Independent Review into the Delivery of Forensic Mental Health Services Planning and Collaboration Short Life Working Group minutes: 17 December 2021

Attendees and apologies

• Mr Gavin Gray (Chair)
• Ms Hannah Axon
• Ms Kate Bell
• Mr Jim Cannon
• Dr Ian Dewar
• Mr Gary Jenkins (from item four)
• Ms Lorraine Keith
• Mr James Meade
• Professor Lindsay Thomson
• Ms Linda Walker
• Professor Angela Wallace

Apologies

• Ms Catriona Dalrymple
• Mr Gordon Johnston

In attendance

• Ms Diane Buchanan
• Ms Jenny Coltman
• Ms Innes Fyfe
• Ms Maggie Young

Items and actions

Welcome and introductions

The Chair welcomed everyone and introduced two new members Mr Jim Cannon, Director of Regional Planning and Ms Linda Walker, Head Occupational Therapist in NHS Lothian & Allied Health Professional Mental Health Lead. These new members will represent the North and South regions respectively. A third new member is still being sought to provide experience of Forensic Intellectual Disability Services. 

Agreement of minute from previous meeting and matters arising

The note of the 19 November was accepted as an accurate record and members noted that all actions had been completed, except one planned for the New Year. The group agreed that an ongoing actions log would be helpful.

Action: the SG Project Team will produce an action log. Jenny Coltman.

Project documentation

Jenny Coltman presented draft project documentation to the group, including draft Project Initiation Document (PID), Timeline and Comms & Engagement Strategy. Jenny advised that a separate Risk Register will also be produced and that a Project Dashboard will be circulated ahead of each meeting to enable the group to easily track progress.

The group noted there are significant gaps between meetings and that it would be important not to lose momentum. 

Action: the SG policy team will look at setting up a shared platform where documents and other communications can be shared between meetings. Maggie Young/Jenny Coltman.

It was noted that although the original timeline for the work had changed, there was still a risk of delays due to pressures on services over winter. 

Action: any risks to delivery that members identify should be sent to Jenny Coltman. All members.

The PID will be enhanced by including a members’ roles and responsibilities. Members were reminded to submit this information. Notwithstanding the addition of this information, the group were content with the draft PID and agreed it accurately reflected the aims and objectives of project.

There was detailed discussion around the purpose of the group and its role in decision making. It was generally accepted that the group should consider itself to be working in service of the wider interest; that members should bring their expertise and act as conduits - ensuring communication to and from their networks/stakeholders and helping those with an interest to engage in the decision making process. 

Action: members agreed to provide the Scottish Government team with details of their networks, committees and groups, together with regularity and dates of planned meetings with these networks when there would be an opportunity to gather feedback and report progress of the work of the group. All members to provide relevant details and dates to the SG Project Team by end January 2022. 

Jenny presented the draft Communications and Engagement Strategy which stimulated discussion around stakeholder mapping and the varying levels of stakeholder accountability/responsibility. Members agreed to help map out those stakeholders with decision making authority; those who may be affected by proposed service changes as well as those who may not be directly impacted but continue to have an interest. Identifying all stakeholders and the various roles and relationships will enable consistent communication to the Short Life Working Group, key decision makers and those with an interest in Forensic Mental Health services as part of a wider distribution list.

Action: members will submit information around their networks, groups and stakeholders to enable the Scottish Government team to start to develop the stakeholder mapping exercise in advance of the next meeting in January. All members to populate an Excel spreadsheet with details of relevant stakeholders. This should be returned to SG Project Team ahead of 27 January 2022.

Approaches to planning, collaboration, governance and accountability

Definition of Forensic Mental Health Services

A discussion paper drawing from the findings of the Independent Review and some initial definitions was discussed from the perspective of how the group will support options identification and appraisal. The group discussed how consensus may be reached around a shared definition to help describe planning and operation of services. Consideration was given to:

• the essential elements of a forensic mental health service
• the unique elements of a forensic mental health service
• the benefits and risks of defined boundaries.

The group was keen to build on existing references and not look to reinvent these. It was suggested that the NHS Education for Scotland and School of Forensic Mental Health 'New to Forensic Mental Health Teaching Programme' might provide examples of useful language. 

Action: the SG Policy Team will undertake further research to develop the draft discussion paper and recirculate it to the group for further input. The aim is to arrive at a shared understanding of forensic mental health services and a working definition to use for decision-making. Diane Buchanan/all.

Approach to developing a long list of options to be explored and described.

The group discussed examples of different ways of organising small specialist services e.g. the Board as described in the Independent Review, a differently cast Board, a new Network, a collaborative model. The group considered that the question was what authorising environment was needed to address the issues set out by the Independent Review, and that it could be helpful to think of this as distinct from the clinical model of delivery.

The group discussed examples from other specialist health services in Scotland and beyond, as well as other sectors and industries towards identifying options for a long list of models for planning, operating and improving services.

Action: the Scottish Government policy team will circulate a template for the group to populate their ideas and suggestions for new service models. Diane Buchanan.

AOB

Kate Bell reiterated the importance of two way communication and asked members to assist this process by providing details of any groups or committees they lead, report to or are otherwise involved in. This information will be added to stakeholders lists for communication purposes and can be provided as part of the table that has already been circulated to members requesting their roles and responsibilities. Action: all members.

Gary Jenkins raised a point about managing expectations given the extra pressures on the system as a result of the COVID-19 Omicron variant. The Chair advised that wherever possible we would try to keep the work on schedule but that it was understandable that competing priorities of stakeholders may impact on our work whilst we are responding to the increased demands as a result of the pandemic.

Action: National Services Scotland and Health Improvement Scotland should be made aware of the work of the Short Life Working Group (SLWG) and the Chair will write to both organisations on behalf of the SLWG by end February 2022. Gavin Gray.

Date of next meeting: 27 January 2022.