NHS Scotland Forum Meeting
8 July 2002

Around 90 members attended the meeting at the MacDonald Holyrood Hotel, Edinburgh. This report is compiled from notes taken during the meeting, is for information only and does not constitute formal minutes. Consequently, I take no responsibility for any inaccuracies, errors or omissions. Opinions expressed within the notes are those of Forum members and have been included for completeness. This does not necessarily mean I agree with them.

The meeting opened with an address by Health Minister Malcolm Chisolm who welcomed everyone. The NHS Scotland Forum was basically the previous Modernisation Forum, but with more patient representatives and representation from the Youth Parliament.

The aim is for collaboration between Government, staff and patients. The first work for the Forum would be to look at the Review of Management and Decision Making within NHS Scotland. Funding, setting of priorities and National Standards are all things which should be done centrally. The Minister saw this group as an important addition to partnership working in Scotland.

A Health Review White Paper is to be issued in January, but there are problems with feeding into this with the current timescales. First Minister Jack McConnell expects the Review of Management and Decision Making within NHS Scotland (hereafter "the Review") to feed into the White Paper and for the White Paper to indicate areas for review. Some concern was expressed as to whether there would be a Green Paper for consultation before the issue of the White Paper. This question was asked but not actually answered and it seems that the Forum may take the place of this consultation on this occasion.

The meeting was then addressed by Trevor Jones, Chief Executive NHS Scotland, who placed the Review in the context of "Our National Health" and stating that such a review was necessary post-devolution and post-internal market NHS Scotland. The key objectives were

The areas being considered in the review were

NHS Scotland will be looking at service delivery before any changes in structure. Several key points were identified under each heading

Development of LHCCs

Improving delivery of Health and Social Care (joint futures)

Improving NHS support functions

Enhancing leadership and management capacity

Relationships, accountabilities and configuration (structure)

The meeting then split into seven discussion groups. The first part of the group working involved each delegate writing down who they were, what experience they had and what they or their organisation could contribute to NHS Scotland.

In the second part, each group looked at one area of the review. Each then reported back with some key points from their discussions. These are noted below.

Improving delivery of Health and Social Care (joint futures)

Development of LHCCs (3 groups)

Improving NHS support functions

More than half of the NHS Boards have already started reorganising support services and therefore any proposals have to cope with these changes. The scale of change varies with e.g. Tayside investigating common public service facilities with the police and local authorities. There was some discussion over how a decision could be made on services when the structure is not known. It was agreed that aggregation of services, contracting out and technology be considered in the discussions. The four main areas that would be central to the discussions would be finance (possibly including procurement), human resources (HR), information technology (IT) and estates.

Aggregation of services: This would result in e.g. one invoice processing centre for the West of Scotland covering the NHS, Social Work, local autorities etc.

Contracting Out: It was noted that British Telecom has no personnel department. All HR issues are managed by a third party American organisation. In parts of England, Allied Healthcare Supplies, another American firm, will manage the procurement of NHS supplies.

Shared services: Invoice processing is a common process across Scotland. It was suggested that all invoice processing and HR record keeping could be handled by the private sector.

Other initiatives such as e-procurement are also in the system. This is automation of the procurement process, where a nurse on a ward orders the item on a computer, it is transmitted to the supplier and a direct delivery is made to the ward. For this to be adopted, there are major standardisation issues to be overcome.

A significant amount of money is to be spent on IT development and the question was raised as to whether the NHS is fit to decide how it is spent. Past history would tend to suggest that it isn’t. The key is to get staff working more efficiently with IT to free up time and reduce bureaucracy. It was noted the IT group at SEHD was very small.

What should the relationships with national bodies such as the CSA?

Should Occupational Health be rationalised across Scotland?

Above section formed the core of the discussions in the group in which I was involved.

Enhancing leadership and management capacity

Relationships, accountabilities and configuration (structure)


Health Minister Malcolm Chisolm then closed the meeting by addressing the participants. SEHD want a collaborative approach, not one part of the service directing another. He admitted there were problems with synchronicity. How does the forum influence workforce planning for example? A separate group is looking at that. SEHD is trying to accelerate the review and get conclusions by the end of the year. This is what they see as the real role for this forum.

The review has other key processes. Individual groups are looking at the different areas and each is involving all the different stakeholders. The NHS Scotland Forum is intended to be more of an overarching body. The other main group involved is the Scottish Partnership Forum. This will also link it to all professional groups, NHS Boards, the Chief Executives Group and COSLA.

The key areas taken from the meeting were –

The Minister was also asked about the involvement of education and what provision is to be made for its role in preventing ill health in the future e.g. in nurseries, primary schools etc. There was an acknowledgement that the representation from the education sector should probably be increased.

Next Steps

The membership of the 5 groups will be made available shortly. Any further written comments should be sent to Dick Manson at SEHD. It was also suggested that using the web might be helpful for this. It is planned to have further meetings in September and November.


Secretary for Scotland
Guild of Healthcare Pharmacists

back to top