Single Authority Models Stakeholder Group minutes: July 2025

Attendees and apologies

• Ivan McKee, Minister for Public Finance (chair)
• Neil Gray, Cabinet Secretary for Health and Social Care
• Cllr Shona Morrison, COSLA President
• Cllr Paul Steel, Council Leader, Comhairle nan Eilean Siar (CnES)
• Naill Houston, Policy Manager, Comhairle nan Eilean Siar (CnES)
• Gordon Jamieson, Chief Executive, NHS Western Isles
• Cllr Jim Lynch, Council Leader, Argyll and Bute Council
• Douglas Hendry, Policy Lead, Argyll and Bute Council
• David Logan, Head of Legal and Regulatory Support, Argyll and Bute Council
• Graeme McMillian, Policy Support, Argyll and Bute Council
• Laura Blackwood, Executive Support Officer
• James Gow, Head of Finance and Transformation  Argyll and Bute Integrated Joint Board
• Sarah Compton-Bishop, Chair, NHS Highland
• David Park, Deputy Chief Executive, NHS HIghland
• Gareth Adkins, Executive Director of People and Culture, NHS Highland
• Meghan McEwen, NHS Orkney Chair, NHS Orkney
• Stephen Brown, Chief Officer (covering interests of Laura Skaife-Knight, Chief Executive), NHS Orkney
• Oliver Reid, Chief Executive, Orkney Islands Council
• Audrey Waterson, Policy Lead, Orkney Islands Council
• Paula Speirs, Deputy Chief Operating Officer NHS Scotland
• Kate Higgins, Special Adviser to the First Minister, Scottish Government
• Simon Mair, Public Service Reform, Scottish Government
• Julie McLachlan, Place Based Service Change, Scottish Government
• Brian Logan, Local Governance Review, Scottish Government
• Jennie Marshall, Health Planning, Scottish Government
• Erica Clarkson, Islands Policy, Scottish Government
• Kirsty MacCormick, Rural Primary Care, Scottish Government
• Nicholas Thompson, Health Planning, Scottish Government
• Ellen Leaver, Place Director for Orkney CPP, Scottish Government

Apologies

• Cllr. Heather Woodbridge, Council Leader, Orkney Islands Council

• Laura Skaife-Knight, Chief Executive, NHS Orkney

• Malcolm Burr, Chief Executive, CnES
• Evan Beswick, Chief Officer, Argyll and Bute Integrated Joint Board
• Gillian McCannon, Chair, NHS Western Isles

Items and actions

National updates

Mr McKee opened the meeting by noting that actions from the March meeting will be picked up through today’s agenda and confirming the strategic importance of Single Authority Models (SAMs), as reflected within Programme for Government and wider PSR and health reform plans.

Cllr Morrison welcomed the pace of the work and noted the importance of making clear links to wider work, including Democracy Matters and fiscal framework with local government.  

Mr Gray introduced the SG “parameters” guidance. This has been purposefully framed to ensure there is flexibility for reform while setting out where there are firm lines of direction from an NHS perspective. Key elements of the legal and financial landscape are also highlighted to help provide a common understanding of existing arrangements when considering how best to move towards an optimum model of local governance. Options which require legislative change will be considered where this is shown to be necessary, while recognising that this would have implications for the timing of overall implementation.

Local partners confirmed that the guidance will be useful when taking forward local discussions on model development and early staff engagement. The strong focus on outcomes was also noted as being helpful.

In relation to the section on staff governance, local government representatives reflected that it will be important to ensure that the principle of “no detriment” in terms and conditions, pay or pensions of staff currently employed in the NHS also applies to staff employed by local government. In addition to the content of the parameters guidance, SGagree with the principle that the development of SAMs should not result in any detriment of the terms and conditions, pay or pensions of any local government staff. More broadly, improving recruitment and retention across key service areas is a key consideration.  

It was clarified that within the existing statutory framework it would be possible for health responsibilities to be held in another (non-island) Board. However, SG do not see this as the starting point for this work which should focus on making best use of financial and human resources available locally. SG expect locally-led model development, with its focus on improving outcomes and making the best possible use of available resource, to provide clarity on the potential value of different options, including those which involve changes to the oversight of key functions.

Local updates

In Orkney, colleagues reflected on productive independently facilitated sessions between NHS, local authority and SG in June. This approach will continue to be a useful tool going forward and broaden out to involve a wider set of interests. Local partners have agreed to focus communications on the opportunity to deliver public service reform and the principles which will guide progress, recognising this is a fresh opportunity to consider with local people and the workforce what will work best for Orkney in the current context. The SG information note reinforces the message that form will follow function in any new arrangements.

In Argyll and Bute, a short life working group with council and NHS representation has been set up and the parameters paper will help shape conversations going forward. In Western Isles, there is an upcoming workshop within the NHS Board and there will then be a joint meeting with CnES in September. There is potential interest from some in both geographies in the Orkney approach of facilitated support.

The core of this work is health and social care, but there is an ambition to explore whether wider functions, such as housing and education, can maximise the impact on outcomes. The design of future arrangements should also seek to dismantle existing barriers to effective and efficient decision-making e.g. siloed/ onerous reporting requirements.

Scottish Government Invest to Save funding (up to £0.9m across the three SAMs councils) is welcomed by all partners, who recognise that whilst the funding sits with local authorities, it is there to support all partners in progressing this work.

The timelines set out in the forward plan (draft preferred models and plans for local engagement in September, with more detailed models in December) are seen as feasible, recognising that the specific outputs may vary by area as localities are at different points in the policy development process.

It was noted that different bodies have statutory requirements for consultation e.g. on major service change. SG advice on this and any other required actions will help to build this into timelines towards milestones. Statutory requirements will be subject to the options for change identified so may vary between geographies. More generally, as local partners develop their thinking, they would find it helpful to share learning across geographies/ sectors.

Local partners noted the importance of the focus on outcomes and welcomed the opportunity to take part in a Theory of Change session involving national and local interests hosted by Prof. Linda Bauld, SG Chief Social Policy Advisor.

Actions

• Scottish Government to clarify if principles relating to staff terms and conditions considerations apply to other workforces (Update: this action is covered under paragraph 5 in these minutes)

• Scottish Government to offer further discussion with NHS Boards in relation to the consultation requirements in the staff governance standards
• Scottish Government to arrange Theory of Change session
• local partners to explore formal mechanism to share learning on cross-geography/ sector basis
• local partners to submit draft first draft preferred options and engagement plans in September