Independent Review into the Delivery of Forensic Mental Health Services Planning and Collaboration Short Life Working Group: 27 January 2022

Attendees and apologies

Items and actions

Welcome and introductions and agreement of AOB

The Chair welcomed everyone and introduced Dr Jamie Kirkland, Consultant Clinical Psychologist Learning Disabilities Psychology Service for Children and Adults, NHS Fife. Dr Kirkland brings experience of Forensic Intellectual Disability Services.

Agreement of minute from previous meeting and matters arising

Jim Cannon noted that the minute was missing details he had raised about the development of options. Subject to this detail being incorporated, members accepted the minute as an accurate record. The minute will be published on the SG Website.

An Action Log and a Project Dash Board were circulated in advance of the meeting

The Action Log will be updated after each meeting and circulated to members to allow progress to be monitored.

The Project Dash Board includes the Risk Register and members should continue to flag any emerging risks to the SG project Team.

Members were content with both papers and had no comments. 

Approaches to planning, collaboration, governance and accountability

Case for Change Document

Dr Jamie Kirkland asked for clarification on the task in hand. The Chair advised the SLWG is working to address the findings of the Independent Review which led to the recommendation for a new NHS board with a robust options appraisal. They will also consider the other linked recommendations as they are affected by any options proposed. They will then make a recommendation to the Minister for Mental Health on a way forward.

Kate Bell presented the draft Case for Change document, setting out the rationale for change and the findings of the Independent Review which led to the recommendation that the current arrangements for strategic governance and oversight of forensic mental health services in Scotland are not sufficient and that a new NHS Board should be established.

The group agreed that this is a critical piece of work and it is vital that the document reflects the collective view of the current position and SLWG members, as subject matter experts, agreed to take ownership of the paper. This document is intended to assist in engaging and including wider stakeholders in the options appraisal process. The Case for Change document will be a standalone document but is likely to have supporting documents e.g. testimonials from those with lived experience.

The group agreed that work should be ongoing between meetings to keep progress on track. There was a discussion on how best to work collectively to flesh out the documents and the practicalities of that and how the Scottish Government team will support smaller groups, particularly in setting out descriptions of options.  

A working definition will be used in the Case for Change Document to promote discussion and to provide a scope that can be useful to the options appraisal process. The group noted that there are gaps in the data on current demand for services in the community, in prison and for the courts. The Case for Change document will reflect the data available to the Independent Review and any additional information that is accurate and useful about services. 

Action: The SG Project Team will recirculate the Case for change document by 7 February 2022. All members to provide written contributions by 16 February 2022.

Developing a long list of options

Innes Fyfe reminded the group that the options appraisal process had two main stages (long list to short list and short list to preferred option). There was work to do in order to prepare for the first workshop where the wider group of stakeholders will consider the long list of options alongside the group members. She explained the different ways that have been considered to generate options (level of governance change, services and diagnostic groups included) and that further work was needed to gather more ideas and to describe the long list options. 

The group discussed the purpose of the long list of options and it was clarified that the role of the group is to propose a model for forensic mental health services that provides oversight of a single system and provides a ‘central brain’. Each option on the long list should offer a different way of providing this. The question is what model will best solve the problems highlighted in the Barron Report, what does that mean for the way people deliver the service and how it will improve patient care?

The group agreed to describe options for the long list in terms of how it would improve current services and incorporate quality assurance and consistency of practice. The criteria for the short listing workshop in April  will be set out using the six dimensions through which quality is expressed: safe, effective, patient centred, timely, efficient and equitable.  The group agreed that additional information such as the principles of realistic medicine, or current work in the health and social care landscape would supplement the criteria, but that the six dimensions would still be the approach. 

The SG Project Team did not receive sufficient feedback for the long list of options following previous meeting and members were asked to consider providing a description of each option for inclusion in the long list so that they may be discussed effectively at the first workshop in March.

The group agreed that it would be helpful to work in smaller groups or pairs to develop the long list of options and to establish descriptions including benefits and risks for each option before re-grouping to discuss. One person from each group should then share their findings at the next meeting or workshop.

A decision is needed on who presents the finalised long list of options at the first workshop.

Action: The SG Policy Team will produce a template and support small groups or pairs to make sure that the level of detail is similar across the options and will be in contact to arrange meetings. SG Policy Team.

Timeline and schedule of meetings

The group discussed a timeline and schedule of meetings, in particular considering the work that was needed to prepare for workshops. Given the ongoing restrictions, it is highly probable that workshops will be undertaken virtually.

The longlist of options will be brought to the first workshop in March with a view to producing a  shortlist that will then be further developed for the second workshop in April. The second workshop will consider and score the shortlist. The group agreed that it will be important to ensure participants fully understand the process of producing the long list and the process to reach a short list of of options.  It is also desirable to maintain consistency/continuity of attendance between the workshops, however there is the option to pre-brief any participants who are coming to the workshops ‘cold’.

Consideration should be given to using pre-existing groups e.g. social work groups. It was pointed out that there will be local elections in May 2022 and this may impact on the participation of some stakeholders. This will need to be factored into timings.

The following dates are proposed

• SLWG fourth meeting: Tuesday 22 February - 13:00 - 14:30
• SLWG fifth meeting: Tuesday 22 March - 13:00 - 14:30
• first workshop: Tuesday 8 March - 10:00 - 16:00
• second workshop: Tuesday 12 April - 10:00 - 16:00

Formal calendar holds will be issued following the meeting and members agreed to advise regarding their availability as soon as possible.

Action: The SG policy team will issue calendar invites for these dates. Maggie Young.

Consultation and engagement

A stakeholder spreadsheet was circulated to members on 12 January asking for information on stakeholders who should be involved in the process of options appraisal and to what extent. Jenny Coltman clarified the request explaining what is required from members and what is meant by various stakeholder groups:

• Inform (Openness): Provide these stakeholders with balanced and objective information to help them understand the process, the problem, and the options
• Involve (Validation): Gather feedback from these stakeholders on the process and progress to assure and gain validity for the process and result
• Collaborate (Decision making): Partner with stakeholders at each stage of the decision-making, including developing option ideas and choosing the preferred option together

Action: Any member who hasn’t already done so, is asked to provide information on stakeholder groups or individuals that they feel should be included as soon as possible and by the 10th February. A priority is to draw up a list of attendees for inclusion in the invitation to participate in the workshops in March and April – so any stakeholders in the ‘involve’ and ‘collaborate’ groups are key. This information can be provided either by populating the original spreadsheet or by email. 

Action: Jim Cannon asked if he should contact counterparts in the other regions to ask about stakeholders and agreed to have a separate discussion with Jenny regarding this. Jim Cannon/Jenny Coltman.

AOB

Dates of next meetings and workshops

• SLWG fourth meeting: Tuesday 22 February - 13:00 - 14:30
• SLWG fifth meeting: Tuesday 22 March - 13:00 -14:30
• first workshop: Tuesday 8 March - 10:00 - 16:00
• second workshop: Tuesday 12 April - 10:00 -16:00