Independent Review into the Delivery of Forensic Mental Health Services - Planning and Collaboration Short Life Working Group minutes: 24 January 2023

Attendees and apologies

• Mr Gavin Gray (Chair)
• Ms Hannah Axon
• Ms Kate Bell
• Mr Gary Jenkins
• Mr Gordon Johnston
• Dr Jamie Kirkland
• Ms Julie Lusk
• Mr James Meade
• Ms Nicola Paterson
• Professor Lindsay Thomson
• Ms Linda Walker

Apologies

• Ms Diane Buchanan
• Mr Jim Cannon
• Ms Michele Mason

Items and actions

Update

The chair welcomed everyone and recorded apologies. He then explained that there was not an agenda because today’s meeting was to update the group on the way forward following consideration of the group’s conclusions and to allow for discussions.

The chair apologised for the delay in coming back to the group, but as all are aware there are a lot of challenges across SG and services, including winter pressures, budgets and the development of the National Care Service. He recapped the outcome of the group’s work, that there was no clear preference for a board or a structured partnership approach but there was a desire for change. 

In light of this and as a sensible step forward Ministers are looking to put in place a collective leadership group, representing key interests, that will have more of a structured focus on resolving some of the longstanding issues in forensic mental health service delivery. This will include accelerating a programme of delivery across the other recommendations of the Barron Review. It will also allow space to consider whether a collective leadership group is enough or whether something else is required to deliver the governance needed for forensic mental health services as a whole system. The collective leadership group will build on the good work of the Forensic Network through collaboration and cooperation, but with more authority. To achieve that there would be a direct link between the collective leadership group and the Minister for Mental Wellbeing and Social Care.

Over the next month or so there will be detailed engagement on what the collective leadership group should look like, what it should cover etc. The intention is for the group to be up and running within the year, hopefully by the summer.

Discussion

Mr Jenkins felt that it was good to get a decision about a collective way forward. The world of health and care has moved in a way that is going to require change anyway. It is reasonable not to lurch out to a new board. Better strategic approach and moving forward on a collaboration basis will remove some of the inertia currently in place. Cross-system activity stalled in light of the Barron review. It would be helpful to identify short- and medium-term wins.

Mr Kirkland noted that during the course of the short life working group the focus had moved from strategic thinking to the senior management of services. He asked how the voices of lived experience would be involved in the collective leadership group. In response, the chair said that there would discussion with stakeholders on membership of the group and that the voices of all would be needed. The Minister will want engagement with those with lived experience at the heart of any new approach.

Professor Thomson said she was pleased that we are working towards a mechanism to take forward Barron recommendations. She emphasised that this mechanism must have authority and that people on it have the authority to act. There is a desire for action to go at pace as there are some plans in place on some of the other Barron recommendations.

Ms Lusk said the work of the short life working group was a really positive piece of work, it will allow us to make better connections between the state hospital and the community. Everyone agrees where issues lie – housing, care packages etc. and she looks forward to seeing what the future direction looks like.

Mr Johnston noted that we are in interesting times with lots of big developments which are all inter dependent. It feels knotted. He asked what kind of group the collective leadership group is going to be – advisory etc. The chair responded that this will be part of the discussions on the role of the group, we want to hear from all interested parties.

Ms Axon said it was important to have clarity around the terms of reference for the collective leadership group, including what is meant by community support, for example.

Professor Thomson said that at moment mental health is in the National Care Service, but not forensic mental health services. It would be difficult for forensic mental health to be treated differently to other mental health services as there is a need to maintain links with other mental health services and mental health care and treatment in the community. The chair said that discussions on NCS remains ongoing, but it was important not to let that hold us back.

Mr Jenkins asked about communicating the way forward as a consistent message was needed. The Chair confirmed that there will be communication to members of the short life working group and chief executives providing an update on the work of the group and the way forward. There was also an outstanding commitment to publish a progress update on delivery of the Barron recommendations. Professor Thomson said it would be helpful if communications could issue prior to 10 February which is when the Forensic Network’s Inter-Regional Group next meets.

Ms Walker asked whether existing groups had been considered rather than establishing a new group. The chair responded that we have looked at some of that as we do not want to duplicate what exists.

As she would not be involved in the project moving forward, Ms Bell thanked everyone for all their work as part of the short life working group. The chair echoed that thanks and that if there were any queries following the meeting members could message him, Diane or Nicola.

With no further comments or queries, the meeting ended.

Actions

• Scottish Government to take forward detailed engagement on the shape and focus of the collective leadership group over the next month or so. This should include:
  • involvement of people with lived experience;
  • clarity on terms such as community support; and
  • the need for the collective leadership group and its members to have authority
• Scottish Government to share the final report of the Group with SLWG members prior to its publication
• Scottish Government to communicate the outcomes of the Group’s work and the way forward. The aim should be to do this before 10 February
• Scottish Government to publish a progress update on delivery of the Barron recommendations (outstanding action)