National Review of Eating Disorder Services Implementation Group minutes: July 2022

Attendees and apologies

In attendance

• The minister Kevin Stewart

Co-chairs

• Dr Charlotte Oakley
• Dennis Robertson

Members

• Fiona Duffy
• Dr Stephen Anderson
• Fiona Huffer
• Dr Karen McMahon
• Susan Hynes
• Dr Lesley Pillans
• Dr Paula Collin
• Dr Helen Smith
• Ellen Maloney
• Officials from the Scottish Government (SG)

Apologies

• Gerald Donnelly
• Dr Joy Olver
• Ailsa Stein
• Johnathan Maclennan
• Diane Kane

Items and actions

Welcome and introductions from co-chairs

The chairs opened the seventh meeting of the national review of eating disorder services implementation group and welcomed members to the meeting. Apologies for the meeting were noted.

Approval of previous meeting minutes

The minutes from the previous meeting in June were shared by email and are confirmed. Members confirmed they were happy for the minutes to be published online.

Updates from chairs

The chairs, welcomed and thanked the minister for his support over the last year. The chairs provided an update on their meeting with the minister. It was agreed that there needs to be a transition period at the closure of the IG and the development of the national network. Working group leads are invited to continue being involved to assist with moving forward and repurposing the IG to support this transition.

It is recognised that it is important to allow time to set up and recruit for the national network and lived experience panel (LEP).

It is agreed to use beat’s conference on 27 September 2022 as a ‘launch pad’ to explain the next steps going forward, discuss recruitment opportunities etc. On the day, the IG group can use presentations, talks and workshops/ breakouts to facilitate this.

Updates from working groups

The training and skills working group have decided to prioritise three areas for future work by the national network:

• Specialist skills development/training for ED as there are still gaps in training provision identified
• Educational training for medical monitoring
• The educational psychologist is looking at evaluating the work that has been developed by beat within Glasgow and then hopefully this will help promote rollout across the country

The group have created a spreadsheet of all known training offers across the boards. Usual resource to integrate to see where efficiency in delivery can be made and the national network could help standardise or create a national even provision.

New initiative re gaining ‘credential’ status with general medical council in accessing a new UK-pilot scheme due to funding source (HEE). This would be to gain ‘credential’ status/ recognition. No more meetings are required.
The quality standards working group has met 5 times already and has developed a good first draft where the components of the national review and the evidence based are mapped into the standards focusing on equity of care (geographically, age etc.), early intervention and quality of care, and ease of access to services. Two distinct sections came up:

• structure and design of services (underpinned by lived experience comments) 
• delivery of care mapped as a journey for a patient and looking to increase diversity of offers and increase access and make more community based

The group is aiming for the highest quality standards for Scotland. They plan to have the next draft to the IG, for feedback, by the end of August. This will allow for the standards to be in a good form to be discussed during beat’s conference on 27 September while aiming to follow the healthcare improvement Scotland’s guidance to make sure they are robust.

The data working group reported their discussions with PHS had been very limited. Close work needs to happen to ensure that there is no duplication of data collection and also to identify gaps in what is actually being captured including both in patients’ and outpatients’ mental health data. The group is working towards the second and final meeting along with LEP members and PHS colleagues to identify additional data that need to be collected to cover outpatients, inpatients, day care, children, adolescents and adults. The group aim to use beat’s conference on 27 September to run a workshop and use it as part of a consultation process.

Minister session

The minister thanked the IG and SG officials for their contribution and dedication. He acknowledged that it is a priority for the next steps to get it right and that some ED services are fantastic but not equal across country. Difficulties in service provision were already there pre-pandemic and exacerbated during the pandemic. Aspires to move ED and other MH and wellbeing offerings into community based services so that people do not reach crisis point. However, it is acknowledged that there still is a need for acute services. He would like the reporting to conclude by end of August to inform his future thinking and strategy planning/development.

Lived experience panel to be reflective of the ED community inclusive of neurodiversity (autism).

Workforce – recognised difficulties in recruitment and retention, because of frequent staff turnover, Brexit etc., and therefore sustainability.

Better targeted advertising and promoting of Scotland and all areas as being good place to work.

Better and earlier promoting of mental health services as a career in the NHS – perhaps in schools etc.

Workforce strategy planning is looking at all these areas and should be reporting by mid next year.

Identity and look to plug gaps e.g. medical support psychology, psychiatric clinicians and professional staff etc. for the longer term.

GP surgeries and involvement – it was agreed that the service being provided by GPs for ED patients can vary across the country and within health boards. There needs to be a campaign to raise awareness with GP surgeries and to develop ways to ensure coordination for community and primary care for ED patients. There is a lot of work to be done in this area in changing attitudes and communication between services but this must be moved forward.

IT infrastructure – it was recognised that there were major problems with the IT infrastructure across boards and the NHS as a whole. It is recognised that systems needs to be integrated and the ability to work remotely needs to be refined so that specialist staff can work across areas particularly in rural environments.

Flexibility in hours. The minister acknowledged that the concept and availability of flexibility for staff hours, job share etc. needs to be improved and become more comparable with the private sector to help retention of skilled staff.

Update on eating disorder lived experience panel

The comments and feedback from latest reiteration has been positive and welcomed. A fuller update will be sent round by email as some discussion was still going on with beat and SG officials. Once completed, a submission will be submitted to the minister for approval. The funding position will then be finalised and beat can start their recruitment campaign.

Close of meeting and AOB

Meeting closed at 12:00.

Next and final meeting agreed as 26 August at 11:30 to 12:30.