Scottish Health Promotion Manager S Group

Scottish Health Promotion Managers Note of meeting held on 13 June 2017 CoSLA, Haymarket, Edinburgh

Present Anna Baxendale (AB), Head of Health Improvement & Health Inequalities NHS GG&C (Chair) Allyson McCollam (AMcC), Associate Director of Public Health, NHS Borders Moyra Burns (MB), Health Promotion Manager, NHS Lothian (AM only) Colin Gilmour (CG), Head of Health Improvement, Western Isles (v/c) Cathy Steer (CS), Head of Health Improvement, NHS Highland Catherine Mackereth (CM), NHS Dumfries and Galloway Elaine Young (EY), Asst Director of Public Health, NHS Ayrshire & Arran Lesley Marley (LM), Directorate Manager, Public Health, NHS Tayside (v/c) Hazel Meechan (HM), Public Health Specialist, NHS Forth Valley Heather Cunningham (HC), Health Promotion Manager, NHS GG&C Linda Smith (LS), Public Health Lead, NHS Grampian Sue Muir (SM), NHS Lothian for Moyra Burns (PM only)

Apologies Ann Conacher (AC), ScotPHN Manager Elspeth Russell, Health Promotion Manager, NHS Lanarkshire Elsbeth Clark (ES), Health Improvement Practitioner, NHS Shetland Sue Baird (SB), NHS Orkney Pauline Craig (PC), NHS Health Scotland Matt Lowther (ML), NHS Health Scotland Elizabeth Robinson (ER), Head of Health Promotion, Shetland Chris Littlejohn (CL), Head of Health Promotion, Grampian Johnny Keenan (JK), Head of Health Improvement, NHS Forth Valley Ruth Bennett (RB), Head of Health Promotion, NHS Fife Guests Gareth Brown, Scottish Government Robert Skey, Scottish Government Tina Everington, NHS Forth Valley Notes Gillian McCartney (GMcC), Network Officer, ScotPHN

Action 1. Welcome, introductions and apologies

 AB provided apologies and introductions were made

2. Note from previous meeting (18/04/17) - Agreed Matters Arising  Loneliness Strategy – still a plan to produce this.  Nursing review – ask PC if there is any update with national group. GMcC  Police Scotland – send contact info to HM on community GMcC development.  Fire & Rescue – need to be linked in with other community planning

1 partnership at a national level. EY mentioned the third sector interface evaluation survey and will circulate it for information. EY  SDsPH Note – Community Justice Groups clarification. GMcC agreed GMcC to circulate the remit of the group. There was an update from MB on her attendance at the SDsPH meeting, in particular the diet and obesity discussion. In terms of next steps the SHPMs will be expected to play into this work. Ruth Campbell (NHS A&A), Heather Cunningham and Fiona Clarke (NHS Highland) can support Drew Walker, DPH NHS Tayside who is leading on this. There is an opportunity to add value. 3. Business Items 3.1 Community Link workers Update The paper provided by Kate Burton was circulated as part of a communication going to the IJB chief officers. This update was a useful summary of the work going on. HC informed the group that a rep from the project would like to come and discuss the different models with the SHPM group. HC will circulate the letter she has. AB wondered if through this group we could offer a Scotland wide approach to training which could be shared. A discussion followed around the link workers and where they are GMcC and what their role is. GMcC to ask Kate Burton if there is someone in the North co-ordinating this. AMcC added that there is a seminar on the 27 June in Edinburgh by VHS. AMcC may attend. 3.2 Healthy working lives update The note of the meeting was circulated in advance. CG stated that VC training wasn’t recorded accurately in the note as that it had been successful. VC training is important as only one source of expertise is required. CS added that they have asked for the wording to be changed. Discussion followed. There are still issues with data recording and the accuracy of notes. CG will have an offline discussion with AB and CL in due course. Action: CG to liaise with AB and CL CG

4. Guests: Gareth Brown and Robert Skey, Scottish Government Framework for public health priorities The health and social care delivery plan, published in December 2016, contains explicit recommendations around public health. GB felt it was worth reflecting the extent to which public health was articulated as an important element. The specific commitments are;  to work with CoSLA to publish high level priorities by December 2017  establish a new national public health body by 2019  build effective local public health partnerships The Scottish government have met with CoSLA and agreed broad principles about how to work together. There was a senior leader’s stakeholder workshop on 27 April 2017 to discuss national priorities and another one is planned soon. There was a broad understanding around the importance of tackling issues in communities i.e. poverty, education etc. In partnership with CoSLA there will be an active engagement process around these priorities over the summer. The plan is to use existing meetings where

possible and happy to engage with the SHPM this way. The priorities of public health will be published in December 2017 and these will be the foundation for joint working and the setting up the new national body by 2019. The transition process will take longer. Health Protection and Health Improvement will be the responsibility of this new body, Health Scotland will move to the new body. The function of health intelligence is still to be decided. The new body is likely to be a special health board and staff will maintain NHS employment but may change terms and conditions within NHS Scotland. It will be not be branded as a NHS body but branded as public health organisation. There will be important links to NHS but the gains are to be made in health improvement and in the wider communities. It will have meaningful accountability to local authorities. This will be worked through over the next year. A Public Health Reform Oversight Board (PHROB) will be responsible for the governance and will be co-chaired by Andrew Scott, Scottish Government and Paula McLeay, CoSLA. Public Health England and Public Health Wales will be involved. The full membership will be confirmed in due course (Andrew Fraser SDsPH could be SHPM link in). The PHROB will consider the priorities and the initial high level plan for transforming and introducing the new body. It will be the main place to take forward the third element around local public health partners which is the least clear as the landscape is so dynamic at the moment. GB feels that if we get the priorities right, get the new body up and running and make it creditable, well led, have a visible presence and an influence on local government, NHS and others, it will set a basis for what to do locally. Regional structures need to be looked at and worked through in partnership. However, the solution is more medium term due to the current landscape. Robert Skey, has just joined the Directorate of population health at Scottish Government to lead on public health reform. He was previously working with CoSLA on secondment from Scottish Government on the social care reform agenda and the national care home contract. Before that he helped create new public bodies i.e. Revenue Scotland and Fire and Police bodies. He added that this conversation isn’t about structures, it’s about public health and the added value, the new vision for public health and the priorities underpinning that vision and how we can build the integrity in the reform agenda. This is why it is important for him to speak to the SHPM group and other networks who have a view on what the future looks like. AB agreed that the SHPM can help him get to the right audience. AB invited GB and RS to the next meeting and confirmed that the SHPM would be happy to support the engagement process in local areas. A general discussion followed on HPHS (a light touch approach was proposed by SHPMs), CoSLA, CPPs, IJBs, regionalisation, partnership working, data sharing and children’s work/policies. 5. Business Items (cont.) 5.1 Public Mental Health SIG Update AMcC circulated an update in advance. This special interest group is a sub group of the SDsPH with representation from SHPM, CFPHS and NHS Health Scotland. It is a new group, set up before the mental health strategy was published. The group has an opportunity to strengthen the strategy

3 around public mental health. There is recognition that there isn’t a forum to discuss public mental health and no opportunities for information sharing. Health Scotland agreed to include outputs from this group in their mental health improvement bulletin as a mechanism for sharing. There was a call for action from the CFPHS and Catherine Mackereth drafted a form of words which was discussed with the group. They agreed there should be a community led approach. There are opportunities for CPD which include submitting an abstract for the CFPHS and a presence at their conference. The SIG intend to hold an event next year for the wider public health workforce. The group has got off to a good start but still needs to agree the focus and what needs to be achieved.

5.2 VTP Business Outline Case Papers were circulated in advance for information. Is it impacting on SHPM work? Discussion followed around;  local area delivery  costs  resourcing  partnership working SHPM happy to engage in the process. HM advised that Henry Pemphrey, NHS Forth Valley did a paper on this some time back and this topic is being looked again HM agreed to circulate the information. Action: HM to circulate NHS Forth Valley information HM

5.3 Realistic Medicine & HPHS This was discussed at the CMO/SDsPH meeting and the SDsPH will support developing this. AB was present and added that the SHPM would be keen to demonstrate the health improvement component and suggested doing mapping of good practice. AB will pull together something for further discussion. She also suggested that they could join up HPHS and RM so that they pull in the same direction particularly around clinical leadership, vulnerability & inequalities. Both suggestions were well received by the CMO. AB stated that this is an opportunity to shape SHPM contribution to both HPHs and RM and input to the SDsPH work. HM added that at a recent HPHS network scoping meeting and a lot was around RM. Another aspect was around lack of governance. Health Scotland agreed to look at this issue. They agreed to look at a two pronged approach one of which is RM and examples of good practice. AB felt it would be useful to join these pieces of work. Discussion followed. It was agreed AB to pick this up with the HPHS network. AB

5.4 PH workforce Development Project AB updated. The overarching group now has an agreed focus. There are a lot of commonalities between specialists and practitioners. CS added that the workshop for specialists was very helpful in supporting people where they are with their portfolios and the issues they have. Some people felt that something might be put in place for the registrars but it didn’t go that far. Fiona MacDonald is looking at where the gaps are. One of the issues was the variation in availability of opportunities for people to develop themselves. CS met with Fiona MacDonald and the hope is to set up

support networks/groups to share information similar to the North PH Network. Discussion followed around;  training opportunities  Perspective of funding – how is it used?  Peer support/co-ordination AB will feed back the issue around funding and advised that discussions around the gaps and opportunities have started. AB will ask the DsPH for support with regards to wider workforce engaging in opportunities such as training in advance of portfolio development. A discussion followed around practitioner support. AB asked for a SHPM rep to join in the meeting which are being arranged with Health Scotland to add support to the local co- ordinators. The following was then discussed;  Participant readiness is an issue, locally and nationally  Need to consider how to get the right people to join the scheme  Support needs to be wider than just registration focus – Health Scotland to facilitate  Need to address assessor / logistic issues identified in cohort 4  Inconsistency between local areas / mixed messages from UKPHR  Consider a more consolidated model- once for Scotland activities rather than fully devolved  Workforce development to be recommended as a function of the new organisation  Structured CPD across the whole workforce was priority  Challenges for the boards i.e. lack of support, money and logistics.  Additional Leadership from SHPM would be beneficial  Scope the public health training requirement – previous ‘national training courses were available’ AB summarised that the SHPM will go back to the workforce development group to say that they are comfortable that we go down the PH Skills & knowledge framework approach – this was agreed. In terms of the conversation with UKPHR who could help the co-ordinators. EY works closely with Clare Back so will be happy to assist. AB asked the group to consider the issue around assessor capacity locally. The UK FPH and UKPHR issued a joint paper around practitioner registration and AB agreed to share them with the group. AB added that with regards to role descriptors Fiona Macdonald has suggested that through the WDG this is something we do once for Scotland. Would need to scope this out. The SHPM were happy to do this nationally. LS added that she is currently identifying functional and sub-functional areas in the PHK&SF with individual roles in her team in Aberdeen which could inform this work. She suggested it could possibly be mapped to eKSF And be used as a framework for providing evidence in annual KSF reviews. AB will follow up with Jane Grove as she has done something around this already. LS will share this work once completed with her team and then liaise with Fiona MacDonald. Action: GMcC to share paper that went to SDsPH meeting on 16 June 2017 Action: SHPM to consider the issue around assessor capacity locally Action: AB to liaise with Jane Grave re role descriptors GMcC

5 Action: LS will share the work around the PHK&SF functional and sub- functional areas once completed and agreed with her team. ALL AB LS 6. Lunch 7. Guest: Tina Everington, NHS Forth Valley This afternoon’s presentation was around the wider prison health agenda. TE had been seconded to the Scottish Prison Service (SPS) as the health improvement manager for 2 years. The background to this was the national health improvement framework – Better Health Better Lives framework. From this in 2013 TE did some work on strategic work to implement the framework. This highlighted the need for a strategic lead aiming to integrate the work into the SPS core agenda. In 2013 the SPS organisational review was published which focused on how they would move from custody and order to care and opportunity with a focus on rehabilitation. Focus on strengths and not negatives. A further purposeful activity review was done in 2014 to deliver on a refresh approach. This is how the secondment came into being. The presentation below covered the key outputs, challenges and the future direction.

NHSFVSPSsecondme ntnotes.pptx The secondment has now come to an end but there is uncertainty in how the work will continue. It would be helpful to explore where the national multi-agency health & wellbeing group currently sits and clarify the support available from SPS for the group (governance needs to be revisited). This group provides a useful vehicle to facilitate the relationship between it and the local work on the ground. It would be helpful if local boards could support the prisoner health improvement practitioners groups in local prisons. Operationally support is more of an advisory/consultancy role. If we could get this relationship established this would help support the implementation of the health and wellbeing action plan. General discussion followed, particularly around differing landscapes, planning and community justice. AB felt that the SHPM could refresh engagement with the practitioner network and local thinking around using advocates of health service more. AB will contact Graham Foster for a discussion around community justice and prisons. AB Action: AB to contact Graham Foster 8. Business Items (cont.) 8.1 Training update A paper was circulated in advance. There are two elements for discussion: 1) SPHWDG proposal around consulting around the training needs of the wider workforce. HS are considering consultation with the wider workforce with a view to build capacity to support public health. There have been discussions about how to map this out and whether or not CHEX may take this forward. AB has approached HS and asked them to consider a process which uses the intelligence and existing relationships with local teams as the starting point and not do this in isolation. AMcC described local work that suggested many third sector organisations would not identify

themselves as PH organisations and it was important to contextualise the mapping.

2) Review of core training programme. WR had indicated this would be progressed through the HI Training Network. SHPM were unsure whether the network was still functioning. Following further discussion AB agreed to liaise with Ruth Bennett to further clarify what is Health Scotland’s offer? And agree a strategic direction for the core training programme which is relevant and builds on link into local teams. Action: AB to liaise with Ruth Bennett AB / RB

8.2 Healthier Wealthier Children Update The group felt that this was an approach that was working well and that feedback on the conversations were positive. AB asked the group to get back to Ashleigh Oates with any gaps. AB felt it would be helpful to ask Kerry Mackenzie to the 15 August meeting to update i.e. to get a good understanding of the lie of the land and what the implications are and what’s feasible? AMcC also thought it would be useful to ask how this work fits into the review of maternity services and the work around the role of health visitor.

8.3 SHPM Priorities A paper was circulated in advance based on review of discussions over the last period. AB welcomed comments/thoughts - Are these most relevant? The group agreed review the list and AB agreed to amend accordingly and circulate for further comment by the end of June 2017. Action: AB to amend the priorities and circulate for further comment AB

8.4 SHPM Contribution: Making it happen Paper was circulated in advance. The actions were reviewed with the aim of consolidating it and looking at more joint/collaborative working. Practically, it is about shared learning and advocacy. The paper will continue o help support he SHPM agenda setting/ workstreams and representation 9. AOCB: 9.1 Scottish Government Health & Welfare Reform group Kate Burton approached AMcC about becoming a member of this group as they were looking for someone from a more rural health board area and they also had no link into the SHPM. This was felt to be a helpful. AMcC will update in due course

9.2 SDsPH Driver Diagram (action plan) This was circulated. It is shaping more into a work plan. AB has been asked to take a lead on expertise across teams which relates to the ‘go to’ list of the groups. AB felt that this is a reflection on being more integrated with the thinking of the SDsPH and Andrew Fraser’s support for MDT working. It is about having a multi-disciplinary public health workforce on the ground and in relation to some of the topics we discuss. How we can understand how practitioners, specialists and consultants can operate together and reflect a

7 perspective on topics i.e. child health, prisoners etc. There is some work to be done. What are we asking people to do? It is not about creating more groups but about bring people together with expertise. How does it all relate with SHPM and HS priorities. AB will continue to liaise with Andrew Fraser and feedback to SHPMs. Next Meeting HM requested that the health improvement priorities of different boards are looked at (are they the same) given we are going back to Gareth Brown to scope these. What can we flag up? This was agreed with a suggestion that business plans are shared to support the discussions.

At the moment there are four potential guests for the 15 August 2017 meeting. AB agreed to speak to Margaret Douglas and GMcC will email Kate Burton, Claire Black and Kerry MacKenzie to check their availability. Action: AB to contact Margaret Douglas (SHIIAN) AB Action: GMcC to email KB, CB and KMacK GMcC 10. Future meetings 15 August 2017 10:30 Room 5.5 Meridian Court, Glasgow 24 October 2017 10:30 CoSLA Verity House, Edinburgh 12 December 2017 10:30 CoSLA Verity House, Edinburgh