Good morning, and welcome to the 21st meeting of the Health and Sport Committee in 2017. I would ask everyone in the room to ensure that their mobile phones are on silent. While it's acceptable to use mobile devices for social media within the room, please do not take photographs or record proceedings. We've received apologies from Neil Findlay. The first item on our agenda is subordinate legislation, and we have two negative instruments to consider today. The first instrument is natural mineral water, spring water and bottled drinking water Scotland, amendment regulations 2017, SSI 2017-287. There has been no motion to annul and the delegated powers and law reform committee have not made any comments on the instrument and I invite comments from members. No comments. The second instrument is the National Health Service General Dental Services Scotland, amendment regulations 2017, SSI 2017-289. There has been no motion to annul and the delegated powers and law reform committee has not made any comments on the instrument and I invite any comments from members. No comments. Then can I ask the committee to agree? That's agreed. Thank you. We move on to agenda item 2, and it's the first evidence session on sport for everyone, phase 2. We have around 60 minutes for this session, and I'd like to welcome to the committee Linda MacDonald, innovation and learning manager from the Robertson Trust, Sheila Begby, director of domestic rugby and interim head of women and girls rugby, Scottish Rugby, and Andrea Cameron, head of school of social and health sciences, Abertau University, and Billy Garrett, director of sport and events Glasgow life, and we'll move directly to questions. The first question is from Colin Smyth. Thank you very much, convener, and good morning to our panel. Can I kick off with a question on the issue of participation in phase 1, that the committee's inquiry found quite a lot of barriers to participation around things like age, gender, family commitment, shortage of suitable facilities, etc. Can the panel give us any community-based examples where you've been successful, where you've seen it first-hand, success in removing barriers to participation in sport and physical activity? We've, as the Robertson Trust, taken a person-centred approach to the funding that we've put into this area, which essentially means looking at what those barriers are and how we can better enable people from across the population to engage in sport and physical activity. I would point you towards some of the work we've done around our youth work and sport initiative, which worked with 11 organisations in Scotland to look at how they could better engage hard to reach young people in sport, and also at Activist, which you may be aware of because it won an award last week at the Scottish Sports Awards, which has worked in the east of Glasgow and looked at how they can better engage hard to reach young people. The other one you may be aware of is a legacy programme, the physical activity fund, which just published its assessment of what worked and what didn't last week. All of those things point to similar barriers, as you've identified, but also approaches that might better work to engage people. Those approaches tend to be community development, youth work approaches, ones that look beyond the sport as the core thing, and look at what the barriers around about that might be. We also, in terms of Scottish Rugby, see that the benefits of having specific women and girls development officers to work with young girls in the community is a really positive step for us. We know that there's a huge confidence gap in terms of girls and women participating in sport, so we certainly have had a really proactive approach in terms of employing women to work as development officers within the region to ensure that we've got positive role models and that we really support girls and women to actively be involved in rugby. I think that rugby is quite specific in terms of having women and girls development officers because we're trying to develop a women's sport within a predominantly male environment, so it's really critical for us that we can use all the tools that we can possibly use to really spark that generation of young girls coming through. We have another example of, in women's rugby, we're trying to create a specific culture for the women's game, and in the Scottish borders it's a really strong area for rugby, but for male rugby. So we were trying to develop the women's game in the borders, and a lot of the people involved in the women's game were also people that were involved in the men's game and bringing the culture from the men's game into the women and girls game, so we set up a facilitation group, the clubs in the borders had asked us to do that, so we set up a facilitation group to look at how could we actually support the development of the women and girls game in the borders, and we wanted to work with the clubs to create a model that would allow us to build and allow for collaboration so that we could allow women and girls to train and play on a regular basis. We worked with the key stakeholders, really getting them to understand how we could actually, if we worked together, achieve this, and we encouraged them all to make the commitment to making this happen. We worked to create the compelling story about why we should have women and girls rugby in the borders, and we looked at what the barriers, the challenges, the choices and the influences were. We then looked at creating, how do we actually create the climate to encourage more women and girls to be actively involved in rugby? So we looked at identity, what did the borders want to be known for in terms of the women and girls game? We looked at skills, belief, knowledge, behaviours and environment. We started from the premise of everybody sitting on opposite sides of the room when we actually started the facilitation day, and at the end of the day, everybody was talking and working together and talking about sharing players, etc., because that was part of the barrier that, if a club had six players and another club had ten players, they actually couldn't, neither team could feel the team, and that's what we wanted to change. So what we've done is we've actually worked with the clubs in the borders and the volunteers, and we've created a strategy for women and girls rugby in the borders. We actually created a role specifically for a women and girls development officer to help us to really try to address that whole culture change, and our member staff started last week. So over the next year, we'll review how that has gone and hopefully be able to feed back on some positive messages that we do have women and girls training and playing on a regular basis and that we can develop the structure and the infrastructure for women and girls rugby in the borders. At our own organisation, we're working mainly with students as volunteer workforce and they're working with community groups in and around Dundee, and particularly one of the initiatives we have been working quite heavily with is active schools and trying to therefore, you'll see in your paper where you had about barriers to participation, one of the barriers was that people have negative experiences of PE school and they carry that then into their adult life and we know that more active children are more likely to be more active adults and so therefore if they've had a poorer experience in the school then they're less likely to stick with sport and exercise as they go into their adulthood and so what we're trying to do is give those pupils a positive experience of PE, making it fun, giving them a range of activities and so therefore not just the traditional school sort of menu of activities for sport and that's been one of the good things of working with a whole range of students is they come with a great skillset and often types of activities that they've been exposed to that you couldn't normally put on a traditional PE curriculum and so they're forgiving the pupils the opportunity to try out these different sports and then connect them with community groups hopefully then that they find something by giving them a broader palette of activities not coming from a PE perspective but making it fun and engaging them in that way that that would be something that they'll then take into their adult life. I've also been working with, there is a Keep Well project in Dundee and it's targeting 45 to 64-year-olds who are at risk of chronic health problems and again we've been using the students as a volunteer workforce to look at particular initiatives so we've had students to lead Nordic walking groups put on barbenton within the community as well and again as initiative to try and find an active lifestyle that works for those individuals brings communities together as well and so the one downside sometimes of these things is we don't necessarily look at evaluating them for the longer term and that's certainly where there's probably more work to be done. I might argue that there's a clue in a sense to opportunities for success in the question when you asked for evidence focused on community based approaches and I think there's something in that. Our view is that the chances of addressing the barriers to participation are greatly increased if you can develop a genuine bottom-up approach. Members of this committee visited Drumchapel community sport hub. I know the first phase of the inquiry and I think at the same awards that you mentioned, Drumchapel community sport hub also won an award. One of the key strengths of Drumchapel community sport hub, which we would pose as an example of best practice, is that it's absolutely community driven. It's absolutely owned by the local people and that has delivered some really really interesting results in that community which I know the committee are aware of. The great strength of the community sport hub model is that it allows local approaches. There's no one community sport hub which is the same although it's a national programme. It allows for local variations and our view is that's been an extremely successful model in Glasgow, can't speak for anyone else in the country. There's Drumchapel community sport hub. I also know that members of this committee visited the Easterhouse Phoenix community sport hub, which again is a slightly different model but beginning to deliver some of the same results and a genuine sense of community ownership. I also think it's important and that was in your question that we understand that there is a range of, there's a shopping basket of barriers that are stopping people getting involved in physical activity and we need to be honest about what they are. Some of it is about experiences people have previously had, some of it is about geographical issues, cultural issues, some of it is about economic issues, we need to be honest about that. Some of it is physical issues and certainly it's about ensuring that we address in as far as we can all of those issues and not to become obsessed with one or two particular barriers but focus across the board and understand from communities which of those barriers is the most predominant. So certainly from our point of view in terms of a community-based approach to the community sport hub model, which of course is a national model funded through Sport Scotland, that that is something which potentially and certainly has been demonstrated in Glasgow. Hold some of the keys to getting people back in participation. Touch on how you actually measure success when it comes to participation. There's been examples there about age-related participation, also gender-related, but I'm keen to know how you measure the socioeconomic background for example of people. Do you actually physically measure that when you're carrying out a project because I think that was one of the issues that came up in phase one at that maybe wasn't something that people recorded, it's quite easy to measure age, it's quite easy to measure gender but it's not so easy to measure socioeconomic background. So do you measure that? And also one of the issues that came up in phase one was the fact that participation levels after a number of initiatives increased but actually it wasn't clear whether it increased because somebody who was already active instead of doing a class three days a week was doing a class five days a week. So do you measure whether or not people who are inactive are becoming active as a result of the initiatives that you've taken? If I can do the first one which you said about the deprivation sort of and picking up socioeconomic sort of thing, certainly because we're working with the schools and that's something which is logged and so therefore we're able to pick that data up as to who's been coming along to sessions and so therefore the impact of that we can measure in relation because we're working heavily with the children then as I say that that's the data that we can examine your second part I'm not able to sort of kind of to sit to respond because it's not the groups I work with. Certainly from our perspective in Glasgow, I mean generally I think it is important that when we are making decisions about how we allocate resources what we focus on that these decisions are evidence based in as far as they can be I think that's a really important principle and certainly in Glasgow given the challenges that Glasgow as a city faces we certainly where we can wish to track the socioeconomic profile of of individuals who are coming through our programmes and we wish to track transfer from inactivity to activity so certainly they're key priorities for us and in terms of our stage one submission I think that the information that we the evidence we submitted at stage one I think we indicated some of the things that we are tracking so based on on a whole suite of different approaches and methodologies we will where possible try and measure all of that that includes questionnaires that includes postcode analysis based on the information that we get from everyone and I think I think I think it is possible to I mean there's nothing wrong with people becoming more active you might be active already it's important to say that if people become more active that's a positive but you're right getting people from inactivity into activity in terms of the overall health of the country is much more important and much more difficult but certainly we have tracked around some of our programmes some really really impressive results around our good move programme for instance and also and I know this is slightly controversial because there's different views we would and we would certainly say that there has been a genuine legacy from the Commonwealth Games in 2014 in Glasgow so you know we would measure junior membership of sports clubs in the city that is about people who weren't previously involved now being involved 401% increase qualified coaches volunteers actively working with junior clubs massive massive increases so I think it is important that we look at a suite of indicators again and not just so I know that there's a lot of attention paid to the Scottish household survey that's a viable piece of information but it should it's one measurement out of a whole suite of different measurements it's very small sample size so certainly from our point of view that evidence-based approach is absolutely key Neil in the head it's a lot of the chat that we're involved in just now is how do we move to a more nuanced view of participation I think in measuring to date we've tend to have quite a binary view of participation so you're either meeting the CMO guidelines or you're not and I think what the evidence tells us is that is for most people not a one-step journey the if they're inactive there might be several steps before they get there so I think if we're looking purely at participation we need to look at measures that enable us to track along that pathway and I think there's work going on in that area just now I think again we need to make the distinction between national level and what we're getting through surveys and what we're starting to gather at programme level so what are the opportunities within areas like active schools, community sports hubs, where we already have levers and we have boots on the ground as it were to start to look beyond that top level participation model at its worst the participation driven model leads purely to people counting bums on seats and it tells us nothing about who they are how long they're engaging for or what difference we're making for them and we would advocate an approach to the measurement that starts to look at those three questions who are we engaging with what difference are we making for them and how long are they engaging for if somebody comes once to a taster session you can get 500 people in a taster session but I think what we should be interested in is how many of those people then move on to have some level of regular physical activity and who are they are they representative of our communities so it's also about targeted engagement and at the planning stages sitting in your communities in your sports hub or in your active school thinking about who is our community and is the work we are doing representing them and then starting to try and match it to that so I don't think there's a simple answer but I know there is work going on in that area to try and give us a more nuanced view of what's happening underneath that top level of participation. Sheila? I would say that through our cashback schools of rugby we are working in areas of social deprivation but I would say also that you know the Scottish Government measures around participation are really focusing a lot on getting inactive people active and just as in rugby we're of course we're focusing on how we grow the game but we're also focusing on how do we retain the people that are already actively participating in rugby and I think that that's something that the Scottish Government has to address as well it can't all be focused on getting the inactive active it needs to be about how do we keep people that are currently active active in the future and can I just we've only managed to get through two questions and it's now 20 past 10 so can I ask perhaps panel keep their answers a little bit tighter and thanks Alison thank you very much convener and good morning panel we've heard you know so far this morning about the need to gather our evidence more carefully we've also heard about how community approaches can succeed when others might have failed I think when we were taking evidence last year and visiting community projects the two barriers that came up time and time again were cost and time so I can see that the community offering might help there's less travel it's on your doorstep it's less time consuming and so on but I just wondered if you could give us a couple of concrete examples of where the community has managed to succeed when other offerings have failed a local authority offering might not be attracting the people that we're trying to reach from a Glasgow perspective I mean that just at the very end of your question you indicated that where community organisations might be having some success where local authorities can't reach in a sense certainly from our point of view in Glasgow you know we don't see the be all and end all of people getting involved in physical activity them them coming through the doors of our facilities as far as that that's not our picture that's not our view we do have we're very fortunate in Glasgow we do have a significant estate of leisure facilities some of them are large scale event venues but a lot of them are smaller scale locally based facilities so in Glasgow no one has ever more than two miles away from from a Glasgow life leisure facility the average walking distance from anywhere in the city is 18 minutes to a Glasgow life leisure facility however we appreciate that there's a number for all sorts of reasons there are people who you know who won't who won't who don't want to go to those facilities who are culturally not not inclined to go to these facilities so we work very closely with community organisations and we deliver our own programmes in community settings so I think it's important to point that out but we don't have facilities everywhere there's a part of the city towards the south around about Darnley south in its hill where we don't have a lot of facilities and local people have responded to that by creating their own organisation St Angelo's participation centre it's effectively a community sport hub but by another name created by local parents at the local primary schools with the support of development staff from within Glasgow sport have created and I made I was I was out there with the deputy leader of the council a few weeks ago on a wet friday afternoon in Glasgow and there were 800 get it but I really need short answers yes and Angela's participation centre in Darnley a real example of community taking ownership and developing things where the local authority isn't really present in any single way there are examples a lot of the work we do is with sport social enterprises so places you may have visited like Spartans but also places like Atlantis and Oben or Broxburn United Sports Club what I would also offer back to you though is that we find that these things are going to work best actually when there's partnerships between statutory organisations and those organisations in the ground again it's not a one or the other and and we would encourage always as is happening in community sports hubs that local community groups and sports groups engage with and work with their statutory partners where possible yeah I was going to give an example in Dundee which is showcased the streets which similarly is a charity social enterprise and it draws on a number of organisations and where we're trying to connect things together rather than compete for the same groups of people that's the kind of way I think to go forward can I support what colleagues here have said but we really think there's a strong case to be made that the best place really to inculcate a culture of participation and sport or physical activity is actually in schools because everybody is actually attending school and the benefits that participation and sport can have in terms of creating confident individuals, responsible citizens, successful learners and effective contributions is massive. Thank you all that was very helpful one thing that I'd like to explore a bit further you know you've spoken about I agree entirely it shouldn't be one or the other and partnership working is key to this one issue that comes up again and again in the cross-party group and sport I see we have a member joining us today is the lack or the difficulties attaining access to the school estate you know we often hear certainly in parts of the country that on a Friday afternoon when schools out getting access to that estate is very difficult I know the Robertson trust have commented on the cost of access and sometimes there are other difficulties because of the way contracts have been drawn up do you think we're missing an opportunity here and what would you like to see us do about that I can only speak anecdotally from what we hear from people on the ground but we do regularly hear from organisations applying to us for funding for sports activities that access to the school estate is difficult either on the grounds of accessibility or cost I don't think we've not done enough work around it to know why but I would highlight it to you that yes it certainly is an issue and I'm not sure I have an answer to your question you know in terms of what we can do about it but again I go back to the partnership model in the sense if there are already organisations who are in there who it can more easily access the school estate then are there things that we could be doing to work with them but there are groups who won't go across the school estate because they have negative associations with schools as such and so therefore hosting things within a school estate will already be a barrier just because of the association they have with schools and authorities etc it's important not to be complacent in Glasgow there's a significant school estate recently modernised and there are challenges around the rationale rationally controlling that estate in terms of managing access to that so I think it is important that we're not complacent but I know that some of the community sport hubs in Glasgow including drumchappel are significant users of the school estate in the city so I think there are ways to overcome that I think it is about building partnerships between the school community and what's happening around the school I think that's important sorry Tom you wanted to come in this specific yes it's a very specific supplementary to Mark made by Billy Garrett in answer to Alison's first question you used the expression culturally not inclined to use facilities just for the record could you unpack and define that for me please ask that so for some individuals the a large leisure facility a kind of palace of sport conjures up the wrong images for them conjures up images of of ultra fit people in spandex and for a lot of people they're absolutely poor off by that they prefer something much more low key something much more local something much more community focused we've certainly found that a lot of people prefer the corner shop as opposed to the supermarket um so in response to that kind of threshold anxiety um we have developed a range of programs which we take out to community settings church halls community facilities parks so we operate park lives along with a number of other cities in the uk um to go where people are much more comfortable being uh where families are much more comfortable being so that's what I was referring to my question actually dovetails beautifully into tom Arthur's supplementary there and it's another barrier um when we went to the murehouse millennium centre in my constituency as part of the visit in the first stage of this inquiry one particular barrier identified by people there was not the availability or the price of the sport or physical activity available to them more the fact that they were embarrassed about taking part they were embarrassed in their own body shape um they're being embarrassed about being made to look full um and that ties into I think a wider issue about body image and what you defined in terms of the the palaces of sport with ultra fit people and that I just won't fit in and I'll I'm so far down the track yet those are the people we most need to target how does the panel think we can break that particular barrier down around body image around the that embarrassment factor and encourage those people who need it most into sporting activities I think I think the context is important um so so how we so we have created specific programmes to try and target the most inactive in the city and we've talked about those with this committee previously so the good move programme which is an aggregation of programmes that we run in partnership with health boards housing associations mcmillan cancer relief all focused on the most inactive those furthest away from activity so we contextualise that by operating it in community context the marketing looks and feels completely different from you know our Glasgow club gym membership marketing uh we market in different channels so we're in bingo halls we're in budget supermarkets we're in very different settings so we construct everything around the programmes entirely differently uh it's a what it's the path into that programme the referral route is through highly trained councillors so every conversation uh is is constructed in such a way as to as to try and remove those barriers and to deal with those anxieties that people have so I think it's about what you wrap around the programme or its essence is a physical activity programme very low low low intensity but it's about what you wrap around that how you market it how you articulate it how you present it I think that we're really rugby is unique in that it's a game for all shapes and sizes it doesn't matter what shape or size you are there's a space for you in rugby and I think it's um also about and I presume that we're talking predominantly about females I think it's about just allowing people to wear what they want to wear to to feel comfortable within the training environments within the clubs and making sure that we're not kind of you know having people in tight fitting tops or whatever so it's a degree of choice in terms of yeah people feeling comfortable I mean I think one of the things is obviously having a range of options for people and there's a range of venues where these things go but also if you've got people who are leading the sessions who don't look like you know we said about spandex being the thing which can be the off-putting it's upside of it and so they are their own models and so they if they can epitomise a range of shapes sizes cultures whichever else that are involved so if we can grow those leaders who then take on those activities use the connections that we have say with health services if they are the individuals that are going to be referring on but look at the breadth of activities that are there as options things which are community things it could just be gardening projects through you know joining people together so there's a lots of things where again it comes back to what already exists and where can we hook people into existing things or where there aren't but our community is telling us that they need something then where are the opportunities just one final question community I've asked two separate panels in the earlier stages of this inquiry as to whether they felt a culture of elitism still exists in sport non professional sport that you know stems from everything in terms of peer selection of who's good at football and who isn't in primary school and that just becoming the received wisdom as to who gets the coaching support and encouraged up the ranks to a range of other sporting disciplines where elitism can exist some professional bodies or governing bodies would absolutely argue that they've stamped that out but then user groups came back and told us no it absolutely still does exist so I'd just be very keen to hear from each of the panel members whether they thought there was still a challenge of that kind of perceived elitism within amateur sport a policy and strategic level we have a set of drivers which focus on participation and progression in sport so the signals that are getting sent from the top down and within the system for sport that we currently have focus on those two things we would say those things are important but participation is only a driver to us as a nation leeching the goals that we want to achieve through sport and physical activity which is healthier happier individuals and communities so I think the opportunity at a strategic level is for us just to reframe the lens on that messaging and to really make the connection about how we want to use sport and physical activity in our society and yes some of that is about progression and medals and that's brilliant but there is a whole wider range of things that sport and physical activity can support us to do and I don't think we make that message strongly or clearly enough at a strategic and political level I think you've picked up on a key thing in terms of how do we balance recreational versus the performance on that side of the participation and keep those people who've enjoyed the recreational in the sport and how do we ensure that there's enough either facilities or coaching support etc for those and I think that will always be a challenge but one of the good things that certainly I see emerging is some of the sports clubs starting to redress that through community projects that they're doing and so particularly you know things like walking football you know going back and getting people to re-engage their mental health and football projects again trying to use something where people have got a connection from their past which they've got enjoyable memories with and they're using that then to sort of work with communities and get them back into sport for the health and wellbeing aspects of it so I said there are a number of projects which are beginning to emerge like that which I think are you know wholly positive. Glasgow sport is an organisation which of course spans that whole spectrum we're involved in the elite end of performance sport but we're also engaged in the in the attempt to create a culture of physical activity in Glasgow I have to say that over the last three to four years our emphasis has been gradually shifting with less focus on the elite and performance end we're looking to sport Scotland governing bodies and sports clubs to take more to carry more of the load on that one and we are much more of our focus is on physical activity and getting the most disengaged engaged but I think it I think it's always a mistake to see and I agree with my colleague Andrea it's a mistake to see those as somehow two adversarial concepts we've certainly seen in Glasgow some real benefits on the participation in physical activity side from hosting for instance international sporting events gymnastics is a real success story nationally but also in Glasgow we've hosted an international Grand Prix we've hosted the world championships and the Commonwealth Games and we're hosting the European Championships next year that has helped to generate you know fantastically successful gymnastics clubs in the city a lot of young people in Glasgow are now involved in gymnastics the demographics of those involved in gymnastics to go back to your question is very very interesting it's much more from lower socioeconomic quintiles than some other sports so that's really really important and that demonstration and inspiration factor the elite sport can give you is having an impact at the other end delivering that culture of physical activity and getting people more active as a as a governing body we realise that the elite end of the game is the part of the game that is really the shop window for our sport and it's really the game that's a driver encourages people to to come into the game and it also generates the revenue that we can then reinvest back into the grassroot side of the game so it's really important for us and we don't look at one or the other we invest in a network of development officers that are out there in the community working with schools and working with clubs to try to get more young girls and more boys active in the game and that's certainly a way that we'll continue to work so the the grassroot side of the game is really important to us thank you for that no i don't for a minute suggest that we shouldn't have elitism in sport and that it does drive inspiration and money as you rightly say and competitiveness it's more that kind of the way that percolates right down to entry level to the point where elitism can be a barrier that if you're not perceived as being good on the first day of tryouts then that's it for you and then and I guess I just wanted to know how do we how far do we still have to go in stopping that because I'm I'm absolutely certain seeing it in my own kids football club that exists at the primary level and how do we how do we mitigate that so that we foster that drive for success and that higher high end performance stuff but not you know starve people out at the very beginning just because they're not necessarily good on a particular day comes down to also the coaches and the teachers that are leading the sessions to make sure that that kind of thing doesn't happen and that we're actually involving everybody within the sessions that we're doing or within the games that we're doing and making sure that that young people have game time equal game time within the game as well I think it's I think there's work to be done I think there still is none of us can afford to be turning anyone off from getting involved in physical activity at any stage and I think I think now I think all sports and all governing bodies and all sports clubs absolutely understand that or well maybe not I think the vast majority do and and that direction of travel I think is absolutely established and isn't about to change so so I think I think it is an improving picture but I think there is still work to be done I think you're right I mean I think I remember my experience of my own kids when they didn't make it to the first team you know they were devastated and we just can't afford to do that so whilst not everyone can be in the first 11 what is the exit strategy what is the you know what is what's constructed around that process to make sure that everyone can continue to be meaningfully involved in sports that they love because we can't afford to turn anyone off and it's having the capacity to do that in the sense of what are the alternatives are there enough pictures to put those individuals who've not made it then and are there enough coaches to support them and also what do you say are the messages that are coming through from the coaches in terms of the value that they're getting from the sport thanks Brian you know good morning panel just to go back to I think an earlier point that was alluded to and I wonder if you think that there's a link between a lack of sort of earliest access to physical education activity and perhaps a reluctance to engage within certain demographics sort of later in life sorry I mean one of the things I put in our response was that we're trying to obviously work with the children and say and to give them positive experiences so that then they become the act of adults now one of the things we have tried to do is that when recognising and working with act of schools and the king who are their user groups where do they have less problems getting the reliant of volunteer workforce so who are they you know and there are some communities where they're more likely to get parent volunteers who are more willing and understand the value of all of these things where there are communities where they will struggle to get those volunteers and so we've worked to try and then skew and redress that balance and put our students into the into the areas where they struggle so they're there and you'll see from some of our statistics where we've had some very positive results in terms of working with particular school groups which have got higher enrollments from the SIMD 15 quintile and sort of and then looking at sorry SIMD 20 quintile looking at that particular group trying to target and offer more opportunities for them to engage so that the again going back to that if they've had a positive experience earlier on then hopefully they'll continue to re-engage with those activities as they go through schooling and also then to think about more targeted opportunities when they go into the secondary school sector where they know there's the drop off. I think that Eileen Hughes affords us a great opportunity not just to engage young children in physical activity but also their families and I would say that is one of the areas there is room to develop and to do more work there's already a lot of work goes on in this area within play and also you would see a lot of kind of walking groups with mums and toddlers and I think that's something for us to build on and I think there is room for sports sports clubs and sports social enterprises a lot of them are already doing this to build on it but also to talk better about what works and the evidence they're getting out of that I think another thing is you'll know this from being out and about a lot of this is happening on the ground but we don't often get to hear about it and we don't often get the evidence out of what works so we can start to replicate that in other spaces. I think we all know that there is a link between a whole series of civic disengagement lower levels of activity lower levels of participation there's a link between that and socioeconomic profiles I mean we can see that and that that is a challenge that we all face which is why I think that there's a requirement for universal mainstream programmes which we deliver but there's a there's a there's an absolute obligation to create a series of targeted programmes which focus on specific issues so that specific issue and as back to comments made by my colleagues we have created a series of programmes in Glasgow one of which for instance is called We Play which is designed to tackle exactly that issue so it's about getting it's an early intervention programme in the same way as there are a whole suite of these across other services as well and that's about creating and I use the phrase and I don't apologise for using it I use the phrase culture of physical activity and I think that's really important because it's to get back to that point it's not just about the children it's about the parents it's about communities but it's also about the wrap around services so it's about safe routes to school it's about you know it's a whole series of issues which can be devil communities which are barriers to people getting involved so is it about a pure experience at school is it about a whole series of other things in a sense in a sense it doesn't really matter we know where the issues are we know where the challenges are so what we need to do is create a suite of programmes which which and interventions which can address that um so we know about we we can all see the link it's it's about what we do about it really I think following on from what I'm really trying to get to is this idea that the most effective way of this sort of physical literacy if you like intervention wouldn't really be early years at school where we have the captive audience and where they have this you know ability to deliver free physical education laying that sort of life skills that allows them then to move on later in life into an active lifestyle that's kind of really where I was trying to get to I put some data in the in the response where we've been involved in active movers programme our students have been delivering that for active schools and that's targeted primary ones to threes and to show the number of pupils that certainly were involved in that and I know from the qualitative commentary that we got back from the pupils about the fun that they've had the teachers have appreciated the programme that's been offered and so we are hopeful whilst obviously it will be a longer time before we get to see what the impact necessarily of that has been but you know we hope that through those positive experiences but giving them the early building blocks of run jumping and throwing that that gives in the literacy to then move into other sports just for you to agree with you Brian and reiterate the point that I made earlier on that we very much see school as being a place where we do have a captive audience that we can really inculcate that whole area of physical activity in sport and young people and to develop that for later life because you know if they are active in sport in their early years then and it's a good experience and it's more likely that they will continue to participate but it's also about getting clubs and governing bodies to actually work to develop links into schools in order that we can create these pathways for young people to continue to develop and to continue to enjoy sport and physical activity as well. Can I ask a specific question to Andrea around that intervention at primary 1, 2 and 3? Is there any evidence gathering around effects on behaviour and attainment? We haven't particularly done that because I say the nature of the project but there is the evidence out there sort of you know and certainly if you look at the daily miles project which has been running in the number of schools that again there's kind of certainly evidence coming back of better behaviour when the pupils come back into class and certainly there is literature around which says in terms of enhanced attainment with regards to sort of say the additional benefits that come with these. There's also projects which have been running in relation to maths and football sort of types of projects where they're using maths particularly as a tool in order to as a say sort of using football as a tool to try and educate the pupils around a bit maths and within our own institution we're supporting the Dundee academy of sport project which again is looking particularly at sport as a context for learning where again we're looking at attainment now. We don't gather the attainment aspects of it but the data that we get back from the schools is positive and certainly some feedback we've had from one of our partner schools St Paul's in Dundee. They've said that they've got a higher proportion of pupils now going into further education and they believe that that's partly through the work that we've been doing in terms of erasing aspirations and erasing attainment. Just as a follow-up question to Brian Whittle, he won't be surprised obviously given my background as a teacher and I should also state for the record that I'm the PLO to the Cabinet Secretary for Education. I'd like to kind of pick up on one of your points Andrea about these negative associations with regard to PE and Sheila you also mentioned that school is where the greatest impact can be achieved in terms of you know health and wellbeing and getting kids involved in the first place as Brian was saying. I wonder therefore if from your experiences you think there's an equity across the board in terms of secondary education with regard to what subject specialisms are delivered in school so in my experience it was always dependent upon the secondary teacher's specialisms so whether or not a hockey club ran was dependent upon whether that was the sport of choice for the PE teacher or somebody else that I took hockey myself on occasion but you know it does depend in my experience on the secondary teacher's specialisms as to whether or not these clubs run so if you want you know take up from kids later in life you need to get involved at an earlier age and if there is no rugby specialist in the school you're not going to get that take up. Is there an issue then in terms of equity across the board in secondary schools are we delivering you know sport for all in every secondary school or is it unequal? I think you're quite right in terms of I mean it's difficult to take those barriers away because people will always come with their specialist area they will have that enthusiasm and therefore then that's what they will you know they'll be able to offer and that's where you are dependent on then to offer broader sort of aspects is who else can you bring in she was already said about you know linking with clubs and getting clubs to come in so are there partnerships that could be evolved there I've talked quite a bit about volunteer workforces we're lucky because we have a very big sport student population within our institution so where there are corrections there our students need the employability skills and that's why we've worked with a number of organisations across our local authorities to try and ensure that they can give them the opportunities they need volunteers but our students need skills and so for you can work in partnership now because we draw students from you know across Scotland and into the sort of the rest of the UK and a few international students then they bring their expert experiences and expertise and if you get the opportunity to put that back into the school curriculum then I think that's only to the benefit of the pupils but we know that you know again it comes back to what's the estate as well as its access and opportunities ultimately and that's been there for a long long time in terms of you know what the experiences people will get through the school system this is where I also have to come out and say that I was a former teacher as well a physical education teacher and do understand what you're saying in terms of you know the expertise and the specialism in the interest of PE staff within schools and that's gonna you know if you were a footballer or a rugby player or whatever that's the team that you took at school and it's maybe a big part of the curriculum within the school as well and I was also a teacher who went out into the local primary schools and I think that we really missed that whole bit of you know developing the physical literacy skills within our young people of you know the running, the jumping, the balance all the sort of coordination stuff that just in terms of life skills that we need people to be able to have but also in terms of sport that we're seeing quite often young people coming through into sport that don't actually you know they can't throw and catch or they don't have good balance or coordination and so I think it's a big gap for us and certainly you know these kind of things are being addressed through our rugby clubs in terms of their mini and midi sections where they're bringing young kids into the club to develop these physical literacy skills. One of the key tasks of the active school network and the active schools officers is to address that very issue in a sense because you're right within a secondary school environment that there can only be so many you know PE teachers with a range of specialisms but active schools officers are there developing their links between the school community and the local sports networks or sports clubs voluntary organisations third sector to utilise the experience and the skills and the opportunities therefore in the community around the school. So I think it's important that we that we recognise that the active schools network is there to do and ensure that that you know I know that within Glasgow we are measuring that very very carefully the number of school to club links that are developed how meaningful those are and how those are operating and I think that's really really important because you're right otherwise unless you do that then you'll always be limited to what's available within the school community which is always going to be quite challenging. Thank you. Thank you panel for coming along to it. I think since for short and time I will probably focus in on a couple of specific issues and as you know Sheila I have a real passion for rugby and my inability to be an elite athlete didn't put me off at all getting involved in this game and I play for the parliamentary team. One of the sort of lingering perceptions about rugby for example is that it is a sport for wealthy people certainly here in Edinburgh and I just wondered although you're doing you in your written submission you documented some brilliant stuff that you're doing to target women and LGBTI community people with learning disabilities and autism and the geography so I know that you're doing great work up in the highlands but is there anything specific that you're doing to target that perception that that sport is for a certain level of wealth? Yeah I mean certainly through the conferences that we're delivering I would say the majority of schools that we're actually working with are state schools so really trying to move away from that sort of private school focus for Scottish rugby so and I would say out in our clubs as well you know we've got a wide spread of clubs that are working within various areas of Scotland and we're the you know the population that's not a kind of elite sport or a sport for money for people with money so we are targeting we are going into areas of deprivation we are working with state schools so I would say that it's it's maybe just a myth as opposed to a fact. I will be living proof of that. Can I ask specifically about the news today again it's in the news about the possibility of rugby causing injuries so young people playing rugby leading to potential for dementia later on in life and this is a story that keeps on coming and it's a broader issue for all sports I would say in that there is whilst most people myself included acknowledge that there is a real danger to being inactive there is also sometimes a perception that sport can lead to injuries and can you know cause some harm and I guess I will ask you specifically Sheila first because the story today in the press was about rugby but it's a it's a broader question for all of you as well. Just as you said I would say that every sport carries a degree of physical risk but we really believe the health and social benefits to young people and being active and enjoying sport are far greater and actually there are as you say more risk through people being inactive than than actually playing rugby. We would say quite categorically that rugby is a safe sport and I don't know if any of you saw the Scotsman editorial today that talked about we mustn't confuse elite sport with the thrilling game that's inspired children for over a century. I would say at Scottish Rugby we're absolutely committed to player welfare at all levels of the game and our rugby right which is an online training programme is mandatory for all coaches, teachers and referees who are required each season to complete the course to ensure players enjoy the game in a safe and informed environment. I would say that concussion awareness has been mandatory for more than seven years and Scottish Rugby did great work in terms of leading the whole area of if and doubt sit them out which was actually signed up to by all the governing bodies and supported through the Scottish Government as well. The course modules in terms of rugby right include player welfare, safe coaching and safe contact techniques and are completed by four and a half thousand coaches, referees et cetera per annum. I would also say that we are very taking very seriously player welfare because we undertake research in partnership with the Scottish Committee of Orthopedic and Trauma Surgeons it's called the Scott Group and they've helped us to implement physical maturity assessments on players so we do take seriously player welfare and we're working with key practitioners and renowned practitioners throughout the world. Can I just add one last little bit? Very briefly because I've got two other committee members who want to ask questions and we've got less than five minutes. Yeah okay I'll just be one sec. So we're actually working this year on Rugby Activate which has been some research delivered through the University of Bath and the RFU which is the English Rugby Union and it's a warm-up and it's shown to reduce the number of injuries in rugby by 70 per cent so we're actually working on that this year to deliver that as part of rugby. Miles, you wanted to come in on? Thank you, Rina. I'll be as brief as I can. I was wanting to ask a question regarding future sustainability around facilities and services, especially around future funding and I know there's discussions around the Barclay review and non-domestic rates at the minute and part of that was the removal of rates exemptions for charitable bodies, sports clubs and arms length organisations such as Glasgow Life and I wondered if the panel had any views on that. And again we need to be extremely brief. I can start. Certainly we welcome Glasgow Life, welcome the announcement that the Scottish Government will seek further engagement with arms length extended organisations and certainly we would welcome that. I'll be very brief understanding the background entirely of the review. We think, however, that there is a real danger that decisions could be taken which would have some significant unintended consequences on the very matters that this committee is discussing in terms of participation, access to physical activity. Glasgow Life operates a service which is not comparable to anything that's happening in the private sector. We are not for profit organisation. Delivering services in parts of the city that the private sector simply wouldn't and delivering services at the private sector simply wouldn't deliver. So making any kind of equity comparison we think is inaccurate. So certainly we welcome further discussion and we will be certainly making representations on that basis. My question was in general terms round about how resources kind of trickle down through all the different organisations that are involved in sport to get to where they make the most difference and in particular we talked earlier about the impact on how to reach socioeconomic groups in terms of participation in sport. And I suppose it's your question director at Mr Garrett round about you talking your submission about Phoenix and Easterhouse, which is an organisation that I'm familiar with. So I suppose the question is to what extent do you think that money trickles down to where it needs to get to and to follow up to that, how much you're talking in glowing terms about Phoenix, how much money are you Glasgow Life putting into Phoenix and Easterhouse at the moment? To start with the end of that question, sorry I don't know but I've got to be honest, certainly, absolutely certainly. But I suspect that most of the support we've given to the Phoenix community sport hub has been around officers working with them to help create it and build participation etc. Glasgow Life's not a grant awarding body as such. But in terms of the wider question, I think you're right, I think there's a real challenge there. I think certainly from our point of view and it's part of the shift in emphasis that I mentioned earlier, much more looking at working with the most disengaged and the most inactive. And what we have had to accept is that in order to do that properly, there are agencies and organisations out there who are much better place to do that than we might be, who are much closer to those communities, much closer to those client groups and those tar groups that we want to work with than we are. So we are, and that's a challenge for us, we are looking at and examining a range of ways in which we can, if you like, devolve that further down to, as you describe it, to the place where it can make the most difference. And actually we think we've got some successes in doing that. There's never enough money for, so when you talk to Richard McShane, of course he wants more resources, he wants more support and that's absolutely legitimate. But I think we are beginning to see in Glasgow one or two examples, I've mentioned some of them already, Drumchapel, St Angela's, where actually, given the challenging financial landscape, because there's no point pretending that there's a lot of money around, it's about how we work smarter, how we utilise existing networks that are out there, as opposed to maybe the old school where, well, we know best, we'll just roll out and deliver it. Certainly we are moving away from that. Yeah, and I'm glad to hear that. Because, I mean, to my understanding, they don't get any support at all. And as you're rightly saying, you're talking, going in terms about the work they're doing, obviously, as a committee who visited that. And apologies for talking very specifically locally, but it's what I know, and I believe it would be not dissimilar in many other parts of the city and the country. Very limited support and really struggling against a lot of barriers, but delivering very much on the ground. So I'm glad to see you recognise that. There are other organisations, I mean, next door, there's the Phoenix, there's the Gladiator Weightlifting Club, which has got youngsters out on medals at the moment on the international stage again, to my knowledge, with very little, if any, support through official channels. So I'm glad you're taking that on board, and if you can have a look at that and get back to us. These are organisations that we know well. We're very, very interested. Interarch, perhaps Mr Garrett could supplies with some written information about what support Glasgow Life has put into sporting facilities in Glasgow, particularly in your constituency. I'd like to thank the panel very much for coming along this morning, and we'll suspend briefly to change witnesses. The second item on the agenda is an evidence session on NHS staff governance with the Cabinet Secretary. I would like to welcome to the committee Sean Robison, Cabinet Secretary for Health and Sport, Paul Gray, director general health and social care and chief executive of NHS Scotland, and Shirley Rogers, director of health workforce and strategic change Scottish Government. I'd like to invite the cabinet secretary to make an opening statement. Thanks, convener. I welcome this opportunity to give evidence. Staff governance is a key part of the governance framework in ensuring that NHS Scotland is an exemplar employer and its diverse workforce is treated and managed well. In 2014, a monitoring framework was agreed in partnership with our trade unions, with boards responsible for the implementation of the staff governance standard at local level. Boards are also held accountable through a national return and annual review process. This is about continuous improvement. We are currently reviewing our approach to ensure that assurance mechanisms are driving any necessary improvements. We have around 160,000 staff and we need to listen to them as it's the workforce who are at the heart of everything that we do. They are our greatest asset. We need to value, support and motivate them to do the best job that they can. We need to lead by example. Our values are important by demonstrating and recognising these. Our staff feel valued for the great work that they do. We see that on a day-to-day basis throughout the NHS. One of our key achievements has been a transformed approach to staff experience through the iMatter programme. iMatter is a continuous improvement tool to measure and improve staff experience developed by our staff for our staff. iMatter has been independently validated and it measures staff experience against the staff governance standard. Evidence shows that staff who feel valued and engaged provide better health and care. We've gone from a context of poor levels of engagement. As you're aware, staff surveys had response rates of around 35%. The current iMatter response rate is over 60% with an employee engagement index score above 70%. The programme rollout is nearing completion and iMatter is engaging individuals and teams in the decisions that affect them. This includes 23 out of the 31 health and social care partnerships who are now using this approach across integrated teams. That means that the programme now involves over 170,000 staff. Figures are indicative at this stage but it shows real progress. The full national report will be published in February next year supplemented by the results of the autumn dignity at work survey. We're also taking action on pay. We recognise that at a time of rising inflation a public sector pay cap becomes increasingly unsustainable which is why we've announced it will take account of rising living costs and setting pay for 2018-19 and why we're working in partnership with the trade unions to commission work to develop an evidence base that will help assess the impact of pay restraint and can be used in the next round of submission to the independent NHS pay review bodies. The committee has heard a lot of evidence on experiences of raising concerns. Concerns are often raised and resolved locally and informally but where that doesn't work staff need to have the confidence that they'll be supported, listened to and responded to. In recent years with our trade union partners we've developed a single national policy, local named policy contacts, non-exec whistleblowing champions and independent whistleblowing alert and advice service and we've introduced a presumption against confidentiality clauses and settlement agreements. We're committed to adding to the routes already in place for raising concerns and we aim to ensure that everyone has a choice about how they do this and an external route to escalate concerns if they're not resolved. We're establishing an independent national whistleblowing officer. The INWO will provide external review where individuals have a legitimate concern about the handling of a whistleblowing case. This is a further step in developing an open and transparent reporting culture in our NHS. The INWO will complement our approach to whistleblowing and provide independent challenge and oversight and should have the powers and functions to do so. We're in discussions with the SPSO with a view to the SPSO hosting the role by the end of 2018 and I received written consent yesterday from the Scottish Parliamentary Corporate Body for legislation to be introduced and I'll announce more details to Parliament in the coming weeks. We have to listen to concerns when raised in value where they give us an opportunity to change. We're clear that it's essential to have honest, open and transparent culture within our NHS and we're making good progress but there's still more work to be done. I'm happy to take any questions. Cabinet Secretary, for that opening statement, are you satisfied with staff governance in the NHS? I think that we have very well developed staff governance arrangements. They have been developed in partnership. The partnership arrangements that we have in the NHS are looked on with some envy, I have to say, from other organisations but we mustn't be complacent and partnership requires effort on both sides to make sure that it delivers and our staff governance arrangements have evolved over the years. I think that we have good staff governance arrangements but I'm not complacent that there's always improvements that can be made and I think that some of the areas that I've laid out today show that we are always looking to ensure that we make further progress. Can I ask on the back of that then if you're satisfied with the progress that's been made towards the staff governance standard since monitoring began in 2006 with the staff survey? Yeah, well I could ask Shirley to come in some of the detail but I think the iMatter development shows that that's an important tool in continually getting that feedback from staff at a rate and a level that has improved from previously. I think the rates of return previously were quite low. The staff feedback was that they didn't feel it was a tool that worked for them so the iMatter was very much developed in collaboration with the staff side and the unions and has I think shown itself to be very much rooted in being developed by staff for staff and I think that will bode well in terms of the returns that we get from that but you know it's something again we need to keep under review as we as iMatter is taking forward do you want to say anything? So I've worked for the NHS for the last 22 years. I recall the introduction of the staff governance standards when I was working in a board and I think those five standards taken as a package have moved the agenda forward quite considerably. They set a benchmark for how the relationship between management, trade unions and staff work across NHS Scotland. They are achieved through a number of means. Some of those means are formal means around partnership working, engagement with the staff side, a whole raft of those kinds of things but they also set a tone for the industrial relations and employee engagement within NHS Scotland. It's not perfect. We know that there is more that we need to do to make sure that when staff raise concerns the first reaction, the first response they get from leaders within boards is not always as great as we would wish it to be. So we're spending a lot of time looking also at our leadership management development arrangements across the NHS. We've worked very closely with the staff side to make sure that those five standards of staff governance are achieved as frequently as is possible to do and the survey results, the staff governance audit results have shown a considerable improvement over the 10, 15-year history of their introduction. There's more to be done. Thank you. Good morning. The 2015 NHS staff survey showed that 41 per cent of staff wouldn't recommend their workplace as a good place to work. The highest levels of satisfaction were amongst executive grades and senior management, where satisfaction was at 75 per cent, but that dipped to 29 per cent from ambulance staff. Do you think that that will have changed now? Are those results illustrative of pressures on the NHS and why do you think there's such a difference between the ambulance staff and the executive staff? I took the annual review for the Scottish Ambulance Service this year and part of that annual review is a good deal of engagement with the staff side and the trade unions. I think that although there are still challenges in the ambulance service, it has changed beyond recognition over the last few years, but it is a very physically demanding role. It can be very stressful and sometimes due to pressures. I absolutely understand some of the concerns raised there. However, there have been a number of developments. The new clinical response model, the rebanding issue, although one thing has resolved a long-standing issue, and the clearer pathways for ambulance staff in terms of their employment opportunities to move through from technician to paramedic and the new specialist roles, I came away from the annual review very heartened that there's been a number of developments and actually the morale was improving and things were in a much better place, but still a lot of work to be done. In some ways, maybe the ambulance service is perhaps a good kind of litmus test of how things are progressing. I think you're right to highlight the ambulance service. It is the area that the most work needs to be done, but I was very heartened by what I heard at the annual review. On another topic, the issue of whistleblowing champions, we discussed that last week at some length. Paul Gray in a letter suggested that the role would be best suited to a non-executive director of each board staff governance committee. That has raised concerns in written submissions and from individuals that I've spoken to, and I'm sure others have had the same experience. Why does the Cabinet Secretary wish non-executive directors to be whistleblowing champions? Do you share any concern about a potential conflict of interest? I understand it, but the idea was to have a leadership within boards that was non-executive so that it was a step removed from those with executive responsibility. The idea being that they would drive and champion the whole area of trust, of being able to speak out and of whistleblowing policies. I still think that's the right thing to do, but it's not the only thing. It is one element of a range of measures that have been taken to try to change culture and provide a clear way of staff being able to raise concerns in addition to the helpline and the independent and national whistleblowing officer. It is one element, and it's probably fair to say it's maybe been working better in some boards than others, and I think we need to perhaps take some lessons from that. However, there have been some very proactive non-execs who have gone around very much around the wards and the areas within our NHS, speaking to staff directly and promoting that culture. Paul, do you want to? I suppose it might help if I gave a couple of examples. In Greater Glasgow and Clyde, the whistleblowing champion asked the board to upgrade the level of investigation as they felt that, in the specific circumstances, it was appropriate to do so, and that was done. Again in Greater Glasgow and Clyde, the whistleblowing champion was not satisfied that a case had been investigated properly and asked to be reinvestigated. In Lothian, the whistleblowing champion was asked indirectly to become involved in an individual case, but the internal processes hadn't been exhausted, so they ensured that they were, and they also ensured that the board took all appropriate actions and received written updates on this and all other live cases on a monthly basis. I'll have a number of further examples, but in view of time, I can share them if the committee would wish. I think that we have evidence that the whistleblowing champions are being proactive and are making a difference. I think that it is important, as the Cabinet Secretary says, to set them in the context of the other avenues that staff have to raise their concerns, whether through their line managers, whether ultimately through the employee director who also sits on the board through public concern at work. The whistleblowing champion is a component, but not a panacea. The fact that we are proceeding, as the Cabinet Secretary has said, with the establishment of an independent national whistleblowing officer, which, of course, the Parliament will have the opportunity to consider as evidence that we are continuing to build on what we already have in this area. It is an area that the Cabinet Secretary would keep under review if it becomes apparent that this individual is not independent or impartial enough, or simply that perception will never be that this one step removed is still a step too close to being actively involved in other aspects of a board's governance. I will be assured that I will keep everything under review and absolutely will keep that under review, and perhaps look at learning from the best practice of where it has worked well and does have the confidence of staff and where there are issues in other boards where perhaps that is not as strongly the case. I do not see anything wrong with it in principle. I think though it is the execution of it and making sure that the person, as some of the cases that Paul Gray highlighted, is shown to actually be driving improvement and benefiting the system. Yes, in short, of course, I am happy to come back to the committee at a later stage if developments are taking forward. I was going to ask a question about best practice, but it is interesting to follow up very quickly on Alison Johnstone's comment myself and the deputy convener. I visited the Ambulance Control Centre in Glasgow during the recess, to some extent on the back of the results we had seen and who we went in were expecting. I think that it is fair to say problems, but we did have quite a good chat with management, we were very open, we spoke with the union representatives and we spent quite a bit of time talking with the staff in the call centre, and frankly it was quite different to what we had expected, a much more positive environment. So to some extent perhaps the survey did its job in terms of highlighting a problem that was then dealt with. My specific question was roundabout, as I said, sharing of best practice, and you touched on it, there will be health boards or parts of the NHS in Scotland that are maybe not best practice, but certainly better practice in the area of staff governance. I just wonder what mechanisms are in place to identify that and then to share best practice and facilitate that between the different health boards? We attempt to and are driving more and more within the NHS to take an approach. It says if there is best practice in one area that works well then there has to be a pretty good reason why that is not happening everywhere and to hold boards to account for making sure that they take forward that best practice in whatever area that is and not least in the area of staff governance. So the good practice that has been highlighted in some of those cases, we would want to make sure that boards could see the benefit of having that culture and having non-execs in the role of champions who actually do effect change. There are some formal and informal ways in which we have an understanding about best practice around staff governance, so my team are working very close contact with the boards. I am from the board myself and I work very closely with our trade union partners as well and with staff and spend quite a lot of time out and about in the service. Indeed, coming back to your ambulance example, I am pleased that you have seen that evolution. The ambulance service is different in some categories to the rest of the health service. It has 150 locations across Scotland and one of the issues that the ambulance service wrestles with and I can say this having worked in the ambulance service for a number of years is leadership visibility in being able to get out into those small pockets that are largely around ambulance crews or the control rooms. Coming back to the specifics of your question, we have some formal mechanisms. I meet with the HR directors of the boards every month. We meet with our trade union partners regularly. We meet with the employee directors and we meet with the whistleblowing champions formally to share good practice. We also have a number of informal means to be able to share that stuff. For example, one of the whistleblowing champions has started to blog and it is actually a whistleblowing champion in Dumfries and Galloway. They have found that people have started to see that as a less formal means of communicating and it is benefiting that system. Being able to share that kind of good practice formally or informally is something that we do. Of course, we still have a particular interest in anything where there is a potential for dispute. When we have issues of concern that are raised or, indeed, as a previous question told us, some stats that make us look at something with a bit more detail, then we have some formal interventions that we can bring to bear there and ask boards to give particular consideration to a particular strategy around something. Thank you, convener. I wondered if you could outline to the committee your role as a prescribed person within the Public Interest Disclosure Act 1998. I think that it is a cabinet secretary who is a prescribed person within the act. Yes, and I would suggest, Mr Briggs, that we should write to the committee about that, because given that it is a legal provision within the act, we have actually just had to answer some questions about that recently and we did get some substantive briefing on the matter. I think that it would be more straightforward if we wrote to the committee and described that, because, as I said, it is a technical legal matter and it would be better if the committee had the formal advice on that, I think. Is there a particular concern that you have? My questioning was around the suspension of members of NHS staff. I think that, especially when they escalate a complaint to one of the prescribed people, including herself, how many people have you met to discuss those concerns, and specifically whether or not you think that it is effective for someone to be when there is a non-medical complaint suspended and then maybe not return to work within the NHS? Let me answer that carefully, because, obviously, these issues are very complex, sensitive, and it would be wrong of me to discuss individual cases, but I have met individuals who have asked me, many of whom have been through, as you can imagine, a very, very long process, and what you find is, as you wouldn't be surprised to hear, that there is a very complex set of relationships that have got the person to the position they have, whether that's in relationship to their management team or actually, in some cases, other colleagues. I always make it very clear that my powers of intervention in these cases are very limited because it's really an employer matter, but in those particular cases I thought it would be helpful for me to hear the concerns being raised by the person, but it is a very tricky territory for me as Cabinet Secretary, because, as you would accept, it would be wrong of me to intervene in a process that has had a very long, complicated route that is an employer relationship and it is very sensitive issues quite often. I tread very carefully, I take very careful advice before meeting someone, but on certain occasions I have, for particular reasons, but it would be wrong to share the specific detail of those. This is where the committee, when we have been doing our work in this area, have found that for some members of NHS staff who have gone through the complaints procedures and have reached a point where they can't then go back to their work, there are real difficulties. In a non-medical complaint case, retaining those people is something that we need to try to look at reforming. I can think, and again I'm not going to get into the specifics, because it would be wrong to do so, but I can think of at least one example where the person ended up working in another board after a very difficult, long process within a particular board and they were redeployed, if you like. And I think you make an important point, when we're possible you don't want to lose those skills and sometimes when you boil it down, it's down to a breakdown of relationships either with a colleague or with a line manager and things are never black and white either, you usually find that they're very much in the grey area of responsibility. So, I mean, I think we would always take the point of view that, and we would expect management within boards to take the point of view that the last thing you want to do is lose those skills and if the person wants to remain working in the NHS, which sometimes they don't, let's be honest about that, but when they do then I think efforts are made to try to find a resolution as I can think of in at least one case. Do you want me to answer that? The relationship that we have with the management of the boards is also to be taken into account in this respect and there are numerous occasions where I will intervene to ask the management of a board to give a particular attention to something or if there's a matter that I think has not been appropriately resolved then I'll intervene to make sure that they are as best as is possible. Thank you. Okay. Can I just ask here isn't it wholly a matter for employees and employers and can the cabinet secretary would intervene in patient safety issues and force an investigation if it's out with an employee issue? Well, I mean, I would have expected before it gets anywhere near me that that would have already happened if there are patient safety concerns, there are very clear procedures for investigation. I mean, I think the culture within the NHS should be one of and the duty of candor that's being introduced next year is really important and pertinent to this should be that staff feel able to give an honest and open account of what has happened when something has gone wrong. That's really important. Now, there may be ultimately disciplinary issues or registration issues in terms of the regulators if something is found to have been so absolutely wrong in terms of the person's capability and actions and culpability but often it's not as straightforward as that and it tends to be more around, you know, the best judgment call at the time and so, you know, I think we have to separate out what the issues are but we would expect before anything came anywhere near me, I would certainly expect that all the processes and procedures to have been gone through and adverse event reviews carried out and obviously there's been a fair bit of attention given to that over recent months and quite rightly so. So, when anything comes to me it's usually at the end of a long process that has gone before. Can I ask just very briefly on that and would an employee be able to access support throughout that process say from a trade union or from another supportive element of the organisation? Yes, and it's very important that when something has gone wrong and that can be a very stressful time for the staff member who could be often and most often be very distraught about something that has gone wrong in terms of patient safety. So it is very important that the staff member is supported and again there's very clear procedures for that and through a, you know, when it's a significant adverse event review that again it's important that staff members are supported and that it's in the atmosphere of a case of learning from what has happened and training and change from what has happened and it's a, you know, if then you're into different territory around disciplinary matters or indeed around registration that is a different sphere but the process is very clearly laid out. It's also the case that anybody suspended from the NHS should have through their HR department somebody allocated to be their contact person who can provide that kind of support whether or not they're a member of a trade union or a professionally regulated body or not. Thank you. Alex. Thank you, convener. Good morning to the panel. I'd like to ask about the national confidential whistleblowing helpline. I've asked the cabinet secretary about this before in the chamber and in this committee. I was struck very recently when a constituent came to see me about concerns they had within the NHS. They were a member of staff and I mentioned this to them. They were unaware of it and then expressed a degree of disbelief in what might happen if they found it, a lack of confidence that it would be taken seriously or acted upon. Can you give us an idea of how that's improving if it is in terms of cold volume, how those calls are being dealt with and what kind of feedback people who make calls to that helpline receive in respect of the complaints or concerns that they've raised? Okay. Well, since its establishment in 2013 that the line has received 309 calls from staff which suggests that there is a demand for the service. It is always room for improvement and I would be concerned if staff didn't know about the helpline because it's pretty well advertised everywhere but you know I'd be happy to look at the specifics and if there's more in that particular locality it needs to be done to promote the service then certainly we would make sure that that happens. Obviously quite often the encouragement given what we've just been talking about about trying to resolve things before they escalate and have a early intervention so often the encouragement would be for the person to raise their concern with their employer in the first instance as it gives the employer then a chance to respond to those concerns and if the individual isn't comfortable in doing so of course the public concern at work staff people who are legally trained advisors they can do that on behalf of the person if the person feels very uncomfortable about doing so. I would hope that given it's now in its fourth year of operation that people would have confidence that it's a very professional service, a wealth of advice and pretty good feedback from those who have used it but again as I've said in answer to previous questions there's always room for improvement and particularly I am concerned but there's that people if you're saying that certain some staff members don't know of its existence or how to access it and that's something we would take very seriously and look to do something about. As you mentioned the 309 calls and you might not have this information in front of you but what is the profile of that in terms of is that a glut at the start when it was first launched or is that just sort of a creeping incremental uptick or? I think it's been pretty consistent Charlie have you got the... I haven't got the precise figures that I can give you those but in the first year of its operations the calls largely fell into three categories the first category being calls from other parts of the UK, second category being a number of people who are ringing to see whether or not it was actually there which is quite interesting and then finally the calls from NHS Scotland itself and thereafter the numbers have been quite high but quite consistent. Can I come back to the point that you were raising about communications because I think that's very important and there are two specifics that I wanted to draw the committee's attention to. The first is we've had a stall for public concern at work at the NHS event for the past several years so we've had the opportunity for people to have dialogue and put a face to something as well as the poster campaigns and other things that the cabinet secretary has already drawn reference to that has put a human face on it and people seem to respond well to the opportunity to be able to go and ask people what's going to happen if there is a concern or whatever that might be. The other thing is I think it's really important for credibility to be able to tell some stories appropriately anonymised of what happened when people did raise concerns so we know that there have been issues that have been raised through public concern at work where action has been taken and it's important for people to have confidence that that is the case so I know of at least a couple of instances where people have drawn concerns around a particular clinical service which has resulted in further investigation, further work and indeed in some remedial action in one case in particular. So we're working with public concern at work to try and find a way to anonymise those stories appropriately but put them out into the NHS domain so that people can see that it's not just a pointless exercise and that actually things happen as a result. Most of the people who raise concerns through the line are raising concerns because they want something to be fixed rather than just because they want to have a learn about something so it's important that those things are fixed. I wonder if I could ask specifically about the duty of candor. I'm a member of a regulated profession myself. I'm a pharmacist regulated by the general pharmaceutical council and I already have a duty of candor so I wonder what is going to be added by the duty of candor that comes in next year in April? I think the duty of candor will add an attempt and driver to change culture so it will explicitly say that by law there is a duty on staff members, members of NHS to give a full and frank and honest account of anything that is of concern so I guess it is part of a basket of measures to drive that cultural change of you know there is a perception rightly or wrongly and I hear this sometimes from patients who are making complaints that sometimes they feel that the barriers go up when something happens and that there's an attempt to you know to kind of circle the wagons and I don't think that is always the case but I can see why that is a perception. The duty of candor really says as an organisation there is a duty on everyone to be honest and open and an expectation and a legal requirement so it adds that kind of sharpness and sharp point to it so that no one should then feel that they have to be part of a you know circling the wagons because they're not a legal duty not to be so if it provides an incentive it's for cultural change but also protection really that everybody is under duty to to give an honest and frank account so you know it's not it's a part of a drive to to improve culture within the NHS it's not the only solution but I think it brings with it a kind of sharp point that will be very clear of what the expectations are and we will to monitor the implementation make sure that we see the duty of candor actually leading to more transparency and openness in the way that the NHS operates. Thank you and a slightly or tenuously related topic would be the question of regulating managerial professionals so one of the I think it was the BMA submission suggested that it might be a good idea to have regulation of management in the same way as there's regulation of the professions and then there would be a parity there I wonder what your thoughts are on that issue. Have you got any thoughts on that Shirley-Anne in terms of whether it's not obviously there's not a clinical there wouldn't be a clinical regulator so it would be more around the performance which I guess is the performance management is done within the NHS in terms of of management's performance rather than by a regulator but it's an interesting concept. It's a question that has been raised for the past 20 years probably and one of the things of course that the duty of candor brings is a requirement on everybody whether they're in a regulated profession or not and I think that's very important that many of the responses that go out managerially from boards are not about they're beyond where the clinical process has taken us so they might be in the resolution of a financial claim or in a whole range of other things so there's a point to be made there I think the approach that's been taken so far has been about making sure that we make appointments that comply with the kind of standards that we expect to see in public life with the kind of cultural and values based recruitment that we are increasingly moving towards that gives us a cadre of managers that are so I have to say is it and then it's just managing myself I think the professionalism and standards is good but but it is something that we continue to wrestle with and will continue to as we develop that professional management leadership cadre I have no doubt we'll come back to that question again and of course there are a number of clinical managers as well so managers who come from the clinical community who will obviously still be regulated and I think that clinical leadership is really really important definitely I suppose it's only to comment that if you are a practicing lawyer or accountant or quantity surveyor in the NHS then you are regulated by your own professional body but I mean I would go so far as to say I would welcome any proposals around the regulation of managers and leaders in the NHS because I think it would bring parity we'd have to think about both the risks and the opportunities but I certainly wouldn't fear it so you know I would be quite the opposite I would welcome it and if there were if there were sensible propositions that could be taken forward I would be very happy with that. Thank you again good morning panel I think in gathering evidence around governance it's there's certainly a growing perception that there's a disconnect between frontline NHS staff and NHS managers and I wondered if that's something that you're aware of and what you would be doing to try and combat that and break down those barriers? Yes I suspect in every workplace you will always get a feeling where some workplaces are better connected and there's more of a positive feeling towards managers and in other settings less so I think where you have good leadership whether that's the senior charge nurse or an award or whether it's a member of the senior management team where that leadership is good it's then respected by staff might not always agree but I think it's respected and likewise I think where you have strong partnership arrangements managers find that an easier environment in which to operate because there are clear and good strong partnership and agents where concerns and problems can be resolved in a spirit of partnership. I think where there's difficulties is where that's maybe not as strong and where perhaps relationships have broken down so I don't think it characterises the whole of the NHS but I think there are areas and an organisation the size of the NHS there are undoubtedly areas where staff management relationships are not as good as they need to be it's then what is done about that and there is a responsibility on both to try to improve partnership arrangements to make sure that issues of concern can be worked through and that concerns that staff rays are being listened to and addressed and it's a mixed picture in an organisation in this size as you would imagine. A very tenuous link in terms of around the NHS being a positive place to work I think there's concern around the health of our healthcare professionals and given that our healthcare professionals are the frontline staff who are giving health advice the idea that the NHS currently, especially among I think frontline nurses and midwives is not a place that's conducive to having a healthy active lifestyle. Is that something again that you're aware of and what can we do to make it a better place in terms of health and wellbeing? I think you touched on an important point I think whether it's the physical health and wellbeing or mental well-being I think both are equally important and there are NHS and care staff work very hard sometimes in very stressful situations and therefore the occupational health support around the system is very important and a lot of effort has been put in to intervene early to make sure that there are clearer pathways so for example if someone who is working in a very physically demanding job reaches a certain age it's important that that's planned for and whether that's lighter duties or a different role as anticipated and well in advance and I think the parts of the service are getting better at that because we want to hold on to staff we don't want to lose staff through ill health retire before their time if they can give further years of service so we need to get better at that. In terms of the general health of our health service staff that is you know a some kind of well documented regular surveys that show that there's work to be done there and that you know we need to lead by example the chief nursing officer I think I'm not going to embarrass her here but I think she has done a lot around the system in terms of the nursing staff and you know the need for for to lead by example but the system needs to support people both their physical health and their mental health and I think it is getting better at doing that and recognising the early intervention is is best. Thank you and can I just ask the the panel one final question you'll be aware that we've taken lots of evidence from integrated joint boards and looked at not just health but also social care staff so to ask whether or not there are any plans aim to have a single governance standard for health and social care staff? I'll let Shirley-Sale a bit more about this in a second I think that there is potential there I know that a number of IIGBs have already taken the the staff governance principles of the NHS I think there was a view at the start that there was sensitivities about it not seeing one system imposing their way of doing things on another but it's fair to say that the staff and unions within local authorities and within the care sector quite like the NHS staff governance aspects of it so we have seen a gradual adoption of some of the the staff governance principles across the IJBs and I think that's probably a direction of travel we'll see more of you're probably closer to the detail. Thank you so the committee may be aware that the NHS Scotland workforce strategy everyone matters was something which was launched in about five years ago now and was a health and NHS Scotland specific document the next iteration of that we've already started to work on with colleagues from across the health and social care platform so from a strategic intent we will have everyone matters for the NHS in Scotland but we will also have some of the principles of that being considered across that wider health and social care agenda and indeed the everyone matters implementation group has representation from people across the wider boundaries than the NHS in Scotland. Cabinet Secretary has already pointed to the success of iMatter being considered as an appropriate tool for the wider implementation and indeed is benefiting and generating good results where it's used in integrated joint boards because iMatter is an OD-based product so it allows people to work together rather than just fill out a survey or just fill out some questions it's about how people work together and it's generating some good and good results in that respect. The fundamental issue in iJBLand has been around making sure that the standards of staff governance which apply to the NHS in Scotland are not diminished in that space so whilst we're content that the people have got different arrangements at this stage as they would do in bringing those kinds of organisations together people employed by the NHS in Scotland continue to have the rights in terms and conditions of the NHS workforce and actually that's been the most persuasive tool of all because people are sitting next to each other working together and seeing what somebody else is got and thinking I like that and we will the health service will need to learn from that because there are things from local authorities and third sector that would be useful and important to engage with for the NHS but fundamentally if the staff governance standards that have been achieved in the NHS has gotten to the best thing then that's something that we would want to be able to share across the piece. Thank you and I thank the panel for coming along this morning and we'll now move into private session as previously agreed. Thank you.