannah Mackay, Corporate Business Management Team
• Jenny Smith, Corporate Business Management Team (Observer)

Apologies

• Lynda Lynch, NHS Grampian (John Tomlinson attending)
• Gary Robinson, NHS Shetland (Malcolm Bell attending)
• Angiolina Foster, Public Health Scotland (Ann McKechin attending)
• Paul Edie, Care Inspectorate
• Richard McCallum, Director Health Finance, Governance and Value
• Jonathan Cameron, Interim Director, Digital Health and Care

Items and actions

Agenda 

• welcome, apologies for absence and attendees
• minutes and actions from the previous meeting (23 August 2021)
• matters arising
• Cabinet Secretary remarks
• update on system pressures (John Burns)
• Care and Wellbeing Programmes (Caroline Lamb and programme leads)
• National Care Service consultation (Donna Bell)
• Feedback from Chairs private meeting
• Any other business
• Date and time of next meeting
• NHS Chairs meeting on 6 December 2021

Minutes

Welcome, apologies for absence and attendees

The Cabinet Secretary for Health and Social Care welcomed everyone to the meeting.

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 23 August 2021 were approved.

Matters arising

There were no matters arising from the previous meeting.

Cabinet Secretary remarks

The Cabinet Secretary highlighted the current areas of focus, which included:

• revised communications on alternative pathways, which would be clinically led
• A&E statistics
• taking forward wellbeing support for staff
• planned care and the use of resources to help with backlogs

Update on system pressures

John Burns, Chief Operating Officer NHS Scotland, highlighted that it had been a challenging week across the system. He outlined the key actions from the last System Response Group (SRG) meeting, which included:

• a paper from marketing colleagues, which included a plan for a leaflet door drop to every household in Scotland
• engagement with SEND and SAMD on proposals around re-direction, which were endorsed
• in relation to reducing delayed discharges, conversations were ongoing on how best to support employees on using Choice Guidance. SEND and SAMD have been engaged and support the approach
• conversations were ongoing for AWI and it was highlighted that focusing on standard delays was important

John outlined the discussions, which took place, at the Chief Executives meeting on Friday:

• delayed discharges
• MACA support - military colleagues joined the meeting to provide briefing on the MACA process to Chief Executives. It was outlined that there was a need for consistency of approach
• private sector capacity secured for planned care

In discussion, Martin Cheyne, NHS 24, highlighted the increase in digital activity in NHS 24, with a stark increase in the public using NHS Inform compared to last year. He suggested it would be beneficial to highlight the use of NHS Inform in any communications issued as it provided a valuable resource.

NHS Chairs requested to be sighted on the papers which went to SRG on re-direction. It was noted that re-design of the system was being discussed at a local level, but that it would be helpful for Chairs to be made aware of any national considerations to allow for alignment.

There was some discussion around communications and what should be included in communications messages to staff and the public. This focused on staff wellbeing, acknowledging current pressures ahead of winter and ensuring that communications to the public are clear and concise to avoid confusion.

The Care and Wellbeing Programmes

Christine McLaughlin, Director of Testing, introduced the item and provided an overview of the Care and Wellbeing Portfolio. It was outlined that Christine and Richard Foggo, have taken on the role as lead directors for this work. An engagement session with Chief Executives is scheduled for Friday and a session with the Cabinet Secretary due to take place at the end of November. They welcomed a further discussion with Chairs and Richard Foggo, COVID-19 Director, encouraged chairs to invite them to local conversations and share any written work with them, to ensure that there is no duplication of work.

Place and wellbeing

Karen MacNee, Place and Wellbeing lead, referred to the paper which had been circulated prior to the meeting and provided an update on the Place and Wellbeing Care Programme. The update included an overview of the key issues, the three workstreams and a description of the Steering Group established for the programme. The Steering Group includes representatives from NHS Boards and a range of other stakeholders. It was raised that the work seemed similar to that of Community Planning partnerships, however, assurance was provided that engagement was ongoing with local government directors to ensure there was no duplication of effort. Chairs from rural territorial Boards requested representation on the Steering Group.

Preventative and proactive care

Donna Bell, Director of Mental Wellbeing and Social Care, provided an update on the Preventative and Proactive Care Programme. She outlined the strategic objectives of the programme and the actions from the first Steering Group meeting which took place on 5 October 2021. Next steps were agreed as follows:

• to develop the programme narrative
• consider older people and family support as potential initial priority areas for the programme
• agree the definition for specialist provision

The terms of reference and Programme Charter for the Steering Group will be agreed at the next meeting on 9th November 2021. Membership includes Chief Executive representatives from NHS Boards. Donna Bell informed chairs that they would receive a quarterly update on the Programme. 

Integrated Planned Care/Integrated Unscheduled Care

John Burns, Chief Operating Officer for NHS Scotland, provided an update on both the work of the Integrated Planned Care (IPC) Programme Board and Integrated Unscheduled Steering Group. He outlined the aims of both programmes and advised that the IPC Programme Board and the Centre for Sustainable Delivery (CFSD) Programme Board will receive updates from existing groups. It was agreed that the CFSD would be discussed further with colleagues at a later date.

Action: John Burns and Susan Douglas-Scott to discuss the Centre for Sustainable Delivery Programme Board at a later date. 

National Care Service consultation

Donna Bell, Director of Mental Wellbeing and Social Care, introduced the item. She outlined that the closing date of the National Care Service consultation had been extended to 3 November 2021. It was highlighted that Chairs had a good and productive discussion with Mr Stewart, Minister for Mental Wellbeing and Social Care, and other colleagues. Nick Morris, Chair of NHS Chairs Group, confirmed that a response from NHS Board Chairs would be provided before the deadline. 

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 Chair's meeting in the afternoon and therefore there was no further feedback to provide. 

Any other business

John Brown, NHS Greater Glasgow and Clyde, expressed concerns over no longer having data available for staff vaccinations which resulted in not being able to target resources to encourage uptake. The Cabinet Secretary requested briefing on this from Officials. 

The Cabinet Secretary committed to ensuring an update was issued to Chairs on the Review of Governance of NHS Endowment Funds. 

There were no other items of business and the Chair closed the meeting.

Action: SG officials to provide briefing to the Cabinet Secretary on data available for staff vaccinations. 

Action: Update on endowment funds to be issued to Chairs. 

Date and time of next meeting

The next NHS Chairs meeting will take place on Monday 6 December 2021.