Health and care reform: Stakeholder Advisory Group minutes - January 2026

Attendees and apologies

• Carol Sinclair, Scottish Ambulance Service
• John McAnaw, NHS 24
• Matt Barclay, Community Pharmacy Scotland
• Susan Webb, NHS Lothian, Scottish Directors of Public Health
• Iain Morrison, SGPC of BMA
• Robbie Pearson, Healthcare Improvement Scotland
• June Brown, NHS Grampian
• Soumen Sengupta, South Lanarkshire Council
• Pavan Srireddy, Royal College of Psychiatrists in Scotland
• Moira Mackenzie, Scotland’s Digital Health & Care Innovation Centre
• Julie Mosgrove, Optometry Scotland
• Rachael King, Chair of the HSCS Integration Joint Board Chair & Vice Chair Network
• James O'Connell, Unite the Union
• John Connaghan, NHS Lothian
• Chris Provan, Royal College of General Practitioners (RCGP) Scotland
• John Robertson, BMA Scotland
• Chris Williams, Royal College of Physicians of Edinburgh
• Katie MacGregor, Royal College of Occupational Therapists
• Sara Redmond, The Health and Social Care Alliance Scotland
• Rachel Cackett, CCPS
• Heather Cameron, Scottish Directors of AHPs
• Iain Kennedy, British Medical Association (Scotland)

Items and actions

Welcome - Caroline Lamb, Chief Executive NHS Scotland/DG Health and Social Care and Cabinet Secretary for Health and Social Care, Neil Gray.

The Cabinet Secretary welcomed members to the seventh Stakeholder Advisory Group (StAG), highlighting the following

• recent focus on the Budget, which supports health services, addressing challenges, and provides record investment to the NHS
• public services are focused on the needs across Scotland underpinned by necessary reform
• looking forward to discussing reform for health and social care and hearing views on the Primary Care and Community Health Route Map

Reform discussion

Richard Foggo, Director for Population Health provided a brief update on portfolio progress for the group, highlighting:

• reflection on overall outcomes, in terms of life expectancy, rebalancing of overall health of population, new regulations for foods, alcohol and drugs plan, and screening programmes consolidation
• on the health and social care reform programme and prevention agendas, he highlighted work to look at preventative budgeting
• the role of prevention in relation to Primary Care – prevention through community, assets based approach, and what we doing round serious harms

Wider group discussion

• question around what work has been done to look at potential risk given real living wage in social care
• point made around underfunding of social care and impact on infrastructure
• work of NHS Boards – progress against maturity towards being Population Health Organisations (PHO), working with PHS Scotland and Scottish Government
• consolidation on screening and vaccination, highlighted levels of vaccination in rural areas
• preventing serious harm – the Thistle Safer Drug Consumption facility as a positive example of this work

The Cabinet Secretary responded to points raised in the discussion:

• prevention and social care – discussions and review of position are ongoing
• position around statutory requirements - recognise the challenge where that is the only income stream
• funding for social care has increased beyond the start of this Parliament
• looking at a washup exercise around this winter’s vaccination programme – focussed on lessons learned and taking an evidence based approach 

Primary Care discussion

Ellie Crawford, Head of Primary Care Strategy, provided a presentation update on development of the Primary Care and Community Health Route Map.

• noted it was being developed via Primary and Community Health steering group, which has a broad sector-wide membership and includes some StAG members
• Primary Care and Community Health Reform as part of whole system change
• explained context and emerging format and content for the Route Map, including a strategic direction and supporting outcomes that have been configured to support the overall HSC vision, models of care and practical change actions across drivers e.g. policy, improvement, assurance and innovation; workforce; infrastructure, data/digital; finance; contracts, governance and planning; monitoring and evaluation
• Route Map is the way we deliver change and a key Year 1 Service Renewal Framework (SRF) commitment
• examples of practical actions to feature in the Route Map discussed System rebalance:
• ensuring key resources and new investment proposals are focused on capacity building and improvement, and support an overall shift in the balance of care to the community and prevention in line with SRF intent Access
•  investment in MDT and training of the workforce to support capacity and capability of workforce in the community Coordinated, connected and person led
• development of annual collaboration plans focusing on urgent care service improvement Quality Primary and Community health care
• implement Digital Prescribing and Dispensing initially in General Practice and then across all primary and community healthcare settings
• highlighted anticipated timeline for publication in June 2026
• asked group for feedback on critical elements to cover in a model of care, and how the Route Map can support an overall system move to a community focus
• it was noted there is nothing in the route map that does not recognise existing modes of delivery in terms of care - seeking to develop and deliver logical improvements and enhancements
• build a way to capture critical components of change (e.g. capital), and maximise response and contribution of those and make sure for planners and communities we are clear of what change we seek, the data we will measure, and the tools we have to move to ambition. Keep the conversation going
• there will be a further deep dive sector discussion in March via the Primary Care Steering Group

Wider group discussion

• points were raised around GP walk in services including: the role of GP hubs offering access to the population with multiple services, GP walk in centres were not part of early discussions but have now been introduced, need investment in general practice and a GP premises plan
• pleased with focus on digital as may be one area we are falling behind in UK
• evidence supports continuity of care and person-centred themes outlined
• need to look at model of care. These must be linked to continuity of care and support join up. Digital is part of joining that up
• need to clarify intent and focus of community hubs – means different things to different people
• outcome measures important. Importance around data and measuring things that matter
• data information standards important to facilitate
• there is a need to consider a cultural shift in the way HSC partnerships managed, and how structures support that
• the community care landscape is complex with lots of initiatives
• willingness to think around future workforce profile amongst community care settings
• welcome discussion on continuity of care, highlighted link to conversations around community planning as community hubs relates to that agenda   

The Cabinet Secretary provided commentary on discussion points raised:

• understand concerns about walk in services and keen to maintain engagement to ensure they are as effective as possible
• GP facilities – noted the need for primary care infrastructure investment to meet policy aspiration of shifting balance of care and moving upstream into more preventative approach Highlighting that, with constrained capital we are looking at revenue-based investment models with the Scottish Futures Trust

Closing remarks

The Director General thanked colleagues for their continued contributions, noting this was the last meeting of the group before the elections in May. Recognition that members will also be involved in ongoing discussions with officials as part of other stakeholder groups. Committed to continue to keep members updated and engaged going forward.