Mental health and wellbeing strategy: Leadership Board - terms of reference

Background

The Mental Health and Wellbeing Strategy: Delivery Plan 2023-2025 and Workforce Action Plan 2023-2025 were published jointly by Scottish Government and COSLA on 7 November 2023. These documents set out the actions that we will take to make progress towards the outcomes and priorities in our new Mental Health and Wellbeing Strategy, which was published on 29 June 2023.

The strategy sets out a clear vision for future population mental health, wellbeing and care, and our priorities to help us get there. Our shared vision is “of a Scotland, free from stigma and inequality, where everyone fulfils their right to achieve the best mental health and wellbeing possible”.

Key areas of focus and outcomes

The focus of the leadership board will be on supporting and ensuring progress towards the stated outcomes (listed in full at annex A) in the Mental Health and Wellbeing Strategy in order to:

Promote positive mental health and wellbeing for the whole population, improving understanding and tackling stigma, inequality and discrimination;

Prevent mental health issues occurring or escalating and tackle underlying causes, adversities and inequalities wherever possible; and

Provide mental health and wellbeing support and care, ensuring people and communities can access the right information, skills, services and opportunities in the right place at the right time, using a person-centred approach.

Purpose and remit

The purpose of the leadership board will be to support and oversee the delivery of the ten priorities in the Mental Health and Wellbeing Strategy (listed in full at annex B) and related actions set out in the Mental Health and Wellbeing Strategy Delivery Plan and the Workforce Action Plan. In particular, the leadership board will:

• ensure that the Joint Chairs have access to information and perspectives as appropriate to inform decisions relating to the delivery of the strategy
• provide national, collective leadership and strategic oversight of priorities
• ensure that activity is ongoing which delivers clear benefits and improvements, aligned with the strategy’s vision, outcomes and principles
• oversee the financial framework for delivery, and support consideration of the prioritisation of resources
• provide constructive support, scrutiny of progress and challenge as appropriate, considering any risks or issues raised, ensuring progress against actions set out in the delivery plan and workforce action plan, influencing change and removing barriers to progress
• in doing so, engage directly with those leading commitments in the delivery plan as needed
• agree the mechanism for, and provide oversight of, evaluating the impact of interventions and sharing learning
• make recommendations on future refreshes of the delivery plan and workforce action plan

To support its work, the leadership board will ensure that it connects with wider relevant groups where appropriate to capture diverse perspectives, including on lived experience, data and evidence etc. 

Governance and accountability

The leadership board will be jointly chaired by the Minister for Social Care, Mental Wellbeing and Sport and the COSLA Spokesperson for Health and Social Care. It will connect the Mental Health and Wellbeing Strategy with work across the policy and delivery landscape, including with other relevant strategies and programmes. This TOR can be amended over the course of the coming months to give more information on how those connections will function. 

The leadership board will report, as appropriate, into Scottish Government and COSLA governance structures. 

The governance structure is set out in full at annex C. It is likely that updates will be needed on an ongoing basis to ensure this structure remains fit for purpose. 

Acknowledging the split of national and local responsibilities for mental health and wellbeing, the board will also connect (through its members) with other formal governance groups as required. This will include NHS Chief Executive and IJB Chief Officer groups.

The leadership board is not established on a statutory basis. It is, therefore, not subject to the formal public appointments process and the requirements of the Code of Practice for Ministerial Appointments to Public Bodies in Scotland. 

Code of conduct

All members of the leadership board, including the Joint Chairs, agree to work together in the following ways:

• to work in accordance with these terms of reference for the leadership board
• to work individually and collectively to progress the purpose and remit of the leadership board
• to promote a safe, supportive, respectful and sensitive environment for members and those participating in its work
• to attend the majority of meetings
• to observe good time keeping
• to prepare effectively for meetings and engage appropriately in agreed activities between meetings
• to take individual responsibility for engaging and completing any assigned tasks

The leadership board will respect the sensitive nature of mental health and wellbeing and will seek to promote a safe and supportive environment for those participating in its work. 

The leadership board will respect the privacy and confidentiality of any personal experiences and information shared by individuals. It will be sensitive to the needs of all members and participants, including in respect of the language used, and will take a trauma-informed and responsive approach in its discussions and work.

Membership

Membership includes representation from a range of Scottish Government portfolio areas, local government, NHS boards, Integrated Joint Boards (IJBs) and the third sector. The board will be jointly chaired by the Minister for Social Care, Mental Wellbeing and Sport and the COSLA Health and Social Care spokesperson.

Members of the board are appointed to represent the interests of their respective organisations or networks, where applicable. It will be the responsibility of individual members to feed in the views of those organisations or networks to the leadership board as appropriate. It will also be for board members to feed back to them on the work of the board. We recognise that this may occasionally be difficult based on the breadth of the groups they are representing but in accepting the invitation, members undertake to input a wider perspective than their own personal views/experience. We also recognise that on occasion members may need to seek further views of those they are representing on arising issues and require time to do so. 

All members of the leadership board will be asked to declare any conflicts of interest. These will be kept on a register of interests, to be maintained by the Secretariat. Any action to be taken on the basis of these declarations will be at the discretion of the Joint Chairs. 

Membership is on a voluntary, non-remunerated basis.

Other individuals and organisations may be consulted on relevant issues. Such individuals and organisations may be invited to attend meetings as and when appropriate. 

Operation of the leadership board

Support for the leadership board will be provided by Scottish Government and COSLA run Secretariat.

The leadership board will meet three times a year, with a quorum of one half of its external (non-Scottish Government/COSLA) membership, with the flexibility to have fewer with the Joint Chairs’ agreement. Should the need arise, the group will meet more frequently and meetings will last no longer than two hours. 

Meetings will be formal with an agenda, minutes and other relevant papers circulated two weeks in advance via email. Items agreed and actions to take place will be documented within the minutes. Draft minutes will be approved by the Joint Chairs prior to circulation, following which members will confirm with the secretariat whether they are content with the minutes and any actions allocated to them.

The leadership board will operate in an open and transparent way. The terms of reference, reports, membership and minutes of meetings will be published on the Scottish Government’s website. 

In taking work forward, the leadership board will consider and apply the principles set out in the Mental Health and Wellbeing Strategy (listed in full at annex D).

Membership of this board, and its rationale, purpose and terms of reference, will be reviewed yearly or at the discretion of the Joint Chairs. It is likely that updates will be needed on an ongoing basis to ensure the board remains operable and relevant, and has the right representation to ensure delivery.

The Joint Chairs are responsible for leading meetings of the board and for agreeing the board’s strategic direction and business. 

Decision-making on Scottish Government funding will necessarily remain with ministers, just as local government funding decisions will remain with local authorities. However, Joint Chairs will consider decisions on a collaborative basis in regards to board decisions. To inform their decision-making, the Joint Chairs will use board meetings to take views, and seek consensus, from board members. 

Every effort will be made to ensure members are able to discuss issues for decision or clearance at a board meeting. If it is not possible to facilitate a discussion at a board meeting due to timeframes, details will be circulated for clearance via correspondence.

Although they will be representing wider perspectives during meetings, board members are appointed individually and personally, and are expected to make every effort to attend all meetings of the leadership board. The attendance of deputies will only be accepted with the agreement of the Joint Chairs.

Members should actively engage with the work of the leadership board, taking responsibility for and progressing any actions agreed by the board. Representatives of key delivery partners are represented on the board in the expectation that they will work with their respective colleagues to support the implementation of any changes agreed by the board.

All members, including the Joint Chairs, will be active advocates for the Mental Health and Wellbeing Strategy, Delivery Plan and Workforce Action Plan and the work of the leadership board. Members will share and promote collaborative leadership within their representative organisations and broader communities to deliver the commitments of the strategy, delivery plan and workforce action plan. 

Escalation

Where there is an issue arising related to the MHW strategy, the Secretariat will discuss, with a presumption of an initial discussion at the executive group. Where any issue cannot be resolved mutually at the executive group, or where it is more appropriate, issues will be escalated to the leadership board. In some instances, it may be more appropriate to refer issues to an alternative mechanism to be resolved (for example, the Joint Strategic Board for Children and Family Mental Health for relevant issues related to children’s mental health policy), referring to the leadership board if still required thereafter.

Mental Health and Wellbeing Strategy outcomes (annex A)

The outcomes below are set out in the Mental Health and Wellbeing Strategy and are underpinned by the actions in the accompanying delivery plan. Our outcomes describe the differences or changes that we want to see as a result of this strategy. They are:

• improved overall mental wellbeing and reduced inequalities
• improved quality of life for people with mental health conditions, free from stigma and discrimination
• improved knowledge and understanding of mental health and wellbeing and how to access appropriate support
• better equipped communities to support people's mental health and wellbeing and provide opportunities to connect with others
• more effective cross-policy action to address the wide-ranging factors that impact people's mental health and wellbeing
• increased availability of timely, effective support, care and treatment that promote and support people's mental health and wellbeing, meeting individual needs
• better informed policy, support, care and treatment, shaped by people with lived experience and practitioners, with a focus on quality and recovery
• better access to and use of evidence and data in policy and practice
• a diverse, skilled, supported, and sustainable workforce across all sectors

Our priorities (annex B)

• tackle mental health stigma and discrimination where it exists and ensure people can talk about their mental health and wellbeing and access the person-centred support they require
• improve population mental health and wellbeing, building resilience and enabling people to access the right information and advice in the right place for them and in a range of formats
• increase mental health capacity within General Practice and primary care, universal services and community-based mental health supports. Promote the whole system, whole person approach by helping partners to work together and removing barriers faced by people from marginalised groups when accessing
• expand and improve the support available to people in mental health distress and crisis and those who care for them through our national approach on Time, Space and Compassion 
• work across Scottish and Local Government and with partners to develop a collective approach to understanding and shared responsibility for promoting good mental health and addressing the causes of mental health inequalities, supporting groups who are particularly at risk
• improve mental health and wellbeing support in a wide range of settings with reduced waiting times and improved outcomes for people accessing all services, including Child and Adolescent Mental Health Services (CAMHS) and psychological therapies
• ensure people receive the quality of care and treatment required for the time required, supporting care as close to home as possible and promoting independence and recovery
• continue to improve support for those in the forensic mental health system
• strengthen support and care pathways for people requiring neurodevelopmental support, working in partnership with health, social care, education, the third sector and other delivery partners. This will ensure those who need it receive the right hand care and support at the right time in a way that works for them
• reduce the risk of poor mental health and wellbeing in adult life by promoting the importance of good relationships and trauma-informed approaches from the earliest years of life, taking account where relevant adverse childhood experience. We will ensure help is available early on when there is a risk of poor mental health, and support the physical health and wellbeing of people with mental health conditions

Governance structure (annex C)

MHW Leadership Board 

The MHW Leadership Board will provide national leadership and strategic oversight of priorities; ensuring progress against actions set out in the delivery plan and that activity delivers clear benefits. The board will be jointly chaired by the Scottish Government and COSLA at ministerial/spokesperson level and membership will include representation from across SG portfolio areas, local government, NHS boards, IJBs and the third sector. 

The leadership board will initially meet three times a year. Papers for the board’s consideration will be prepared by the Secretariat, in addition to those provided by external sources, hosted by the Scottish Government’s Mental Health Directorate. 

SG-COSLA Executive Group 

A small, joint, official-level SG-COSLA Executive Group will be formed as a mechanism for early discussion of any issues arising in relation to policy/delivery issues.

Leadership board secretariat

The Secretariat will facilitate and support the effective running of the leadership board and executive group as set out in their terms of reference. It will support the groups in executing their remit by providing a central co-ordination and administration function, facilitating communication between them, and the rest of the Mental Health and Wellbeing Strategy governance structure, programmes and workstreams, Programme Management Office and wider stakeholder network. The Secretariat will circulate discussion materials to the various groups.

Advisory groups

In order to properly fulfil its role, the MHW Leadership Board will require access to a range of information and expertise. The board will have direct access to key advisory groups, including the Equality and Human Rights Forum and Diverse Experiences Advisory Panel. These groups will feed into the board as well as informing programmes and workstreams.

Scottish Government/local government governance groups 

Given the cross-portfolio nature of the strategy, it will be important to make connections at a senior level with governance groups for related pieces of work, particularly those overseeing wider interests across the system (e.g. NCS). The leadership board will play a key role in making those connections and exchanging information with relevant SG and LG governance groups.  

SG Programme Management Office (PMO)

The PMO provides portfolio oversight and programme management support for all current mental health policy led by Scottish Government. This includes actions related to the joint Mental Health and Wellbeing Strategy. The PMO will provide the Secretariat with progress reports and a high level summary on the Mental Health and Wellbeing Strategy-related actions, bringing together COSLA and Scottish Government reporting on progress and arising issues. The Secretariat will then discuss the collective reporting and mutually agree next steps, including, based on agreed criteria, whether discussion at an executive group meeting is required. 

Aside from the provision of reporting as described, the PMO is not a formal part of the MHW Strategy governance structure. 

Core principles (annex D)

• founded on equality and human rights
• focused on the mental health and wellbeing of individuals, families, communities and society, supporting those who are impacted by mental illness
• outcomes-focused
• trauma-informed and trauma-responsive
• based on a 'whole person' approach. This means looking at a person and their wider circumstances (like housing, relationships, physical health, employment etc.), not just their mental health
• driven by data and evidence
• developed and delivered in partnership with partners, stakeholders and the public
• based on a 'no wrong door' approach. This means anyone asking for help with their mental health and wellbeing should be able to access the right support, care and treatment, regardless of where they first request it
• informed by the voice of people with lived experience and practitioners, including marginalised groups, children and young people
• based on a 'life stage' approach. This means it is focused on prevention, early detection, recovery and treatment of mental illness and poor mental wellbeing, identifying opportunities for minimising risk factors, enhancing protective factors and providing appropriate support at important life stages