NHS Scotland Executive Group minutes: July 2025

Attendees and apologies

NHS Boards

• Claire Burden, NHS Ayrshire and Arran (V)
• Peter Moore, NHS Borders (IP)
• Carol Potter, NHS Fife (V)
• Ross McGuffie, NHS Forth Valley (V)
• Adam Coldwells, NHS Grampian (V)
• Jann Gardner, NHS Greater Glasgow and Clyde (IP)
• Fiona Davies, NHS Highland (V)
• Caroline Hiscox, NHS Lothian (IP)
• Laura Skaife-Knight, NHS Orkney (V)
• Nicky Connor, NHS Tayside (V)

Special Health Boards

• Karen Reid, NHS Education for Scotland (V)
• Gordon James, NHS Golden Jubilee (V)
• Mary Morgan, NHS National Services Scotland (IP)
• Michael Dickson, Scottish Ambulance Service (IP)
• Gary Jenkins, The State Hospitals Board for Scotland (V)

Scottish Government

• Caroline Lamb, DG HSC/Chief Executive NHS Scotland (IP)
• Christine McLaughlin, NHS Scotland Chief Operating Officer/DCE (IP)
• Fiona Hogg, Chief People Officer (V)
• Fiona Bennett, Director of Health and Social Care Finance (IP)
• Angie Wood, Director of Social Care Resilience and Improvement (awaiting IP or V confirmation)

Other Attendees

• David Rowland, NHS Dumfries and Galloway, Director of Strategic Planning and Transformation (for Julie White) (V)
• Jacqui Jones, NHS Lanarkshire, Director of HR (for Louise Long) (V)
• Ann Gow, Healthcare Improvement Scotland, Deputy Chief Executive (for Robbie Pearson) (V)
• Jacqui Hepburn, NHS 24, Deputy Chief Executive/Director of Workforce (V)
• George Dodds, Public Health Scotland, Chief Officer (V)
• Irene Barkby, Deputy Director CNOD (for CNO) (V)
• Dougie McLaren, Deputy Chief Operating Officer - Performance and Delivery
• Paula Speirs, Deputy Chief Operating Officer – Planning and Sponsorship (V)
• Aislinn Ni Ghráinne, NHS Corporate Communications (V)

Secretariat

• Laurie Whyte, Board Governance and Appointments Team (IP)
• Kat Dobell, Board Governance and Appointments Team (IP)

NHS Chief Executive Support Team

• Claire Gilroy, NHS Executive Support Team (V)

Apologies

• Julie White, NHS Dumfries and Galloway (David Rowland attending)
• Louise Long, NHS Lanarkshire (Jacqui Jones attending)
• Brian Chittick, NHS Shetland
• Gordon Jamieson, NHS Western Isles
• Robbie Pearson, Healthcare Improvement Scotland (Ann Gow attending)
• Jim Miller, NHS 24 (Jacqui Hepburn attending)
• Paul Johnston, Public Health Scotland (George Dodds attending)
• Anne Armstrong, Chief Nursing Officer (Irene Barkby attending)
• Gregor Smith, Chief Medical Officer (Graham Ellis attending)
• Robert Kirkwood, Head of NHS Executive Office
• John Harden, National Lead for Quality and Safety
• Sarah Hobkirk, Board Governance and Appointments Team

 

Items and actions

MINUTES

Welcome, apologies for absence and attendees

Caroline Hiscox, Chief Executive, NHS Lothian and Chair of Chief Executives Group, welcomed colleagues to the seventh meeting of the NHS Scotland Executive group.  

Caroline Hiscox, acknowledged apologies and welcomed deputies for colleagues, due to summer and leave period. A full list of attendees and apologies for absence is provided at annex a. 

Minutes of previous meeting, actions, matters arising (NHSEG/25/36)

The minutes from the last meeting of the executive group held on 5 June 2025 were approved. 

A copy of the action tracker was shared, which provided an update on the actions from the last meeting.  Colleagues were invited to provide additional information on actions which were not included on the agenda.  

Christine McLaughlin, NHS Scotland Chief Operating Officer, provided an update on governance plans. She advised that colleagues should now have received a letter which acknowledged annual delivery plans and outlined a future shift towards providing assurances on the operational improvement plan (OIP). 

Christine McLaughlin informed colleagues about a review of the governance landscape as set out in the service renewal framework, to provide clarity around delivery of key national priorities. As a first step, she explained that herself and Karen Reid, Chief Executive, NHS Education for Scotland, as joint Chairs of the planning and delivery board were developing a paper on transitioning to a new way of working to support population level planning. A proposal will go to Chief Executives and assurance will be given on current projects that are being taken through the board. 

Karen Reid reiterated the importance of right touch governance, that streamlining process and proposals will help keep pace and structure for national work. 

Feedback from board Chief Executives (NHSEG/25/37)

Karen Reid was invited to update on outstanding board Chief Executives’ (BCE) actions and introduce the BCE delivery plan. 

The delivery plan is a working document which outlines how the BCEs will support the delivery of the OIP, service renewal framework (SRF) and population health framework (PHF) over the next year. The plan focuses on 7 key priorities: population health; leadership and collaboration; workforce; performance and quality; finance; reform and renewal and, governance. The purpose of this plan is to ensure consistent implementation of national initiatives. Executive leads are developing complimentary plans. Colleagues were asked to offer thoughts and provide feedback.  

Fiona Hogg, Chief People Officer, asked that colleagues demonstrate the link to wider public service reform and Fiona Bennet, Interim Director of Finance, proposed that best value is reflected across all priority areas and not as a standalone part of finance. Colleagues confirmed that these links would be made more explicit. 

Action no - action - lead - timescale

NHSEG25/46 - colleagues to feedback on the BCE delivery plan - Caroline Hiscox/Karen Reid - ongoing/ iterative
NHSEG25/47 - update plan to explicitly link to public service reform and ensure best value is filtered throughout - Caroline Hiscox/Karen Reid - August 2025

Business systems (NHSEG/25/38)

Caroline Hiscox invited Peter Moore, Chief Executive, NHS Borders, to provide an update on business systems and commended him for the integrity and leadership that he has provided in progressing this work. 

Peter Moore summarised the development of the outline business case (OBC) which BCEs had agreed to at the 8 July meeting. He reflected on the significant engagement that had taken place to develop the business case and highlighted the importance of next steps as the programme board moves towards implementation. Carol Potter confirmed that BCE portfolio will consider how to support the transition and recommendations on next steps will be submitted to BCEs in August. Colleagues assured DoFs and HRDs would be included to support this change. 

Colleagues reflected on the positive collective ownership of this transformational programme and agreed that any learning from this should be available to share with other transformational change programmes.  BCEs were asked to ensure their boards were fully aware of the programme.

Clear messaging is required to support the implementation of this programme, in particular on how it will positively impact productivity, reduce cost and labour of the workforce. Colleagues proposed a joint session with Executive teams on this programme to ensure consistency across the leadership cohort in autumn.

Fiona Bennet assured colleagues of the engagement of the DoFs and that there is a standing item on this at their meeting to ensure options are properly appraised. 

Colleagues reflected that there is significant improvement capability across Scotland through CfSD, HIS and NES and that these staff should be pivoted to support transformational programmes. It was agreed that leads from these areas should come together to discuss how best to respond to change and reform and use this capability efficiently.

Colleagues confirmed agreement on the OBC and for additional updates to be provided at the next BCE meeting with a further update to NHS EG in October 2025. 

Action no - action - lead - timescale

NHSEG25/48 - leadership session with executive teams on business systems programme - Mary Morgan/Jacqui Jones - Autumn 2025
NHSEG25/49 - meeting of CfSD, HIS, NES and SG improvement leads on transformation and improvement capability alignment - Robbie Pearson (lead)/Gordon James/Karen Reid/Christine McLaughlin/ Angie Wood - initial meeting summer 2025
NHSEG25/50 - update on business systems programme to NHS EG - Peter Moore - October 2025

Vascular (NHSEG/25/39)

Nicky Connor, Chief Executive NHS Tayside, summarised the work on vascular to date and outlined how the paper addressed concerns raised by colleagues at the last NHS EG meeting, drawing attention to the engagement, impact assessment, risks and linkage with the OIP/SRF/PHF. The significant risk held by NHS Highland was highlighted and colleagues were asked to confirm agreement with the next phase of implementation. 

Colleagues noted the risk at NHS Highland and implications on mutual aid resilience. It was agreed that there needs to be substantial progress and that it will be important to stay on track with the timeline submitted. Colleagues were challenged to start planning for the next phase of implementation and were offered an open invitation to have input from the DoFs on this. It was noted that BCEs will have a development session on collaborative risk. 

Fiona Davies, Chief Executive, NHS Highland, thanked Nicky Connor for progressing this work and asked for assurance that learning will be shared. Commenting that service failure should not be the catalyst to look at service sustainability and that collectively leaders need a way to formally recognise local risks and how to collectively support to ensure sustainability across Scotland. 

Colleagues were asked to provide strategic endorsement and agree actions for urgent pathway implementation to confirm agreement with a range of next steps/actions:

• colleagues formally acknowledged the significant level of clinical and operational risk currently held by NHS Highland
• colleagues approved a coordinated, Scotland-wide response to accelerate mitigation efforts
• colleagues recognised the work of the task and finish group on the vascular sustainable operating todel, target operating model & feasibility assessment report and agreed that this concludes the work of task and finish group
• colleagues agreed progression to the next phase with direct engagement across impacted boards to collaboratively assess the broader consequences of the recommended model
• colleagues agreed to the formation of a strategic implementation group, chaired by the senior responsible officer (SRO), tasked with delivering the group's recommendations and ensuring ongoing engagement and impact assessment throughout implementation.  Colleagues requested an update on risks at the next NHSEG meeting.
• colleagues endorsed the initial action of convening a full-day, in-person strategic workshop involving Chief Executives, Medical Directors, Directors of Acute services, and planning Directors from Highland, Grampian, Tayside, Fife, Lothian.

Action no - action - lead - timescale

NHSEG25/51 - progression to the next phase with direct engagement across impacted boards to collaboratively assess the broader consequences of the recommended model - Nicky Connor - July 2025
NHSEG25/52 - formation of a strategic implementation group, chaired by the senior responsible officer (SRO), tasked with delivering the group's recommendations and ensuring ongoing engagement and impact assessment throughout implementation - Nicky Connor - July 2025
NHSEG25/53 - an update on risks at the next NHSEG meeting - Nicky Connor - August 2025
NHSEG25/54 - convening a full-day, in-person strategic workshop involving Chief Executives, Medical Directors, Directors of Acute services, and planning Directors from Highland, Grampian, Tayside, Fife, Lothian - Nicky Connor - July/August 2025

Operational improvement plan (NHSEG/25/40)

Christine McLaughlin updated colleagues on the governance and performance executive arrangements on reporting against the OIP to Ministers. Christine confirmed that within SG, she is the SRO for the OIP. The paper highlighted what is to be delivered in boards but also the role of the government. 

Christine challenged BCEs on how progress is monitored within boards and while there is demonstrated commitment on long waits more is needed on other areas such as unscheduled care, frailty and hospital at home. Christine challenged BCEs to be ambitious against the OIP and look forward at how to not only to deliver against the plan but to consider what they would want to be achieved by the end of this financial year, setting out progress that moves beyond the current work towards more sustainable services as demonstrated in the SRF and PHF. 

Chief Executives met on 8 July and discussed requirements of the OIP/SRF and reflected that these are not necessarily adequately reflected in ADPs. Chief Executives agreed to have further discussions to review the links in their local systems but to also feedback into regional/national and collectively reflect on performance of the country. 

Colleagues agreed there was a need to work together to ensure reporting is aligned and consistent across Scotland and ensure that the narrative around reporting clearly demonstrates the impact to the people of Scotland. It would be important to work together to ensure reporting against OIP is consistent and impactful.  

Action no - action - lead - timescale

NHSEG25/55 - Discussion on impactful reporting against OIP and to provide regular updates against priorities - Caroline Hiscox/Gordon James/Christine McLaughlin/ Angie Wood - update at August NHSEG

Papers for note

Accelerated national innovation adoption (ANIA) new innovation proposal (ECG patches) and update (Type 2 Diabetes prevention) (NHSEG/25/41)

Caroline Hiscox invited colleagues to agree with the proposal for the new proposal to be taken through to funding process as described and to note progress. 

Colleagues agreed with no additional comments. 

Maternity (NHSEG/25/42a)and neonatal (NHSEG/25/42b)

Caroline Hiscox invited colleagues to note the papers on maternity and neonatal. 

Colleagues considered the HIS report on maternity and whether this group was the right forum for this to be brought. An option is to be considered that these go through the quality and safety subgroup and themes from reports are included in the quarterly update from the subgroup. 

Right decision services (NHSEG/25/43)

Caroline Hiscox invited colleagues to note the paper on right decision services and confirmed the need for input from professional groups regarding cost and clinical input.  

Any other business

Chief Executive and First Minister Meeting (August 2025)

Caroline Lamb reminded colleagues that the next meeting of the group coincides with the meeting with the First Minister. It was reiterated that colleagues need to be prepared to discuss delivery against the OIP and also the next steps boards are taking into reform and renewal. 

Executive recruitment and retention

Caroline Lamb encouraged Chief Executives to collaborate on an alternative approach to Executive recruitment, where appropriate, in line with the policy direction set out for public sector reform and for certain positions. Fiona Hogg and Jacqui Jones agreed to take this forward. 

Colleagues recognised the importance of this and that there will be a behavioural piece needed to do on this at board level to ensure clarity for Chairs and non-executives. 

Action no - action - lead - timescale

NHSEG25/56 - Paper on whole system executive recruitment and proposals to CEs - Jacqui Jones/ Fiona Hogg - August BCE
NHSEG25/57 - Discussion with NHS Chair of Chairs on Executive Recruitment - Caroline Hiscox/Carole Wilkinson - August BC