Health and Justice Collaboration Improvement Board minutes: December 2017

Attendees and apologies

Attendees

• Paul Gray (co-chair), Scottish Government
• Paul Johnston (co-chair), Scottish Government
• Wayne Mawson, Police Scotland
• Iain Bushell, Scottish Fire and Rescue Service
• Pauline Howe, Scottish Ambulance Service
• Jane Grant, NHS GGC
• Cathie Cowan, NHS Forth Valley
• Colin McConnell, Scottish Prison Service
• Karyn McCluskey, Community Justice Scotland
• Ann Gow Healthcare, Improvement Scotland
• David Williams, IJB Chief Officers Group
• David Harvie, Crown Office and Procurator Fiscal Service
• Shiona Strachan, Clackmannanshire and Stirling IJB
• Sally Loudon, COSLA
• Andrew Scott, Scottish Government
• Neil Rennick, Scottish Government
• Daniel Kleinberg, Scottish Government

Supporting Official

• Orlando Heijmer-Mason

Items and actions

1. Welcome, introductions and apologies Members were welcomed to the second meeting of the Health and Justice Collaboration Improvement Board and introductions were made. Due to an IT malfunction, it was agreed that the agenda be rearranged, extending the timing for agenda item 3 and omitting item 4.

2. Minutes of last meeting The minutes were agreed to be a faithful record of the meeting on 7 Sep 2017.

3. Discussion: Reflections on the board members’ exchange visits At the last Board meeting on 7 September, Board members had agreed to visit one another’s frontline operations to better understand each other’s services and the pressures they are under. The arranged visits were as follows:

• Paul Gray - Stewart Street Police Station, Glasgow
• Paul Johnston - Navigators Project, Edinburgh Royal Infirmary
• Iain Livingstone - GG&C Mental Health Services
• Iain Bushell - Renfrewshire Council Senior Social Workers
• Colin McConnell - Glasgow City Social Care Department
• Karyn McCluskey - City of Edinburgh Council Homelessness Service
• Jane Grant - Police Scotland, Glasgow
• David Harvie - Scottish Ambulance Service
• Pauline Howie - Crown Office and Procurator Fiscal Service
• Robbie Pearson - Scottish Fire and Rescue Service Control Room, Tollcross
• David Williams - Scottish Ambulance Service Control Room
• Sally Loudon - HMP Glenochil
• Andrew Scott - HMP Edinburgh
• Neil Rennick - Scottish Ambulance Service Control Room

The Board members described their visits and shared their impressions of the services they had seen, the challenges faced by staff, and any lessons they had taken away. While board members had visited a wide variety of services, numerous common themes emerged:

Board members had been struck by the volume and breadth of cases services had to deal with. Very often, services deal with repeat clients – whether in A&E, prisons, social work, police care – whose needs are so complex that they transcend the ability of individual services to resolve them.

Many board members expressed their admiration for the staff’s skill, resilience and dedication. Frontline staff can take decisions that are absolutely valid within their own terms of reference – clinical prioritisation in A&E for example – but have negative operational repercussions on other public services.

Often, organisations hold information on clients which – if they were shared – would allow others public services to provide a considerably more personcentred response, but there is a culture of risk aversion around information sharing which prevents these benefits to the client.

ACTION – All board members were asked to identify collaborative projects to address areas that would benefit from better joint working.

Break

4. Presentation: Emerging themes from Health/Justice event on 8 Nov and updates from Distress, Health and Social Care in Prisons, FME Taskforce Orlando Heijmer-Mason presented an update on work underway within the remit of the Board:

The publication of new national standards for forensic medical services for victims of sexual assault.

The establishment of a Programme Board for Health and Social Care in Prisons early in the new year.

Many of the board members had taken part in a Health and Justice Leaders event at Central Hall on 8 November, at which the Cabinet Secretaries for Justice and Health & Sport had reflected on their own exchanges – Mr Matheson had visited the Scottish Ambulance Service and NHS24 Control Rooms, and Ms Robison social care services at HMP Edinburgh. The Board were presented with the main themes that had been identified by delegates as most promising opportunities for better collaborative working. These included:

• data and information sharing
• developing more person-centred pathways through the wider health and justice system, especially around mental health distress
• up-skilling and developing the workforce
• shifting focus onto prevention

5. Discussion – Mental Health Strategy Workforce and Justice Andrew Scott presented and moderated the discussion. Action 15 of the Scottish Government’s Mental Health Strategy states a commitment to:

“Increase the workforce to give access to dedicated mental health professionals to all A&Es, all GP practices, every police station custody suite, and to our prisons. Over the next five years increasing additional investment to £35m for 800 additional mental health workers in those key settings.”

The funding is due to scale up every year to £35m per annum in 2021-22 and thereafter (subject to spending reviews). This money will be ring-fenced for specific investments to be agreed. Ministers have requested that the Health and Justice Collaboration Improvement Board develop recommendations to them on how this investment would be most effective by its next meeting on 27 March. Andrew Scott requested that the Board consider the following criteria for any recommendations:

• proposals must add additional value/staff, filling service gaps, not replacing current services.
• the number of additional staff and their impact must be measurable
• investment must act as a catalyst for improving and joining up frontline services

The Board agreed that this investment represented a very exciting opportunity. Several themes emerged from the discussion:

Whether the Board might broaden or refine the list of settings stated in the commitment. For example, whether the commitment to give every police custody suite access to mental health professionals allowed for frontline police officers to benefit from that access.

It was important to consider wider action to ensure how these additional professionals could be most effective. It was emphasised that the workforce needed to be an informed one, and that data and information sharing arrangements be developed to ensure they could add the maximum value to users of public services.

It was desirable that investment was focused around prevention. The commitment should increase the system’s capacity’s to prevent crises, rather than merely improve the public service reaction to crises.

It was desirable that the existing landscape of innovative approaches be taken into account so that effective practice could be identified and built upon.

ACTION - The Board agreed to set up a short life working group to develop draft recommendations in advance of the next Board meeting.

6. AOB and next meeting The next meeting is scheduled for 27 March 2018.