Coronavirus (COVID-19): Children and Families Collective Leadership Group minutes - 25 February 2021

Attendees and apologies

Chair: Michael Chalmers

Attendees:

• Association of Directors of Education in Scotland (ADES) - Jennifer King, apologies from Douglas Hutchison
• Care Inspectorate - Peter Macleod, Karen McCormack
• CELCIS, University of Strathclyde - Claire Burns
• Children’s Hearings Scotland (CHS) - Elliot Jackson
• Children in Scotland - apologies from Jackie Brock  
• Child Protection Committees Scotland - Alan Small
• Coalition of Care and Support Providers in Scotland (CCPS) - Sheila Gordon
• COSLA - Jillian Ingram, Jillian Gisbon, apologies from Eddie Follan
• Disabled Children and Young People Advisory Group (DCYPAG) - Jim Carle 
• Education Scotland - Laura-Ann Currie
• The Promise - Thomas Carlton, Fi McFarlane
• Inspiring Children’s Futures, University of Strathclyde - apologies from Jennifer Davidson
• NHS Chief Executives - Angela Wallace 
• Police Scotland - apologies from Sam McCluskey, Martin Maclean
• Public Health Scotland - Debby Wason
• Scottish Children’s Reporter Administration (SCRA) - Neil Hunter
• SOLACE - Grace Vickers, apologies from Margo Williamson
• Social Work Scotland - Alison Gordon
• Scottish Social Services Council - apologies from Cheryl Glen/Laura Lamb
• Scottish Youth Parliament - Liam Fowley MSYP

Scottish Government:

• Iona Colvin
• Ann Holmes
• Wendy Mitchell
• Kate Smith
• Angela Davidson
• Bill Scott-Watson
• Mairi Macpherson
• Bryony Revell
• Diana Beveridge
• Kieran McQuaid
• Carolyn Younie
• Tom McNamara
• Lesley Sheppard
• Ruth Christie
• Maggie Fallon
• Adam Smith
• Carolyn Wilson

Additional meeting participants:

• Harriet Waugh, Head of Perinatal and Early Years Mental Health, Scottish Government
• Dr Anne McFadyen, Chair of the Infant Mental Health Implementation and Advisory Group
• Laura Meikle, Head of Support for Wellbeing Unit, Directorate for Learning
• Laura-Ann Currie, Education Scotland
• Stephen McLeod, Professional Advisor, Directorate for Mental Health and Social Care
• Hannah Axon, COSLA
• Clare Simpson, Chair of the CYPF Advisory Group
• Amy Woodhouse, Children in Scotland

Leadership Group secretariat:

• Peter Donachie
• Claire Scott
• Chris Lindores 

Items and actions

Introduction

Michael Chalmers welcomed members to a deep dive session on children and young people’s mental health and wellbeing. Two new members of Leadership Group were attending the meeting: Liam Fowley from the Scottish Youth Parliament and Sheila Gordon who is replacing Annie Gunner Logan as CCPS representative on Leadership Group. No amendments to the note of the last meeting (11 February) had been received.

Overview of session 

Angela Davidson highlighted the negative impacts the pandemic is having on children and young people’s mental health and wellbeing and how existing inequalities are being exacerbated. Angela highlighted the Scottish Government’s Mental Health – Transition and Recovery Plan published in October 2020 and covering four main areas of work:

• promoting and supporting the conditions for good mental health and wellbeing at population level
• providing accessible signposting to help, advice and support
• providing a rapid and easily accessible response to those in distress
• ensuring safe, effective treatment and care of people living with mental illness

The plan has a strong focus on meeting the needs of children and young people including by supporting and developing resilience. £120 million is being provided to deliver the plan in 2021-22. £4.4 million has also been announced to support the mental health and wellbeing of college students and lecturers. Michael Chalmers emphasised the importance of maintaining coherency across the different funding streams. This includes ensuring a good fit with existing funding channels for children’s services and on preventative work.      

Angela noted that the deep dive session will cover three main pillars of work - perinatal and infant mental health; schools; and community services. This would help to give members a whole system overview.

Infant mental health

Harri Waugh and Anne McFadyen provided a presentation on perinatal and infant mental health.  

Harri described the policy context for the work taking place including the report on Delivering Effective Services for Specialist and Universal Perinatal Health Services and the Perinatal and Infant Mental Health Delivery Plan. Harri also highlighted the Infant Mental Health Campaign and resources available through Parent Club. An emphasis is being placed on lived experience in helping to shape policy and deliver services. Clear links have been made with the principles of The Promise.  

Anne spoke about the work taking place to build an Infant Mental Health System encompassing prevention, early intervention, support and treatment. This includes assisting families in adversity as a result of domestic abuse and substance misuse. Creating better understanding of infant mental health and supporting the development of strong parent/child relationships is central to every area of work. Anne highlighted Covid specific challenges including supportive infrastructure being less available to families experiencing adversity. There are also difficulties in helping some babies in neonatal units with their early development skills in visual communication due to the prolonged duration of mask wearing by staff and parents. Anne provided examples of good practice and innovation in infant mental health in Fife and Lanarkshire.         

Discussion – action plan priorities – early years/under fives

Members discussed concerns raised in Anne’s presentation over Health Visitor staff being redeployed in some Health Boards to assist vaccinations work. Michael Chalmers and the Chief Nursing Officer had written to Health Boards reinforcing the importance of maintaining universal health services for children in their local planning response to the pandemic. There is no evidence of significant numbers of health visitors being redeployed. However, Leadership Group members would continue to monitor the situation through their interactions with Health Boards.           

Action:

• Angela Wallace and Ann Holmes to discuss at Nurse Directors meeting 

Carolyn Wilson outlined work on the action plan taking place through the Early Years/Under Five sub-group. The group is considering how best to connect with families and identify their needs at an early stage. Initial options being considered are strengthening outreach work by health visitors and providing earlier access to early learning and childcare. Links ae being made to work on perinatal and infant mental health.

Members discussed how best to deliver multi-agency working in practice through whole systems approaches using GIRFEC and statutory Children’s Services Plans. 

Additional points from MS Teams Chat:

Need for a greater range of provision in early years and to promote infant mental health which does not involve parents separating from infants.

Stay and Play a key part of the Promise. Nursery provision is not enough and not always 'family support.' It has to be about facilitating support for parents to build relationships with each other and their baby.

Scottish Government is working closely with some providers to deliver Stay, Play and Learn as part of the universal ELC delivery.

CiSS has been exploring Nordic Open Kindergarten model with Midlothian Sure Start, which is centred around support for parents/carers: 

• is there any investment in Family Nurse Partnership from the funds that have been spoken about? 
• FNP teams are engaged in this work where it is being tested out.  Not direct investment though but something we are keen to explore as the pilots evolve
• FNP part of Fife team but as already funded not separately resourced and Family nurses are part of all developing systems

Mental Health in Schools Working Group

Laura Meikle and Laura-Ann described the work taking place to support mental health and wellbeing amongst children, young people and staff in schools. This builds on previous initiatives such as implementing counselling services for schools. Current work is assisting school staff to support children and young people’s mental health and wellbeing. This includes developing a whole school approach; increasing the confidence of staff across schools in dealing with the issues involved; and providing practical training resources and other materials. Laura-Ann highlighted the Compassionate and Connected Community materials that can help to promote confidence and resilience amongst staff, children and young people. Members emphasised the need to evaluate the effectiveness of the approaches being taken and ensure sustainability where they are working well.

Community services and covid response

Hannah Axon and Stephen McLeod gave a presentation on community services and Covid response.  

Hannah noted that the framework for services enhanced existing community based support and promoted innovation. The framework is designed to be prevention focused; as accessible to families as possible; and address a wide range of distress and wellbeing issues.    

Stephen discussed the development of a National Neurodevelopmental Service Specification for children and young people due to be published in the spring. This results from a recommendation by the Children and Young People’s Mental Health and Wellbeing Programme Board. The service specification will assist all parts of the children’s services system to identify and support children and young people with neurodevelopmental profiles and support needs. To help ensure a whole system approach, it is embedded in GIRFEC and national practice model. The support for implementation will include workforce development and data and analytic capacity.

Discussion – action plan priorities – community services

Members raised the following issues:

• important to ensure a joined-up approach to funding for community services. The additional resources are welcome but there is a lack of certainty over the continuation of some of these funding streams. This presents challenges for future planning of services
• achieving the right balance between diagnostic assessments and a needs-based approach will be a significant part of work going forward
• there is a key role for educational psychologists. Stephen confirmed that educational psychologists are among the professional groups contributing to the specification. Harri Waugh noted the involvement of educational psychologists in the Infant Mental Health Campaign
• there are links with the Advanced Practice Framework for Social Workers and supporting the whole team around the child

Action:

• Iona Colvin and Stephen McLeod to discuss links between service specification and advanced practice framework for social workers

Additional points from MS Teams chat:

Has there been a connection made for the 3-5 age group, linking from IMH to the community work? - The wider work of the new joint delivery board will consider the 3-5 age group which should link with the community services work when further developed. This might be something for the Early Years sub-group of the LG to be aware of in terms of what is maybe needed now.

Does the ND pathway just go up to age 18? The model seems to lend itself well to any neurodevelopmental issues arising in the adult population particularly for parents themselves - Up to 18 for now but with implementation of the Transition Care Planning guidance, recommend we consider increasing the age range beyond 18, for those young people that wish it, where they are supported by CAMHS and ND services at 18. This would be a major service redesign.

What can we do to prevent/mitigate neurodevelopmental issues with some premature babies? - Pre-13 months it’s difficult to screen children effectively as there are just natural differences before that age, but more effective after 13 months.

Next steps on the action plan

Iona Colvin provided an update on the action plan. The Leadership Group’s sub-groups are working hard to identify actions that can be implemented quickly. Iona thanked Claire Burns and Diana Beveridge for the support being provided to the sub-groups through CELCIS and CYPIC.  

Action:

• Iona to provide progress highlight report to LG on 11 March

AOB

Michael Chalmers noted that members will be sent an invitation to complete a short survey on Trauma Informed Practice as part of the National Trauma Training Programme. Members’ support would be appreciated in completing this short anonymous survey and sharing it with colleagues and networks. 

Action:

• survey to be issued by Secretariat. Deadline for completion is 5 March