NHS Scotland Executive Group minutes: March 2025

Attendees and apologies

NHS Boards

• Claire Burden, NHS Ayrshire and Arran
• Peter Moore, NHS Borders
• Julie White, NHS Dumfries and Galloway
• Carol Potter, NHS Fife
• Ross McGuffie, NHS Forth Valley
• Jann Gardner, NHS Greater Glasgow and Clyde
• Fiona Davies, NHS Highland
• Colin Lauder, NHS Lanarkshire, Interim CE
• Caroline Hiscox, NHS Lothian (Vice Chair of CEs)
• Laura Skaife-Knight, NHS Orkney
• Brian Chittick, NHS Shetland
• Nicky Connor, NHS Tayside

Special Health Boards

• Robbie Pearson, Healthcare Improvement Scotland (Chair of CEs)
• Karen Reid, NHS Education for Scotland
• 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

• Caroline Lamb, DG HSC/CE NHS Scotland
• John Burns, NHS Scotland Chief Operating Officer
• Alan Gray, Director of Health and Social Care Finance
• Fiona Hogg, Chief People Officer
• Christine McLaughlin, Co-Director of Population Health
• Robert Kirkwood, Head of Office of the Chief Executive

Other Attendees

• June Brown, NHS Grampian, Deputy Chief Executive/Executive Nurse Director (for Adam Coldwells)
• Jacqui Hepburn, Deputy Chief Executive and Director of Workforce, NHS 24 (for Jim Miller)
• Paula Speirs, Deputy Chief Operating Officer – Planning and Sponsorship
• Dougie McLaren, Deputy Chief Operating Officer - Performance and Delivery
• Derek Grieve, Head of Social Care Response
• Aislinn Ni Ghráinne, Strategic Insights and Briefing Unit Head
• Alistair Hodgson, Head of Strategy and Policy, Digital Health and Care (Agenda Item 9)
• David McColl, Deputy Director of Technology Services, NHS Education for Scotland (Agenda Item 9)

Secretariat

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

NHS Chief Executive Support Team

• Fraser McJannett, Executive Support Team
• Sam Martens, Executive Support Team
• Jenna Stone, Executive Support Team
• Rhea Crighton, Executive Support Team

Apologies

• Gordon Jamieson, NHS Western Isles
• Adam Coldwells, NHS Grampian (June Brown attending)
• Jim Miller, NHS 24 (Jacqui Hepburn attending)
• Mary Morgan, NHS National Services Scotland
• Angie Wood, Director of Social Care Resilience and Improvement (Derek Grieve attending)
• Anne Armstrong, Interim Chief Nursing Officer
• Gregor Smith, Chief Medical Officer
• John Harden,National Lead for Quality and Safety
   

Items and actions

Minutes

Welcome, apologies for absence and attendees
1.   Caroline Lamb, DG Health & Social Care, welcomed everyone to the fourth meeting of the NHS Scotland Executive group and thanked colleagues for their attendance in person at the meeting with the First Minister, which took place directly before today’s meeting.
2.    Caroline welcomed Colin Lauder, Interim CE, NHS Lanarkshire to his first Executive Group meeting.  
3.    Caroline advised colleagues that agenda item 10 would be discussed earlier in the meeting due to Paul Johnston requiring to leave early for another meeting.

A list of attendees and apologies for absence is provided at annex a. 
Reflections from the First Minister meeting
5.    Caroline thanked Chief Executives for their engagement with the First Minister and Cabinet Secretary and invited them to reflect on discussions. It was a positive meeting, where Chief Executives were able to highlight the collaborative approach they were taking to address the challenges faced. They were encouraged by the discussion and felt empowered and motivated to take forward the tasks ahead. 
6.    Caroline thanked colleagues for the work they were doing, and for providing the First Minister and Cabinet Secretary with assurance around delivery. Chief Executives welcomed the opportunity to meet with the First Minister on a quarterly basis to discuss progress against key priorities. 
Action no/action lead/timescale
NHSEG25/15: First Minister to meet with Chief Executives on a quarterly basis/board governance and appointments team/provisional dates identified by 28 March 2025
Minutes of previous meeting, actions, matters arising (NHSEG/25/12)
7.    The minutes from the last meeting of the executive group held on 22 January 2025 were approved.
8.    A copy of the action tracker was shared, which provided an update on the actions from the last meeting.  Colleagues were invited to provide any further updates on actions not included as part of the agenda.  No further comments were provided.  
Feedback from BCE action items
9.    Robbie Pearson, Healthcare Improvement Scotland (Chair of CEs) provided an update on actions that Chief Executives were collectively responsible for from the action tracker:

• obesity drugs: discussions on this had taken place and further work on current pathways is being undertaken by NHS Lothian and Scottish Government colleagues.
•  innovation: success with ANIA was noted and it was acknowledged that there was a need to look at other examples of innovative practice that would provide best value
•  cancer: There is a need to implement learning and centre for sustainable delivery (CfSD) colleagues are available to help. Colin Lauder extended an invitation for colleagues to shadow his team in NHS Lanarkshire. John Burns re iterated the need to have clear outputs and measurable changes to demonstrate improvement. 
• diagnostic improvement is required as most delays were attributed to the diagnostic elements of the pathway. The target for May 2025 should have no-one waiting for more than 6 weeks, therefore there must be correlation where optimising impact. The academy were happy to offer in board training and Chief Executives are asked to reach out to engage with this offer. 
• Chief Executives need to be assured that their own boards are looking at potential areas of improvement and what they would expect to see on a 62 day target.

Action no/action lead/timescale
NHSEG25/16/NHS CEs to take up the opportunity to engage with CfSD and the offer of shadowing at NHS Lanarkshire/NHS CEs/Update to be provided 16 April meeting
NHSEG25/17/NHS CEs to contact the academy re the offer for in board training on diagnostics/NHS CEs/Update to be provided 16 April meeting
Planned care
10.    Dougie McLaren, Deputy Chief Operating Officer, Performance and Delivery and Gordon James, Chief Executive, NHS Golden Jubilee, provided colleagues with a short update on planned care. 
11.    Meetings have taken place with boards and updated orthopaedic plans have been submitted.  Work has been undertaken around activity plans with all boards having been asked to submit their revised plans by close of play Wednesday 5 March. This information will be consolidated, and it was noted that further work will be required on the seven key specialties, which will require collaboration across boards. 
12.    The orthopaedics position would be taken to the First Minister’s meeting on Wednesday 18 March. Whilst boards have been asked to submit local opportunities for further improvements, decisions on funding would be made in alignment with the planned care principles framework.  
13.    Colleagues referenced recent practices in NHS England:

• man marked long waits
• use of the independent sector
•  super Saturdays
• financial incentive

14.    Further work is needed to review data so that waiting lists are reducing in the right way, with the longest and most urgent being prioritised. 
15.    It was noted that Mr McKee, Minister for Public Finance is interested in site level information and understanding how an asset-based approach could reduce waiting times. 
Health and social care reform (NHSEG/25/18)
16.    Paul Johnston, Chief Executive, Public Health Scotland and Christine McLaughlin, Co-Director of Population Health were invited to talk to this item. 

17.    A paper had been circulated to attendees in advance of the meeting covering the following:

• feedback from BCE Session on reform which took place on 18 February
•  leadership and collaboration.

18.    At the meeting with the First Minister, it was suggested that consideration be given to the title of the “population health framework” to reflect the need for ownership by the whole system . 
19.    Work on the reform products is underway, with the first product being the operational improvement plan. Engagement events are continuing with a series of upcoming discussions being planned with SOLACE, COSLA and Chief Officers.  This is just the start of meaningful engagement and new, collaborative, ways of working.  
Unscheduled care 
20.    Dougie McLaren, Deputy Chief Operating Officer, Performance and Delivery provided a verbal update for this agenda item.
21.    Circa £200m funding has been committed in the budget across waiting times and hospital capacity and flow, which will require a deliberate focus and a work plan for the transformation board. A commission has been sent out to Chief Executives and Chief Officers regarding capacity flow planning (due 5 March 2025), which will inform the operational improvement plan. Once returns have been considered, Chief Executives will look at actions, shared space to drive improvements and trajectories ahead of whole system engagement.  
22.    John Burns advised that important whole system work was ongoing via the collaborative response and assurance group (CRAG) to strengthen working relationships and focus on capacity risk. It was noted that further action should still be taken within NHS as small improvements would still make a big difference. 
Action no/action lead/timescale
NHSEG25/18/After review of board returns, SG to work with Chief Executives to look at actions, improvements, trajectories and what they can do etc/Dougie McLaren/Chief Executives/asap in March/April
2025-26 Service pressures (NHSEG/25/15)
23.    Paula Speirs, Deputy Chief Operating Officer, NHS Scotland provided an update on Service Pressures for 2025-2026 noting that an updated paper had been shared in advance of the meeting. 
24.    This paper was brought as a further update to the NHS Scotland Executive Group on the position with identified 2025-2026 service pressures. As requested in January, the areas have been split into three areas – ministerial; national decisions; and local resolution. 
25.    Changes over the last few months were highlighted: 
•    a Chair had been appointed for the children’s palliative care task and finish group
•    A paper relating to Thrombectomy was with Ministers around next steps and an update would come through the Planning and Delivery Board
•    for those requiring funding decisions, discussions continued with Health Finance to conclude
26.    A number of areas, including CAR-T, TAVI and thrombectomy related to services that had been de-designated and were now planned within regions. This has led to inconsistency of standards of services and access to services and therefore it was agreed that planning still required a national approach and that they would report into the planning and delivery board to ensure oversight and appropriate governance. It was noted that the development of a single plan was agreed for transcatheter aortic valve implantation (TAVI) in August 2024. This should progress as a priority
27.    Caroline Hiscox indicated that she had feedback on the paper and would provide this separately to Paula Speirs. She also noted her agreement for the principle that all items within this paper should be reported via the NHS Scotland planning and delivery board. 
28.    A predominant issue was the lack of clarity on funding position. Alan Gray, Director of Health and Social Care Finance agreed to follow-up alignment of the issues in this paper with funding decisions, simplifying some of the decisions required. The paper would be resubmitted at the next Executive group meeting.
29.    Progress on the neonatal/best start programme was highlighted, following the current programme coming to an end.  To address the delays in implementation, it was agreed that a short-life working group would be established to review through a population health lens, including transport and workforce issues. It was noted that this would bring together programme resource from the perinatal network, policy and boards. 
Action no/action lead/timescale
NHSEG25/19: Alan Gray to review finance in discussion with Paula Speirs and provide clarity around the finance streams. A revised paper to  be submitted for the next Executive Group meeting in April/Alan Gray/Paula Speirs/16 April 2025
NHSEG25/20: A short-life working group to review neo-natal best start, CAMHS work through a population health lens/Paula Speirs/31 March 2025
NHSEG25/21: NSD to be commissioned to produce regular reports on CAR-T, TAVI and thrombectomy for planning and delivery board/Paula Speirs/31 March 2025
NHSEG25/22: Caroline Hiscox  to provide feedback to Paula Speirs from the thrombectomy paper/Caroline Hiscox/31 March 2025
Business systems transformation programme update (NHSEG/25/16)
30.    Peter Moore, Chief Executive, NHS Borders and Paula Speirs were invited to talk to this item. A paper had been circulated to attendees in advance of the meeting.  

31.    The paper highlighted the key changes in the business systems transformation programme, clarifying the programme architecture going forward, setting out clear actions that all NHS boards needed to take and illustrated where the new business systems would provide opportunities to develop more effective and efficient ways of delivering business services.  
32.    A full business case will be prepared looking to secure a cost-effective model for shared, single, business services. Capgemini is providing support to the work with National Services for Scotland (NSS) supporting all individual boards, working in conjunction with nominated board Strategic Leads. 
33.    Delivery of this new model will, in time, require governance changes and also a change in ways of working. The Scottish partnership forum would need to be consulted and brought on board with any proposals. This should be dealt with at pace over the next 3-4 months setting out a clear direction of travel. 
34.    Paula Speirs questioned whether the refreshed business transformation (BT) programme included eRostering, noting that with the current programme structure about to end that NHS Scotland Executive group had previously approved that this would report through the BT programme. This would also ensure management of dependencies with any new payroll system and how information is taken from eRostering. 
Action no: action lead/timescale
NHSEG25/23: Peter Moore to update the paper to include eRostering, prepare business case and bring back to a future NHS Scotland Executive group meeting. Peter to arrange an SPF briefing on business system progress/Peter Moore/Carol Potter/Mary Morgan/Paula Speirs/28 May 2025 NHS Scotland Executive group meeting
Delivering digital front door (NHSEG/25/17)
35.    Christine McLaughlin, Co-Director of Population Health, Karen Reid, Chief Executive, NHS Education for Scotland and Alistair Hodgson, Head of Strategy & Policy, Digital Health & Care were invited to outline the paper that had been circulated in advance of this meeting. 
36.    Christine advised that the paper followed on from previous discussions on a digital first approach for Scotland, the programme for governance (PfG) commitment regarding digital front door and the First Minister’s speech in January which accelerated the first development of a health and care app for Scotland. This will be delivered through a ‘minimum viable product’ with NHS Lanarkshire in December 2025.    
37.    Work would be required within all territorial boards to develop a migration plan and understand the requirements required for local implementation. Boards were asked to nominate a board lead to work with NHS Education Scotland who would be the delivery partner.  

38.    An outline business case from NES was currently being reviewed and the NHS Scotland Executive group was asked to delegate approval of the OBC to the digital strategic leadership board, of which Jann Gardner is co-chair.  
39.    NHS Education for Scotland are looking for early adopters and encourage Chief Executives to nominate their board. It was noted that this is not only a technology solution but will require boards to undertake service redesign and allocate appropriate resource to achieve this.
40.    The NHS Scotland Executive group were asked to: 
Action no: action lead/timescale
NHSEG25/24: note that NES need to engage with all boards and that boards will need to identify key strategic leads to support engagement with NES as part of implementation planning as part of a 'one team' approach – and that this engagement should confirm local resource requirements and plans for specific public facing services and shift from local contractual arrangements to the national ‘digital front door’ service/Chief Executives/by 21 March 2025
NHSEG25/25: note that the OBC for digital front door will be progressed via digital governance/Chief Executives/by 21 March 2025
Any other business
41.    There were no other items of business raised.  
42.    Caroline thanked Robbie Pearson for his time as Chair of Chief Executives.  She looks forward to co-chairing future NHS Scotland Executive group meetings with Caroline Hiscox, who takes over as Chair of Chief Executives in April.
Date and time of next meeting
43.    The next meeting will take place on Wednesday 16 April 2025 at 13:00. 
Board Governance and Appointments Team
7 March 2025