Independent Oversight and Assurance Group on Tayside's Mental Health Services

Closing Remarks

387. We have been privileged to serve as the Independent Oversight and Assurance Group for Tayside's Mental Health Services. It has been an honour to accept the responsibilities which accompany our appointments.

388. We have listened hard to what people have told us. And we have asked lots of questions! We know we have brought support and challenge and at all times we have sought to be a helpful presence. We are thankful to the teams in Tayside for their openness and their patience: we have appreciated their welcome and the way they have worked with us. From all of our engagements with staff working across Tayside, we have been so impressed by their care and compassion and the commitment they demonstrate for change.

389. Tayside Executive Partners have undoubtedly made progress implementing the recommendations from Trust and Respect, some of it commendable and in key areas. There does, however, remain a significant gap between Tayside's assessment and our own. When we were appointed, we said that we believed the gap between where Tayside were and where they needed to be, was one that is capable of being closed. Having spent more than a year working with teams and communities across Tayside, we continue to hold that view.

390. In this report, alongside our assessment of progress, we also highlight what we think still needs to be done. We hope that our report is written in such a way that is helpful and reflects confidence on our part that the further improvements and actions that are required, should be capable of being achieved. Chief amongst those actions are the Key Priorities we highlight at the beginning of this report, not least the need to redesign inpatient services and for them to be located on a single site.

391. As we conclude our work, we are conscious that it will shortly be the third anniversary of the publication of Trust and Respect. People have attached importance to the establishment of the Oversight Group reporting, as it does, directly to Scottish Ministers. Looking ahead, people have told us that they are concerned about a potential loss of momentum and progress stalling. People have been here before. Therefore, the question that remains is what is going to be different this time to ensure that communities across Tayside receive safe and effective mental health services in which they can have trust and confidence.

392. We particularly welcome the improved clarity that is provided by the revised integration schemes in Dundee, Angus and Perth and Kinross. Importantly, the collaborative approach that has been put in place across the Integration Authorities through the Chief Officers, together with the Executive Director of Nursing and the Medical Director in the Health Board is, in our view, a model to be replicated elsewhere. More than this will be required, however, and this group will need to receive and benefit from the collective leadership of Tayside Executive Partners.

393. In all of our meetings with Tayside Executive Partners, they have reiterated that they have no formal governance role. We agree with that. They do, however, have a vital collaborative leadership role: they need to use that to best effect to empower staff to work with communities, across organisational boundaries and to support Members of the Integration Joint Boards, Health Board and Councils, to take the decisions that will be necessary to effect change in Tayside.

394. Given the breadth of our report, it is perhaps easy to focus only on what is happening in Tayside. There were two recommendations within Trust and Respect that were for the Scottish Government and in our assessment, progress here could have been quicker. We believe that there is much within our report, beyond these two specific recommendations, where effective collaborative working between the Scottish Government and colleagues in Tayside is required to deliver the change that people need to see.

395. Our final word must go to the people in Tayside who have told us their stories. We

have been humbled and heartened in equal measure. At times we have also been harrowed by the unimaginable pain some families have experienced. We have listened to patients, their families and those who have been bereaved through suicide. We have heard from third sector and community organisations who offer kindness, care and support. These are different people from different places but what unites them is a desire to help others and to create community hope. For all of that, they have our thanks and admiration.

Fiona Lees - Chair

Fraser McKinlay - Member

David Williams - Member

Independent Oversight and Assurance Group on Tayside's Mental Health Services

December 2022