Delivering for Mental Health: plan

Support for change

A National Improvement Programme will be established to ensure the delivery of the targets and commitments set out within the plan over the next four years. The Programme will run from April 2007. Solutions must meet local needs and circumstances and more importantly we need to engage with and actively involve staff in the change process in order to achieve sustainable improvement.

With the Improvement and Support Team in the Health Department we will commission an improvement programme, known as a 'Collaborative'. Collaboratives are a method of improvement where teams, including front line staff use a variety of design tools and techniques to diagnose the cause of waits and delays and then test potential solutions through small scale rapid cycles of change. Fundamental to the methodology is rigorous data analysis and the use of 'information for improvement'. This will sit well with the need to better improve the information which we currently have in relation to mental health care in Scotland, particularly in primary care. The Programme will also apply other Collaborative ways of working, for example, by sharing ideas, information and change management knowledge.

Leadership Programme

A leadership programme will be commissioned to work alongside the improvement programme in order to ensure that the leadership component of change is tailored to meet the needs of those working in both the delivery of services and also those using them. Therefore the design of the programme needs to be tailored to meet the needs of a wide range of participants from users and carers to senior managers. We will work with NHS Board Chief Executives to identify who from within their Board area (including national and local partner agency staff) will participate within the programme. Selection will be based on, amongst other criteria, the ability of the Chief Executive to put forward a project specification that the cohort could work on and develop, both as part of their personal development but also by way of making a contribution to the delivery of a key target or commitment within the Delivery Plan. In the first year we would select up to seven NHS Board areas to participate.

Within the programme a number of different approaches will be taken in relation to ensuring effective learning and sharing takes place. These will range from e-learning to face to face seminars and from taught modules to web-based learning. The key learning outcomes will be around the need to develop qualities and skills for leadership, to increase knowledge, translate learning into practice and demonstrate improvements in service design and delivery, whilst growing capacity for leading change in the future. The first cohort of participants will be selected in early 2007 and the programme will commence in April the same year. We will also evaluate the programme at the end of the first year.

Training and Education and workforce planning

We will work with NHS Education for Scotland, NHS Boards, Local Authorities, Voluntary Organisations, Non Governmental Organisations and others to ensure that we can grow a stable and adaptable workforce in order to deliver the targets and commitments set out within the plan, particularly in relation to talking and psychological therapies within community and primary care.

Benchmarking and Information

Benchmarking activities support the search for further opportunities for efficiency, the demonstration of best value for investment and the implementation of redesign. It will allow us to measure 'like for like' in the future.

Work has been undertaken to identify potential mental health and social care indicators by using particular domains and key areas for development. At the same time we are reviewing the available baseline data with stakeholders and its coverage which relates to mental health demand, capacity and utilisation to establish its relevance, reliability, completeness, accuracy and validity in terms of supporting a continuous improvement process for mental health. This work will provide information and trend data that will assist the service in their formulation and implementation of local plans for delivering change. Benchmarking information will also support the setting of delivery targets and supporting measures. It will allow us to link with other domains around health improvement and/or patient experience and will enable an assessment of quality or other added benefits and so support Best Value analysis.

Scotland is working as a collaborating country with the World Health Organization European Office to develop a benchmark of services relative to the commitments made in the Helsinki Declaration on Mental Health which was signed by Ministers in January 2005 and that work will allow us to assess delivery of mental health policy and services in Scotland relative to other European countries.

We will work with the Information and Statistics Division ( ISD) of NHSNSS and other related partners to ensure that we have the right level of information, infrastructure and analytical capability.

Performance management

Performance indicators should cover three key areas:

• Outcomes supported by existing evidence which are easily collected and measurable
• Health systems checks in keeping with clinical governance strategies
• Quality assurance measures, not supported by evidence but which can contribute to ensuring that the clinical care provided is of the highest quality

We will put in place a robust performance management system that allows the Scottish Executive, NHS Boards and Local Authorities, as well as service users and carers to see what progress we are making in delivering change. We will build on what we already have by way of performance management systems and information, such as the Joint Local Improvement Plans process and the annual accountability review process for NHS Boards. We are awaiting the joint outcomes work being taken forward between the NHS and Local Authorities and would intend to draw on that as part of the implementation process.

Programme Evaluation

We will commission an external evaluation of aspects of the programme that will add value to and complement the performance management and benchmarking work as well as the programmes for improvement and leadership.

Finance

Spend in healthcare in Scotland has never been greater. Indeed NHS spend in mental health has risen from £400m in 1999 to £670m in 2006. However, we recognise that some financial support is needed to deliver the targets and commitments within this plan. That is why the Health Department will fund the central support programme and the various strands of work that sit within it. In doing this we will work with NHS Boards and other partners to ensure that clinical, as well as financial solutions are found that will help to drive forward improvements in the care and delivery of mental health services across Scotland.

Conclusion

We are in a process of change. This document is not the beginning, we have achieved much already, nor will delivering our commitments be the end, there will still be more to do. But the commitments in this plan are important steps along the road and take us in the direction we need to go to improve mental health in Scotland.