Children and Young People’s Mental Health and Wellbeing Joint Delivery Board minutes: April 2021

Attendees and apologies

Attendees:

• Donna Bell (DB), Scottish Government (Co-chair) 
• Angela Scott, SOLACE
• Alex Pirrie, Integration Joint Board (IJB) Network
• Carrie Lindsay, Association of Directors of Education in Scotland (ADES)
• Morven Graham, Association of Scottish Principal Educational Psychologists (ASPEP)
• Ben Farrugia, Social Work Scotland
• Roch Cantwell, Perinatal and Infant Mental Health Programme Board
• Cathy Richards, CAMHS Lead Clinicians
• Judy Thomson, NHS Education for Scotland (NES)
• Margret Wilson, National Parent Forum of Scotland (NPFS)
• Martin Dorchester, Children in Scotland (CiS) Forum representative
• Martin Crewe, Coalition of Care and Support Providers in Scotland (CCPS) Forum representative
• Laura Meikle, on behalf of Director of Learning, Scottish Government
• Michael Chalmers, Director of Children and Families, Scottish Government

Support:

• Angela Davidson (AD), Mental Health and Social Care Directorate, Scottish Government
• Maggie Fallon (MF), Mental Health and Social Care Directorate, Scottish Government
• Stephen McLeod (SM), Mental Health and Social Care Directorate, Scottish Government
• Neil Guy (NG),  Mental Health and Social Care Directorate, Scottish Government
• Helen Crompton, Mental Health and Social Care Directorate, Scottish Government
• Ruth Christie, Mental Health and Social Care Directorate, Scottish Government
• Carolyn Wales, Mental Health and Social Care Directorate, Scottish Government
• Leon Young, Mental Health and Social Care Directorate, Scottish Government
• Rebecca Macpherson, Mental Health and Social Care Directorate, Scottish Government
• Zac Gilmiche, Mental Health and Social Care Directorate, Scottish Government

Apologies:

• Jane O’Donnell, Cosla (Co-Chair)
• TBC, NHS Chief Executives
• Erin Campbell, CYP rep, Scottish Youth Parliament (SYP)
• Kirsty Morrison, Support, Scottish Youth Parliament (SYP)

Items and actions

Welcome and introductions

DB welcomed previous and new board members to the meeting and thanked everyone for attending. Introductions were made and apologies noted. 

DB outlined that this work will be taken forward in partnership with COSLA and acknowledged the successful delivery of work of the previous Children and Young People’s Mental Health and Wellbeing Programme Board. DB thanked Programme Board members for their commitment and work since its inception and throughout the Covid-19 period. DB confirmed that this work remains a high priority for the Government and the work of the Joint Delivery Board (JDB) should be taken forward in a full and frank manner as part of a collaborative effort. DB provided an update on the pre-election period we are currently in. She highlighted that mental health is a priority for all political parties and is central in all manifestos. The current programme of work outlined by previous Scottish Ministers remains relevant. 

DB outlined that the work of the JDB will be progressed through Task and Finish Groups. SG officials have met with a number of members previously to discuss the work of the Board and the Task and Finish groups and also the role of the sponsor. 

DB confirmed that a webpage will be developed on the Scottish Government website for all agreed meeting papers to be published.  

Joint Delivery Board – new structure 

AD provided an overview of the structure of the new JDB confirming that it will continue to build on the previous work of the Programme Board to ensure the development of a coherent, whole system approach with a focus on the pathways and journeys children, young people and their families may take, and ensure children and young people receive the support when they need it. As with the previous Programme Board, the focus remains on prevention and early support. A key range of deliverables have been agreed with Ministers and COSLA Leaders and these are designed to have maximum impact, it is the role of the Board to oversee these deliverables being put into action. The JDB will report on progress to the Minister for Mental Health and COSLA Boards on a regular basis. The work of the Board is expected to be completed by December 2022. 

AD explained the Task and Finish Groups will be more streamlined than before and focus on core delivery. Membership will be made up of a broad representation of stakeholders who have expertise in the specific are of mental health. Key to all the Task and Finish groups will be the voices of children and young people. Task and Finish groups will have a designated senior programme lead and also a board member who acts as a sponsor. Their role will be to chair the Task and Finish group; support the work of the group, provide feedback/updates to Board meetings and ensure that views of the Board are taken into account by the task and finish groups. 

Terms of reference

AD provided an overview of the Terms of Reference (ToR). A number of points were raised by members:

• include the impact of the pandemic on children and young people and families in the ToR–suggested adding to the purpose Para 4
• ToR should be more explicit to how this work contributes to the delivery of the Promise
• consider representation from CNOD/other networks, Who Cares Scotland, member of SYP, medical advisor
• whether we should disseminate minutes/papers to wider groups more proactively?
• consider interim timescales for the work of the JDB 

DB acknowledged the comments and was happy to consider suggestions for representation and affirmed the aim to be transparent and sharing progress with various networks. DB agreed that comms must be open and transparent and this is what the Communications group will be looking at. DB agreed to keep the ToR under review and if gaps identified these will be updated. 

Actions:

• consider suggestions for additional membership and where this would best sit within the board structure
• agreed updates to be made to the ToR, these will be issued by email for clearance

Deliverables overview 

The deliverables overview paper was issued in advance of the meeting. MF provided an overview of all the deliverables. MF explained that four of the deliverables have been carried forward from the Programme Board and are now at the implementation stage (deliverable 1, 4, 5 and 6); two of the deliverables were paused due to COVID (deliverable 2 and 3) so at the very early stages of development; and two are new (deliverable 7 and 8) – these deliverables were suggestions from the previous Programme Board which were identified at a workshop between Board members and SG officials. In addition MF provide an update on the workforce deliverable, NES will be publishing the Knowledge and Skills Framework shortly, a link to the Framework will be issued to board members. Further work will be undertaken to add training materials and programmes currently used across the children and families’ workforce to the framework. A group will be established to oversee this work.

Comments received from group members:

• there  are many crossovers, need to ensure joint work and close alignment with across NSPLG
• deliverable 7 to be looked at within its own context but also across all groups - it is useful to keep 3 – 5 year olds in their minds when thinking of the other objectives of the deliverables
• greater clarity on linkages between groups - suggestion to set up a spider diagram which would outline a map of links
• subject matter of the JDB is broad and important to ensure no duplication or gaps
• communication – how do we ensure the right stakeholders receive updated information on progress of the JDB
• board need to consider how will we know we are delivering and seeing improvements – Task and Finish groups play an important part in this
• NES rep will have more discussions about linkages with the MH workforce group
• suggestion by members to meet with colleagues in Chief Social worker team for appropriate representation on Task and Finish groups

Actions:

• knowledge and Skills Framework to be issued to JDB once published
• develop spider-diagram demonstrating interconnectivity between relevant mental health boards
• CiS forum rep to provide name of CiS members for membership of T and F groups
• CiS forum rep to share research findings
• set up meeting with Chief Social Workers team to discuss T and F membership

Crisis services and community based support

A paper on Crisis Services was issued in advance of the meeting. NG provided an overview of this paper to develop 24/7 telephone and text crisis support for children, young people and their families. This is a deliverable from the PB that had been paused due to Covid-19. The recommendations in the paper also considered the recommendations from the Audit Scotland report, the Scottish Youth Commission and the Rejected Referrals to CAMHS: audit. A Task and Finish group will be established to produce an options appraisal for the board to consider. 

NG also provided an update on the Community based support deliverable which is now being implemented across authorities. This deliverable was part of the work of the Taskforce and taken forward by the Programme Board. A framework was published in early 2020 which called for new and enhanced services where CYP could self-refer. Funding of £15m per annum has been made available to local authorities since January to establish new services. This has been challenging but local authorities have advised that over 100 new and enhanced services are now in place across Scotland. These services are intended to offer support in a community setting where CAMHS is not appropriate. The Task and Finish groups will consider:

• how do we promote best practice
• how do we make sure it’s working
• need evidence

Comments from members included:

• further questions about the number of YP already using services and accessing crisis support
• NPFS offered to hold a focus group with parents to help any of the Task and Finish with work around their deliverable, there are now parent reps in 29 out of the 32 local authorities
• consider if proposal of 24 hr telephone/text care remains the best solution given recent developments
• consider how crisis is being supported within our systems for existing services users
• GPs are crucial
• is it still the same issues, is this now out of date?
• consider linking to work already underway through National Suicide Prevention Leadership Group (NSPLG) and Distress Briefing Intervention (DBI)

Action:

• NG to form Task and Finish Group which will consider comments as part of an options appraisal which will be presented to the board  

Neurodevelopmental Service Specification

The Neurodevelopmental Service Specification paper was issued in advance of the meeting. SM provided an overview of the paper and a presentation on the background. The Neurodevelopmental Service Specification had already had input from the previous Programme Board. SM clarified that there is a £40m investment for CAMHS and ND services in 2021/2022, we now have the opportunity to deliver something at scale.  

Comments from members on the Neurodevelopmental Service Specification included:

• members recommended some test of change/self-evaluation for this work in advance of a national roll out
• tests roll-outs could help build an understanding of the scale of need/demand which is likely to be revealed
• what evaluation has been done on the CAMHS standard as a basis of how effective the standards/spec are? 
• allows for services to evidence how they are meeting the standards
• could emphasis the maximum standard as well as the minimum standard to strengthen standards in practice
• research into implementation - monitoring implementation and outcomes is essential and could inform further research
• DBI learning could also help with this work

The Neurodevelopmental Standards were agreed for publication and the Task and Finish group would advise and support implementation, monitoring and impact. Additional agreed actions: 

• CiS to send in comments separately and arrange a follow up discussion
• JDB members representing IJB and SOLACE to have further discussions with colleagues about the possibility of test of change within work at Aberdeen City which could feed into the T and F group
• SM to develop proposals on the implementation of a model for  test for changes for next board meeting
• SM to establish Task and Finish group

Principles

Due to time constraints, DB suggested postponing the CYP Principles for Participation and Engagement paper and the DBI presentation until the next board meeting on the 26 May. 

DBI update

As above.

AOB and close

DB thanked everyone for attending and closed the meeting.