NHS Scotland Executive Group minutes: June 2025

Attendees and apologies

NHS Boards

• Peter Moore, NHS Borders
• Julie White, NHS Dumfries and Galloway
• Carol Potter, NHS Fife
• Ross McGuffie, NHS Forth Valley
• Jann Gardne, NHS Greater Glasgow and Clyde
• Louise Long, NHS Lanarkshire
• Laura Skaife-Knight, NHS Orkney
• Nicky Connor, NHS Tayside
• Fiona Davie, NHS Highland
• Brian Chittick, NHS Shetland
• Gordon Jamieson, NHS Western Isles

Special Health Boards

• Robbie Pearson, Healthcare Improvement Scotland
• Karen Reid, NHS Education for Scotland (Vice Chair of CEs)
• Gordon James, NHS Golden Jubilee
• Paul Johnston, Public Health Scotland
• Michael Dickson, Scottish Ambulance Service
• Gary Jenkins, The State Hospitals Board for Scotland

Scottish Government

• Christine McLaughlin, NHS Scotland Chief Operating Officer/Deputy CE
• Fiona Hogg, Chief People Officer
• Alan Gray, Director of Health and Social Care Finance
• Angie Wood, Director of Social Care Resilience and Improvement
• Anne Armstrong, Interim Chief Nursing Officer
• Robert Kirkwood, Head of Office of the Chief Executive

Other Attendees

• June Brow, Executive Nurse Director/Deputy CE, NHS Grampian (attending for Adam Coldwells)
• Jim Crombie, Deputy CE, NHS Lothian (attending for Caroline Hiscox)
• John Gebbie, Director of Finance, NHS 24 (attending for Jim Miller)
• Carolyn Low, Director of Finance, NHS National Services Scotland (attending for Mary Morgan)
• Paula Speirs, Deputy Chief Operating Officer – Planning and Sponsorship
• Dougie McLaren, Deputy Chief Operating Officer - Performance and Delivery
• Jason Birc, Deputy Director, Chief Nursing Officer Directorate (attending for Anne Armstrong)
• Tracy Slater, Head of Performance and Delivery, Chief Operating Officer Directorate 
• Andrew Murray, Medical Director, NHS Forth Valley (Agenda Item 6 – Vascular)
• Sharon Hilton-Christie, Executive Medical Director, NHS National Services Scotland
• Magnus Jeffrey, Risk Manager (Strategy, Policy and Risk)
• Joanna Swanson, Divisional Head (attending for John Harden for Q&S Paper for Information)
• Alan Payne, Board Governance Lead
• Aislinn Ni Ghráinne, NHS Corporate Communications

Secretariat

• Kat Dobell, Board Governance and Appointments Team
• Sarah Hobkirk, Board Governance and Appointments Team

NHS Chief Executive Support Team

• Sam Martens, Executive Support Team

Apologies

• Claire Burden, NHS Ayrshire and Arran
• Adam Coldwells, NHS Grampian (June Brown, Executive Nurse Director/Deputy CE attending)
• Caroline Hiscox, NHS Lothian (Chair of CEs) (Jim Crombie, Deputy CE attending)
• Jim Miller, NHS 24 (John Gebbie, Director of Finance attending)
• Mary Morgan, NHS National Services Scotland (Carolyn Low, Director of Finance attending)
• Caroline Lamb , DG HSC/CE NHS Scotland
• Gregor Smith, Chief Medical Officer
• Anne Armstrong, Interim Chief Nursing Officer
• John Harden, National Lead for Quality and Safety (Joanna Swanson attending)

Items and actions

Welcome, apologies for absence and attendees

Christine McLaughlin, Chief Operating Officer and Deputy Chief Executive of NHS Scotland, welcomed colleagues to the sixth meeting of the NHS Scotland Executive Group.

Christine acknowledged apologies from Caroline Lamb and Caroline Hiscox, noting Karen Reid as Vice Chair of Chief Executives would step in as appropriate during the meeting. Christine additionally acknowledged deputies attending the meeting for those unable to attend.

Christine thanked colleagues for facilitating the time for the meeting after changes to scheduling due to the First Minister's meeting on 27 May. Noting that the meeting would usually be hybrid but, in this instance, was virtual to accommodate the date change.

A full list of attendees and apologies for absence is provided at annex a.

Minutes of previous meeting, actions, matters arising (NHSEG/25/26)

The minutes from the last meeting of the Executive Group held on 16 April 2025 were approved.

A copy of the action tracker was shared, which provided an update on the actions from previous meetings.  Colleagues were invited to provide any further updates on actions not included as part of the agenda.

Peter Moore, Chief Executive, NHS Borders provided colleagues with an update relating to action NHSEG25/23.  Highlighting that there will be a portfolio discussion on Friday 13 June on integrating eRostering into the wider business systems transformation programme.

Colleagues were asked to send through updates on actions if any are still outstanding. It was noted that most actions still in progress were on the agenda for discussion.

Chief Executives had provided papers in relation to the following group actions:

• dental services
• Chief Executives' collective workplan
• operational improvement plan – feedback with national perspective on waiting list validation and variation
• matters arising from the BCE meetings on 13 and 14 May 2025.

Feedback from First Minister meeting

Christine reflected to colleagues the range of discussions taking place with the First Minister and Cabinet Secretary on the priority for health boards to ensure that by March 2026 no one is waiting longer than a year for their new outpatient appointment or inpatient/day-case procedure.

Christine noted that the First Minister was grateful for the letter from the Chief Executives relating to actions being taken forward on this priority. There is a clear drive for delivery across the system and discussions need to focus on operational delivery to ensure impact. Understanding the reasons for the backlog will provide important context but clear leadership and planning on addressing the 52 week priority will be essential over the coming months. Christine met with Chairs on 2 June to discuss this priority and ensure clarity of messaging across leadership teams. Chief Medical Officer and Chief Nursing Officer have also raised this with Medical and Nurse Directors, highlighting the importance of clinical leadership.

It was noted that based on current plans some boards are showing clear plans to meet the zero target where as others are not. Consistency is key and understanding the capacity across Scotland to bring those numbers down in local systems will be important to this work. Scottish Government will continue working closely with boards on this and will ensure the plans put to the First Minister and Cabinet Secretary are agreed. Plans need to be deliverable and clearly demonstrate a path to zero.

Tracy Slater shared slides highlighting the current 52 week waits across the system. This demonstrated the variation across Scotland. Colleagues were asked to examine the data and reflect on the actions, both already in place or required, to move to zero. It was essential that, as a system, local, regional and national interventions would need to be considered. Colleagues were reminded of the support available through the centre for sustainable delivery and national elective coordination unit.

The Executive Group reflected the following points:

• the data clearly shows the variation across Scotland. However, there is a need to understand how this data captures those medically unfit or those offered appointments and not attending. Data on those likely to move into the 52 week waits is required to understand the depth of the issue. Concerns were raised that the data on neurology and neurosurgery were put together, but are vastly different in delivery
• colleagues questioned if data is being collected consistently and in the same way across Scotland. Colleagues from the NHS academy are looking at training on waiting list management and will roll this out to all boards
• Greater Glasgow and Clyde is managing a substantial challenge and iterative plans are being submitted. This includes: outlining that work is underway to ensure lists are accurate; working with clinicians to assess risks of urgent to regular lists; looking at obtaining capacity from other boards; and, understanding the opportunity around private sector capacity
• issues around patients having to travel were raised. This has been common practice for a number of boards but needs population wide messaging. A population based approach would be key to delivering this priority and addressing other challenges
• Chief Executives would ensure that, at the next meeting with the First Minister, they would bring specific detail on meeting the 52 week priority

Christine thanked colleagues for their reflections and agreed that it was important that the paper on the path to zero long waits was clear on the actions that would be required to deliver.

Christine acknowledged that Boards had previously submitted their annual delivery plans, however, with this clear priority and the publication of the operational improvement plan, service renewal framework and population health framework there is a need to pause and reassess how performance against plans is monitored.  A note will be issued to clarify the next steps  to ensure local delivery of ADPs continue. If colleagues have any questions or concerns these can be raised through Paula Speirs, Deputy Chief Operating Officer, Planning and Sponsorship.

Business systems transformation (NHSEG/25/28)

Peter Moore, Chief Executive NHS Borders, gave a summary of the paper provided to update colleagues on progress to date. It was acknowledged that the outline business case will be signed off at the end of June, with an invitation to initial tender published 21 July 2025.

Sessions have been run with HR Directors and Directors of Finance to ensure their concerns are addressed and risks and benefits are clearly identified. Further discussions will take place before the next Executive Group and an update will be provided in July.

It was acknowledged that as this work progresses there will need to be a greater resource put behind the work to support delivery and implementation. The current programme board is fit for purpose at this stage, however, there will be a need to repurpose and additional support will be required.

Colleagues agreed that the impact on service and resource cannot be underestimated, considering the scale of this transformation programme. This programme will impact on the work of not only the implementation team but staff across the system will need to free up time to take this on that will impact on other aspects.

This work is a key enabler of the service renewal framework.

Action no  /  action /   lead  /  timescale

NHSEG25/36 / Updated paper to be brought to next Executive Group meeting following extraordinary BCE meeting and BCE meeting / Peter Moore  /  9 July 2025 Executive Group meeting

2025-26 System Pressures

Vascular (NHSEG/25/29)

Andrew Murray, Medical Director at NHS Forth Valley and Chair of the vascular task and finish group, provided the conclusion of the group’s work, which was to develop a single, sustainable model for vascular services in Scotland. A supporting paper had been circulated in advance, with earlier iterations previously reviewed by the Executive Group.

Andrew outlined the critical challenges facing vascular services in Scotland, highlighting the fragility and unsustainability of current models. He emphasised the clinical risks associated with the existing system, where severely ill patients are frequently transferred across regions under extended mutual aid arrangements.

To address these issues, the task and finish group has proposed a new, sustainable model (option 5), which includes the establishment of a north of Scotland network. This model aims to replace ad hoc mutual aid with a structured, population-based planning approach.

Andrew noted broad clinical consensus on the need for change. However, concerns remain regarding the level of public engagement and the potential impact on local service delivery. The group will share its interim report to inform wider endorsement of the proposed direction. The Cabinet Secretary is closely monitoring developments and expects a detailed implementation plan to be submitted.

Colleagues discussed the following points:

• the current delivery model poses significant clinical risks and is not sustainable
• the proposed model involving a north of Scotland network, developed and agreed with the clinical community to promote equity and long-term viability
• population based planning and a move away from reactive mutual aid to proactive, structured service planning
• governance and oversight and the clear roles and responsibilities required for Medical Directors and Chief Executives
• strong emphasis on engaging communities and explaining the rationale behind changes to ensure transparency and public trust
• while consensus exists broadly, some local concerns remain about public engagement and service impact
• the transition will be complex, requiring clarity on timelines, capacity, resources, and infrastructure
• this reform could serve as a learning opportunity and blueprint for further service redesign, aligning with SRF

The group agreed on the need for robust governance, phased implementation, and clear communication strategies. Further detail is required on the implementation plan and transition to the target operating model, which will be addressed through rapid development of a phased transition plan.

Action no  /  action /   lead   / timescale

NHSEG25/37 /  report from task and finish group to be shared with colleagues  /  Andrew Murray and Sharon Hilton-Christie  /  10 June 2025

NHSEG25/38  /  agreement to move to implementation of the phased model and Nicky Connor/Paula Speirs to follow up to agree mobilisation of the oversight group / Nicky Connor and Paula Speirs  /  written update by 30/6

NHSEG25/39  /  implementation group to develop an implementation plan based on target operating model.  This should include clear ways forward on community engagement and governance arrangements include SRO, CEs and MDs roles/responsibilities  /  Nicky Connor and Paula Speirs  /  9 July 2025

NHSEG25/40  /  update on progress to Cabinet Secretary  /  Paula Speirs  /  23 June 2025

Diagnostics (NHSEG/25/30)

Paula Speirs, Deputy Chief Operating Officer asked colleagues to reflect on the report shared with colleagues today and to provide comments by Friday 13 June, noting that this paper had been endorsed by the planning and delivery board and subsequent discussion at the board Chief Executives meeting on 14 May 2025.  Colleagues were asked to include Ross McGuffie in those emails, as portfolio lead.

Colleagues noted the complexity and implications related to this work and the need to be mindful of how to ensure meaningful clinical engagement.

Action no  /  action  /  lead  /  timescale

NHSEG25/41 /   BCEs to provide comments on diagnostic plan to Paula Speirs and Ross McGuffie  /  BCEs  / 13 June 2025
NHSEG25/42  /  BCEs to have further discussion on this  /  Ross McGuffie  /  future BCE meeting
NHSEG25/43  /  share learnings from national laboratories programme  /  Carolyn Low  / 13 June 2025

Neonatal services (NHSEG/25/31)

Jann Gardner, Chief Executive NHS Greater Glasgow and Clyde, Laura Skaife-knight, NHS Orkney, Carol Potter, Chief Executive NHS Fife, were invited to provide an update from each regional perspective.

Colleagues recognised the challenges on this area in relation to clinical and public health concerns. It was noted that each region had different challenges. Progress in this area has been slower than hoped for and further work would be required in this important service.

Action no  /  action  /  lead  /  timescale

NHSEG25/44  /  each region to bring a more detailed update on respective plans   /  Jann Gardner, Carol Potter and Laura Skaife-Knight  /  guture EG meeting

Power and communications resilience in NHS Scotland (NHSEG/25/31)

Magnus Jeffrey, Unit Head Strategy, Policy and Risk, Health EPRR talked to the paper that had been circulated to colleagues in advance of the meeting.

The discussion focused on the urgent need for a robust and system-wide approach to resilience in health and care, particularly in light of power and communications outages. A report was presented (not for wider circulation) assessing the risk of a national power outage and its potential catastrophic impact on service delivery.

Colleagues discussed the following points:

• learning from recent outages and agreeing to share lessons
• requirement for more thought on cybersecurity measures, considering recent events
• impact of aging infrastructure, including capital buildings but also reliance on the Airwave communications system
• agreement that there is a clear need for a national strategy that integrates health along with broader civil contingency planning

Colleagues welcomed the opportunity to have a wider discussion on resilience at a BCE meeting and confirmed that Brian Chittick would be the Chief Executive sponsor for power and communications resilience.

Action no  /  action  /  lead  /  timescale

NHSEG25/45  / resilience session at private BCE meeting  /  Brian Chittick and Chief Executives  / future BCE meeting

Any other business

Anti-racism plans

Fiona Hogg, Chief People Officer highlighted the work to date on anti-racism plans and reminded boards that they will be asked to provide updates on implementation. Boards will have the opportunity to have a 1:1 feedback session with Scottish Government on their plans and this should include executive level, EDI and local network representatives. The First Minister has raised the importance of making sure lived experience is captured in the plans and any actions. Fiona reminded colleagues that support is available through the ethnic minority forum, NHS Education for Scotland, Public Health Scotland and Scottish Government.

Papers for information

Three papers were provided for information and leads for each were offered the opportunity to give further information on these. 

• service renewal framework (NHSEG/25/32) – it was confirmed that the SRF is set to be published in mid-June. Christine confirmed with colleagues that she would work with Caroline Hiscox to agree ways of working outside of meetings to develop and implement the framework. It was noted that Nicky Connor and Gordon James offered to support this
• quality and Safety Proposal (NHSEG/25/33) – colleagues noted the update and that updates would be provided from the quality and safety group 
• oncology (NHSEG/25/34) – colleagues noted.

There were no other items of business raised.

Date and time of next meeting

The next meeting will take place on 9 July 2025 at 14:00.