NHS Chief Executives minutes: October 2022

Attendees and apologies

NHS Board Chief Executives

• Crawford McGuffie, NHS Ayrshire and Arran, Medical Director/Co-Chair of SAMD (on behalf of Claire Burden)
• Ralph Roberts, NHS Borders (Chair of CEs Group)
• Jeff Ace, NHS Dumfries and Galloway
• Carol Potter, NHS Fife
• Adam Coldwells, NHS Grampian, Deputy Chief Executive (on behalf of Caroline Hiscox)
• Jane Grant, NHS Greater Glasgow and Clyde
• Pam Dudek, NHS Highland
• Heather Knox, NHS Lanarkshire
• Calum Campbell, NHS Lothian
• Michael Dickson, NHS Orkney and Shetland
• Grant Archibald, NHS Tayside
• Robbie Pearson , Healthcare Improvement Scotland
• Jim Miller, NHS 24
• Karen Reid, NHS Education for Scotland
• Anne Marie Cavanagh, NHS Golden Jubilee, Director of Nursing and AHPs (on behalf of Jann Gardner)
• Mary Morgan, NHS National Services Scotland
• Angela Leitch, Public Health Scotland
• Pauline Howie, Scottish Ambulance Service

Scottish Government

• Caroline Lamb, DG Health and Social Care/Chief Executive NHS Scotland
• John Burns, NHS Scotland Chief Operating Officer
• Paula Speirs, Deputy Chief Operating Officer - Planning and Sponsorship
• Stephen Lea-Ross, Deputy Director of Health Workforce (on behalf of Gillian Russell)
• Jason Leitch, National Clinical Director
• Alan Gray, Infrastructure Planning Lead (on behalf of Richard McCallum)
• Fiona Bennett, Interim Deputy Director – NHS, Integration and Social Care Finance (on behalf of Richard McCallum)
• Gillian Barclay, Deputy Director of Social Care and NCS Development (on behalf of Donna Bell)
• Hugh McAloon, Interim Director of Mental Health and Wellbeing
• Christine McLaughlin, Co-Director of Population Health
• Innes Fyfe, Interim Deputy Director of Primary Care (on behalf of Tim McDonnell)
• Gregor Smith, Chief Medical Officer
• Alex McMahon, Chief Nursing Officer
• Tom Ferris, Chief Dental Officer
• Robert Kirkwood, Office of the Chief Executive NHS Scotland
• Laurie Whyte, Office of the Chief Executive NHS Scotland
• Sarah Hildersley, Office of the Chief Executive NHS Scotland
• Hannah Mackay, Office of the Chief Executive NHS Scotland

In attendance

• Colin Briggs, Director of Planning
• Julie Carter, Director of Finance
• Jacqui Jones, Director of HR
• Ann Gow, NMAHP Director and Deputy Chief Executive/Chair of SEND
• Roslynn Barclay, Executive Support to NHS Board Chairs and Chief Executives

Apologies

• Claire Burden, NHS Ayrshire and Arran (Crawford McGuffie attending)
• Caroline Hiscox, NHS Grampian (Adam Coldwells attending)
• Gordon Jamieson, NHS Western Isles
• Jann Gardner, NHS Golden Jubilee (Anne Marie Cavanagh attending)
• Gary Jenkins, The State Hospitals Board for Scotland
• Claire Pearce, NMAHP Director and Deputy Chief Executive/Chair of SEND
• Gillian Russell, Director of Health Workforce (Stephen Lea-Ross attending)
• Richard McCallum, Director of Health Finance and Governance and Value (Alan Gray and Fiona Bennett attending)
• Donna Bell, Director of Social Care and NCS Development (Gillian Barclay attending)
• Gordon James, Deputy Chief Operating Officer – Performance and Delivery
• John Harden, Deputy National Clinical Director
• Graham Ellis, Deputy Chief Medical Officer
• Richard Tran, Scottish Clinical Leadership Fellow

Items and actions

Welcome, apologies for absence and attendees

Caroline Lamb, DG Health and Social Care and Chief Executive NHS Scotland welcomed everyone to the meeting. 

A list of attendees and apologies for absence are provided at Annex A.

Caroline Lamb thanked Heather Knox for her tenure as Chief Executive, NHS Lanarkshire over the last 2 years ahead of her retiring in November.  Colleagues echoed Caroline’s thanks.  

 Caroline Lamb advised that Jann Gardner, current Chief Executive of NHS Golden Jubilee has been appointed as the new Chief Executive of NHS Lanarkshire  effective from 1 December 2022.  She will be working between NHS Golden Jubilee and NHS Lanarkshire during November.  

She also advised that Gordon James, current Deputy Chief Operating Officer will be taking over as Interim Chief Executive of NHS Golden Jubilee effective from 1 December 2022.  He will be working between SG and NHS Golden Jubilee during November.  

She made colleagues aware of the appointment of a new Chair for NHS Grampian, Alison Evison, who took up post on 10 October 2022.  

Minutes of the previous meeting on 11 May 2022 

The minutes of the meeting held on 11 May 2022 were cleared at the NHS Strategic Session on 15 June 2022.  

Caroline Lamb reminded colleagues that the 14 September 2022 meeting had been cancelled due to the passing of Queen Elizabeth II.  

Matters arising 

There were no items under matters arising.  

Feedback from Chief Executives private meeting

Ralph Roberts, Chief Executive NHS Borders and Chair of NHS Chief Executives Group provided feedback from the private meeting and strategic session.  These focussed on:

• infected blood inquiry (IBI)
• pay negotiations and industrial action
• reform
• winter
• unscheduled care
• workforce
• innovation design authority
• continuing improvement of the cancer journey services
• NSD Chimeric antigen receptor (Car-T)
• Chief Executives organisational development, future proof learning
• national care service

Innovative ideas 

Ralph Roberts introduced this item, referring to the innovative ideas paper that had been circulated to colleagues in advance of the meeting.  He then invited Chief Executives to share areas of work that could be taken forward collectively on a “One for Scotland” basis.  Examples shared by colleagues were:

• shared services
• workforce staffing oool
• mandatory training via TURAS
• volunteers
• paramedic science
• artificial intelligence

Colleagues welcomed the discussion but were mindful that some of these examples had been discussed before with little movement.  

Caroline Lamb invited colleagues to prepare a paper setting out 5 or 6 areas where change could be taken forward quickly.  The paper should include current good practice, set out barriers that are hindering change, set out funding requirements, what support is required from Scottish Government, and how to make the change happen and by when.  

John Burns agreed to pick up the ask above linking in with Sustainability and Value colleagues and the Chair of Chief Executives Group to progress this work.  It was agreed that the work should be taken forward by small groups anchored into existing areas of work.  

It was raised that it was worth signalling to Chairs the benefits and value added from shared services.   

Action for John Burns to link in with the sustainability and value programme.

Emergency budget review

Fiona Bennett, Interim Deputy Director, NHS Integration and Social Care Finance provided a short verbal update for colleagues.  An announcement is expected in Scotland around mid-week of week commencing 24 October at which point a further update will be provided to Board Chief Executives and Directors of Finance.  

Sustainability and value

Alan Gray, Infrastructure Planning Lead provided colleagues with an overview of the paper that had been circulated in advance of the meeting.  This discussion expanded on what had been discussed earlier around innovative ideas.  He confirmed the establishment of a Sustainability and Value Programme Board.  The purpose of the board will be to work collaboratively on a national basis, ensuring appropriate governance and sharing improvement methodology across Scotland.  The Terms of Reference for the board are included in the paper circulated.  

Alan advised colleagues that Jim Miller, Chief Executive of NHS 24 would co-Chair the Sustainability and Value Board with a colleague from the Chief Officers Group (a nominee is expected w/c 17 October 2022).  The Chair of the Chief Executives rroup asked that a Chief Executive from one of the Territorial Boards be invited to sit on the Board, as they would have a different perspective to that of a Chief Executive from a National Board.  

Colleagues were supportive of the sustainability and value work and how this builds on discussions held over the last few months, also how it will realise the links to innovation.  It was highlighted that a clear line of sight is required and that work needs to be driven forward with small expert groups, providing agile working.  Outputs will then be shared on a trusted basis.  

Work is under way on preparing a route map to achieve financial balance.  A further discussion of this should take place at either a Chief Executives business meeting.  

Action for OCENHS secretariat to liaise with Alan Gray to determine next steps re further discussion on route map to financial balance

Any other business

John Burns, Chief Operating Officer shared with colleagues that a co signed letter,setting out the ask of Local Authorities, IJBs and NHS boards ahead of winter would issue shortly.  The letter will cover delayed discharges and social care and actions expected in partnerships with councils and others going forward.  This follows on from conversations that have been taking place over the last few weeks.  

Date and time of next meeting

NHS Joint meeting on Wednesday 9 November 2023 at 15:00 – Hybrid Meeting  in person at COSLA/virtually Microsoft Teams.  The Cabinet Secretary is attending.  

The Chair and Vice Chair of the Chairs Group and Chief Executives Group would work with John Burns and Paula Speirs to set the Agenda for this meeting, with a focus on linking up with winter planning and providing the Cabinet Secretary with assurances around addressing immediate concerns and pressures around accident and emergency and delayed discharges.  This should lead into discussions around the reform work where incremental sustainable improvements are being made.

NHS Chief Executives business meeting on Wednesday 18 January 2023 at 14:00.