Independent Oversight and Assurance Group on Tayside's Mental Health Services and the Tayside Executive Partnership minutes: May 2022

Attendees and apologies

Present

• Fiona Lees, Chair of the Oversight and Assurance Group
• Fraser McKinlay, Member of the Oversight and Assurance Group
• Grant Archibald, Chief Executive, NHS Tayside
• Greg Colgan, Chief Executive, Dundee City Council
• Phil Davison, Divisional Commander, Tayside, Police Scotland
• Thomas Glen, Chief Executive, Perth and Kinross Council
• Margo Williamson, Chief Executive, Angus Council

Apologies

• Stephanie Cymber, Mental Health Division, Scottish Government
• David Williams, Member of the Oversight and Assurance Group

Secretariat

• Rebecca Dey, Mental Health Division, Scottish Government
• Lucy Mcdonald, Mental Health Division, Scottish Government

Items and actions

Welcome

The Chair welcomed colleagues and thanked Thomas Glen for suggesting The Neuk as a venue for the meeting. The Chair highlighted that Wendy Given, Chief Operating Officer of The Neuk, would be providing an overview of their work prior to the commencement of formal business, and there would be an opportunity at the end of the meeting to have an informal chat with staff and service users.  The Chair also explained that the main business was to discuss each of the Oversight Group’s themed work plans and the progress on these.

Minutes from the previous meeting and matters arising

The minutes from the previous meeting on 28 February 2022 were agreed.

There remained an outstanding action for Tayside Executive Partners to provide the Oversight Group with a copy of their response to the Clare Haughey letter, dated 1 June 2020, regarding the review of integration schemes.  Action:  Grant Archibald will look into locating the letter.

Presentation from Wendy Given, The Neuk

Wendy Given then joined the meeting and following introductions, the Chair thanked Wendy, and her colleagues at The Neuk, for the use of their venue and hospitality. Wendy provided an overview of the service, explaining that The Neuk had been in operation since June 2020 but has been a 24 hour service since April 2021, providing mental wellbeing support to those who experience a mental health crisis. Staff include wellbeing mentors, a hypnotherapist and counsellors. People who present are offered 6 sessions to work on a wellbeing recovery action plan. Since opening, they have supported over 800 people.  Colleagues had the opportunity to ask questions and following discussion, the Chair thanked Wendy for her presentation and The Neuk for the work they do supporting people and keeping them safe.

Oversight Group - second quarterly report, progress on themed work plans, key milestones and final report

The Chair advised that the second quarterly report would be submitted to the Minister for Mental Wellbeing and Social Care in the course of the next week. It was noted that this will not provide a reassessment of the 51 recommendations but will instead focus on progress made on the themed work plans, which have been shared with the TEP previously. It was confirmed that there will be a reassessment of the 51 recommendations, by the Oversight Group, which will be contained in their final report in October.

Work plan 1 - integration

The Chair noted that the draft revised schemes are either out for consultation, or consultation has concluded, and noting the proposed changes contained therein, consideration will need to be given to how these will be delivered operationally.

It was noted that at the next meeting of the Oversight Group and the TEP in July, the focus will specifically be on Integration and there are dates planned throughout June and July for the Oversight Group to meet with IJBs and Chief Officers to explore these themes in more detail.

Work plan 2 - patient safety

The Chair advised that the Oversight Group have almost concluded work on the patient safety work plan. The Group will be issuing a final question set, intended to capture any outstanding matters. The arrangements put in place to have an executive lead for the patient safety work plan (in this instance, Claire Pearce) have worked very well. In respect of recommendations 11 and 31, the Oversight Group are also seeking to engage a subject matter expert to review completed SAERs, following the introduction of new procedures, and are in conversation with Scottish Government colleagues on this.

The Chair highlighted that the Oversight Group had spent time in the wards at Murray Royal, Carseview and Strathmartine, and had the opportunity to hear from Senior Charge Nurses regarding de-escalation and enhanced observation protocols, and were assured that significant work was underway in this area. There is an outstanding matter which is a request to see the data that is being routinely collated by NHS Tayside that demonstrates the positive impact of the implementation of the improving observation protocol within inpatient units - this will be included in the final question set.

The Chair advised that the Oversight Group will be making 3 recommendations to the TEP in the second quarterly report, based on conversations to date and visits to the hospital sites. These will cover progressing the decision about single site provision in Tayside for inpatient mental health care as a matter of priority, taking action to improve the physical environment at Strathmartine and addressing the impact of delayed discharges.

Colleagues further discussed the next steps needed to progress towards single site and recognised there is a need to engage with communities on this whilst being mindful of expectations. It was acknowledged that a decision on single site was made 4 years ago but since then, little progress had been made to date. TEP recognised that this needed to be progressed with a degree of urgency.

Work plan 3 - engagement and culture

It was noted that the culture and engagement work plan will be the area of focus in early August and includes 15 recommendations. The Oversight Group highlighted that they have received feedback regarding defensiveness around the topic of leadership culture in mental health and highlighted that there is a need for the TEP to demonstrate that the culture within Tayside is open and willing to change.          

Work plan 4 - workforce

The Oversight Group discussed the key issues in relation to workforce, in particular the extent to which staff in inpatient and community services felt safe and secure to speak up regarding issues or concerns. The Oversight Group were looking forward to making progress on this work plan and having the opportunity to meet colleagues and undertake workforce visits. TEP discussed the difficulties regarding recruitment, particularly clinical psychiatrists, and the need to look for guidance and models elsewhere which could support this.

Work plan 5 - governance

Whilst not a published work plan, the Oversight Group briefly discussed progress to date on governance, including their attendance at key NHS Tayside standing committees, IJB meetings and their plans to meet with the new IJB chairs, vice-chairs, along with Chief Officers, in the coming weeks.

Final report

The Chair confirmed that the third quarterly report will be published in early August and the final report is due to be published at the end of October. In the case of the latter, consideration was already being given to the content and structure. The final report will provide a reassessment by the Oversight Group of progress on the 51 recommendations and will also contain an assessment of the commitment and capacity within Tayside, for change and continuous improvement. This will include commentary on the leadership of the transition from Listen Learn Change to Living Life Well with an accompanying action plan and resource framework.

The Oversight Group will be asking the TEP to do their own reassessment and evaluation of the progress they have made, and guidance will be issued on how the Oversight Group would expect to receive that information. The TEP agreed to provide the Oversight Group with a final submission in September, setting out progress to date, an assessment of the current position and plans for future improvement.

Collective leadership - TEP update and reflections on Columba 1400

There was discussion regarding the future role of the Tayside Executive Partnership, with members highlighting that they had originally come together for the purpose of improving mental health service delivery but there is a need to continue to work together to deliver actions across all health disciplines, with a focus on health inequalities and poverty.

The TEP noted the Oversight Group’s feedback about the continuing need to engage with service users, those with lived experience and key stakeholders including MSPs and MPs.

The TEP reflected on their experience of Columba 1400, stating that they had found this to be a worthwhile experience that enhanced relationships by creating opportunities to listen to one another, to undertake problem solving and to generally reflect on the partners work together.

Any other relevant business

There was no other business.

Future business

• meeting on 5 July - focus on integration
• meeting on 29 August - focus on workforce and engagement & culture
• meeting on 26 October - focus on final report