Mental Health Scrutiny and Assurance Collaborative

Collaborative Aims, and Benefits

The Collaborative is a joint approach that establishes key principles for cooperation between scrutiny and assurance bodies. It supports defining roles, responsibilities, and actions to improve the scrutiny system, ultimately enhancing care quality, safety, and patient experience and outcomes. We would intend, where appropriate, for intelligence shared via the Collaborative to support scrutiny bodies strategic plans and Scottish Government policy.

Each individual organisation is directly accountable for their own delivery via their Board structures and is accountable for their own planning of core scrutiny, assurance and inspection and visit activities. This includes reporting and raising of concerns. Each scrutiny body will maintain its full statutory independence and decision-making authority and continue to operate as previously agreed with Ministers and Scottish Government sponsorship.

The Collaborative is designed to support coordination and information sharing without compromising the individual mandates or autonomy of participating organisations. There will be:

• Preservation of individual scrutiny and inspection and visit methodologies.
• Retention of separate reporting structures and agreed and approved escalation processes. This will help ensure complementary approaches and a comprehensive assurance of mental health services.
• Maintenance of independent decision-making processes.
• Clear delineation of roles within the Collaborative.

As a minimum, two primary scrutiny bodies will be consistently involved, namely the Mental Welfare Commission and Healthcare Improvement Scotland. The Care Inspectorate will be a secondary stakeholder as their inspections are undertaken in community settings which are not yet within scope.

All three bodies will continue to contribute to strategic discussions on the future of mental health scrutiny. A summary of bodies roles is offered at Appendix B.

Other bodies may be invited to contribute to scrutiny and assurance discussions where required. This may include, for example, Public Health Scotland, NHS Education Scotland, the Scottish Public Services Ombudsman, and Audit Scotland.

The Collaborative aims to:

1. Support and enhance existing mechanisms and opportunities for joint planning, coordination and delivery of inspection and visit activity and information/intelligence sharing to inform inspection activity (if appropriate).

2. Enable cross agency learning through sharing of scrutiny and assurance methodologies, findings and follow up to any recommendations made.

3. Support a strategic direction for scrutiny and assurance in mental health by identifying, addressing and escalating any gaps, supporting a pro-active and systematic approach to scrutiny and assurance activities.

4. Further supporting the promotion, protection, and realisation of people’s human rights.

5. Further promote the involvement of people with lived experience in scrutiny activity.

6. Identify and highlight to Scottish Government where legislative change may need to be considered to support the above actions, as part of the mental health law reform programme.

The Collaborative has the potential to enable a series of benefits:

1. Regular sharing of unique organisational perspectives with scrutiny and assurance partners to ensure broad ‘micro to macro’ understanding.

2. Improve and strengthen broader intelligence sharing, particularly with the Sharing Health and Care Intelligence Network through offering stronger 'thematic cluster’ feedback as it relates to mental health services. Consideration of collective intelligence as a potential early warning system and thus enable a proactive response to emergent risks or concerns.

3. Where appropriate, inform planning and focus of scrutiny and inspection activities by individual bodies.

4. Consideration and planning of joint scrutiny and inspections, where intelligence indicates this may be of benefit.

5. Where appropriate, leverage the statutory powers of individual bodies in response to concerns.

6. Where appropriate, identify and discuss examples of best practice gleaned through scrutiny and assurance activities, sharing with other relevant bodies.

7. Consider a collective response to published reviews which have set out a clear case for changes to scrutiny and assurance activities and strategically consider how to address gaps in assurance of mental health services.

8. Improved policy influence because of collective intelligence.

9. Strengthen the voice of lived experience.

10. Improve sharing of information from Scottish Government.

The Mental Welfare Commission will contribute to Collaborative discussions through:

1. Feeding back on specific findings from local visits, including areas identified for improvement and areas of positive/innovative practice.

2. Offering analysis of recurring themes from visits and associated recommendations.

3. Sharing learning from thematic reviews and investigations that have been published.

4. Sharing analysis of patterns/trends/themes from contact with the Mental Welfare Commission from professionals and members of the public (including people with lived experience and carers).

Healthcare Improvement Scotland will contribute to Collaborative discussions through:

1. The Quality Improvement Directorate will share relevant risks and intelligence.

2. Sharing relevant feedback from assurance activity that concern (secondary) mental health services within the agreed scope of this Collaborative.

3. Sharing analysis of patterns/trends/themes from contact with Healthcare Improvement Scotland from healthcare professionals and members of the public.

4. Reporting themes emerging from analysis of Significant Adverse Event Reviews in MH.

5. Sharing findings from the new national programme of Safe Delivery of Care inspections.

The Care Inspectorate will initially contribute to the Collaborative as a secondary stakeholder on an as required basis:

1. Sharing relevant feedback from regulatory visits that concern (secondary) mental health services within the agreed scope of this Collaborative.

2. Sharing analysis of patterns/trends/themes from contact with the Care Inspectorate from social work/care professionals and members of the public (including people with lived experience and carers).