Perinatal and Infant Mental Health Programme Board minutes: 1 September 2021

Attendees and apologies

Author:

• Alex Brown

Present:

• Hugh Masters, Chair, Scottish Government
• Kaylie Allen, Head of Funds, Inspiring Scotland
• Sally Amor, Child Health Commissioner, NHS Highland
• Elizabeth Archibald, PNIMH Service Development Adviser, Scottish Government
• Hannah Axon, Policy Manager, COSLA
• Laura Bennison, Everyone’s Business, Support Coordinator, Maternal Mental Health Alliance
• Alex Brown, Assistant Programme Manager, NHS National Services Scotland 
• Roch Cantwell, Vice Chair, NHS National Services Scotland 
• Helen Cheyne, Professor of Maternal and Child Health Research, University of Stirling
• Ruth Christie, Workstream Lead Children, Young People, Families and Relationships, Scottish Government
• Emma Currer, National Officer, Royal College of Midwives
• Amanullah Durrani, Consultant Perinatal Psychiatrist, Royal College of Psychiatrists
• Catriona Johnson, Associate Programme Director, NHS National Services Scotland
• Sally Ann Kelly, Chief Executive, Aberlour
• Jacqueline Lambert, Professional Midwifery Adviser, Scottish Government
• Anne McFadyen, Infant Mental Health Lead, Perinatal Mental Health Managed Clinical Network, NHS National Services Scotland 
• Ross McGuffie, Chief Officer, Health and Social Care, NHS Lanarkshire
• Clare McGuire, Head of Programme, NHS Education for Scotland
• David Pickering-Gummer, CAMHS General Manager, NHS Lothian
• Marie Claire Shankland, Programme Director, NHS Education for Scotland
• Helen Sloan, Nurse Consultant Perinatal Mental Health, NHS Greater Glasgow and Clyde
• Clare Thompson, Participation Officer, Maternal Mental Health Scotland 
• Harri Waugh, Head of Perinatal and Early Years Mental Health Team, Scottish Government

In attendance:

• Kelda Gaffney on behalf of Jackie Kerr, Interim Head of Adult Services/ Specialist Mental Health Services, NHS Greater Glasgow and Clyde
• Barbara Kennie, Perinatal and Early Years Mental Health Team, Scottish Government
• Irene Permaul, Perinatal and Early Years Mental Health Team, Scottish Government
• Paula Sheils on behalf of Sheila Gordon, Head of Counselling Services, CrossReach

Apologies

• Fiona Fraser, Consultant Clinical Psychologist, NHS Greater Glasgow and Clyde
• Sheila Gordon, Director, CrossReach
• Jackie Kerr, Assistant Chief Officer, NHS Greater Glasgow and Clyde
• Wendy Mitchell, Professional Adviser, Early Years and Children’s Services, Scottish Government

Items and actions

Welcome, apologies and housekeeping

Prof Hugh Masters (Chair) welcomed everyone to the fourteenth Perinatal and Infant Mental Health Programme Board (PB) meeting, and apologies were noted as above. Hugh advised that Dr Roch Cantwell would continue in the role of PB Vice Chair, and thanked Roch and the Scottish Government (SG) Policy Team for their hard work whilst Hugh was away working with the SG Chief Nursing Officer Directorate.

The minutes were agreed as an accurate representation of the May meeting. Roch provided an update on the Peer Support action plan. The SG Policy Team have engaged with the two Mother and Baby Units regarding Peer Support Workers, and, at the time of the meeting, were discussing funds to be released over the course of the coming year.

Lizzy Archibald was introduced as the new SG Perinatal and Infant Mental Health (PIMH) Service Development Adviser. Lizzy is a trained Occupational Therapist and has a clinical background in Child and Adolescent Mental Health Services (CAMHS) and Neurodiversity services. Lizzy has worked in NHS Grampian mental health services for 20 years, most recently as Allied Health Professions Manager. Lizzy will be working closely with the SG Policy Team and all PB groups to support Health Boards and services in the implementation of their PIMH service roll out. Introductory meetings for Lizzy are being organised with key stakeholders and implementation groups in the coming weeks, and Hugh encouraged PB members to make contact if interested.

PNIMH Programme Board updates

Harri Waugh (Head of Perinatal and Early Years Mental Health Team, Scottish Government) updated the group on recent progress:

Katy Lister has been promoted to Senior Policy Officer, and Fiona Wilson will fill that role on a short-term basis for the remainder of Katy’s maternity leave. Other vacancies in the team are going through the recruitment process

2021/22 Delivery Plan

Harri thanked all those that had given feedback on the PB’s draft 2021/22 Delivery Plan. Due to the large amount of input that needed to be considered and incorporated, and the drive to ensure a variety of viewpoints and accessibility, publishing of the final version had been delayed. Harri advised the group that this Delivery Plan would run September 2021-September 2022, rather than the financial year format of previous publications, given that the document would be launched over half way through the year.

Health Board monitoring

Following feedback from the Health Boards on the 2020/21 Monitoring template, the SG Policy Team are looking to make revisions to the document to improve ease of use for the Boards, and to also ensure that SG are collating the right information. Harri advised that Alex Brown (Assistant Programme Manager, NHS National Services Scotland) would share the 2020/21 template with PB members for their feedback on the elements of the document that needed to change, be removed, or definitely remain to allow for both emerging learning and consistency in reporting over time.

Action: Alex Brown/all

Harri explained that the Minister for Mental Wellbeing and Social Care requested monitoring reports for statutory services in each Board area with details on underspend and ongoing engagement. The report was compiled and recently submitted by the SG Policy Team. Harri stated that the documents gave a picture of the overall progress across Scotland, and, at the time of the meeting, there were two areas of significant concern, four needing extra support, and eight where service development was progressing well. The documents will be utilised by Lizzy Archibald in communications with Boards, and the Boards will be asked if they are happy for their monitoring information to be shared, with the intention of circulating the documents to PB members.

Paula Sheils (Head of Counselling Services, CrossReach) asked for clarity around what would be required from Third Sector organisations in future reporting. Harri clarified that there would not be an additional ask for organisations as the monitoring work and learning already established by Inspiring Scotland would be incorporated in the reporting.

Laura Bennison (Everyone’s Business Scotland Coordinator, Maternal Mental Health Alliance) agreed to clarify the request for information regarding PB allocations and spend out with the meeting, via email to the SG Policy Team.

Action: Laura Bennison

The Chair committed to providing more information on funding and progress of statutory services at the next meeting.

Action: Scottish Government Policy Team

Minister for Mental Wellbeing and Social Care Meeting

Ruth Christie (Workstream Lead, Scottish Government) gave an update on the meeting of the Minister with the PB Chair and Vice Chair, Clare Thompson (Participation Officer, Maternal Mental Health Scotland), and Dr Anne McFadyen (Infant Mental Health Lead, NHS National Services Scotland) in August. Ruth advised that the Minister is enthusiastic and wants to learn more about the PIMH agenda. The Minister is keen to see progress, and hopes to attend a PB meeting in the near future.

Subgroup updates

Workforce and sustainability

David Pickering-Gummer (CAMHS General Manager, NHS Lothian) chairs the Workforce and Sustainability subgroup, which has met three times and currently has a membership of 18 people. David advised that the focus of the subgroup is the statutory workforce, retention, wellbeing of staff, and sustainability of services.

In their first few meetings, the subgroup discussed the impact of Covid-19 on recruitment, and the current recruitment position in the Health Boards. Going forward, David has suggested collating the current wellbeing strategies of the Boards to develop an approach for PIMH and Maternity and Neonatal Psychological Intervention (MNPI) services, with the intention of protecting and sustaining the workforce. David emphasised the importance of collaboration across regional areas to ensure work is not duplicated.

The Workforce and Sustainability subgroup will meet the Equalities subgroup on 22nd September 2021 to discuss recruitment challenges and opportunities for collaboration.

Equalities

Helen Sloan (Perinatal Mental Health Nurse Consultant, NHS Greater Glasgow and Clyde) and SallyAnn Kelly (Chief Executive, Aberlour) co-chair the Equalities subgroup, which has met three times and currently has a membership of 19 people. Helen noted that the subgroup members were from a range of backgrounds; statutory services, the third sector, education and lived experience.

In their first few meetings, the subgroup discussed the Equality Impact Assessment (EQIA), and the Stigma literature review carried out by SG graduate intern, Aigli Raouna.
Dilraj Watson, Co-Chief Executive Officer at Amina Muslim Women’s Resource Centre, presented research findings on the impact of Covid-19 on black and ethnic minority women in Scotland. Lucy Warwick-Guasp presented on the NHS Greater Glasgow and Clyde (GG and C) Mental Health Network’s training on the needs and experiences of LGBTQ+ parents. Going forward, Helen anticipates further discussion on inclusive language, financial equality, and on how the subgroup can support services to identify appropriate and credible training.

Sally Amor (Child Health Commissioner, NHS Highland) asked if the EQIA encompasses responsibilities from the United Nations Convention on the Rights of the Child. Harri noted that the EQIA was focused on equalities rather than rights (which are assessed through a Children’s Rights and Wellbeing Impact Assessment), but committed the SG Policy Team to increasing awareness of how protected characteristics and intersectionality can differ between parent and child.

Action: Scottish Government Policy Team

Monitoring and evaluation

Prof Helen Cheyne (Maternal and Child Health Research, University of Stirling) chairs the Monitoring and Evaluation subgroup, which has met twice and currently has a membership of 12 people. In their first meetings, the subgroup discussed the PB Evaluability Assessment that was conducted by Public Health Scotland (PHS). Helen Cheyne advised that PHS had been asked to support the coordination of the evaluation studies outlined in the report, and were waiting for confirmation at the time of the meeting.
Going forward, Helen highlighted the importance of working closely with the Infant Mental Health (IMH) evaluation subgroup who have already produced advanced work.

Harri Waugh advised that a Scottish Social Science graduate intern will be starting work in 2021 on the literature component of the Evaluability Assessment, and hopefully bring that piece of work together with the existing literature on the impact of Covid-19 on PIMH.

SallyAnn Kelly stated that the PB needs to engage with the SG Collective Leadership Group for Children’s Services and other groups around evaluation expectations, and those links need to be visible in the Delivery Plan. The Chair and Ruth Christie agreed on the importance of cross-policy working, and assured SallyAnn that the PB would continue to connect with all relevant teams across SG.

Third Sector

Small Grants Fund

Harri Waugh advised that the Small Grants Fund assessment process had concluded and was waiting for ministerial approval. The process was conducted by Inspiring Scotland, and assessed by the SG Policy Team, the PB Chair and Vice Chair, and the same panel that were involved in the PIMH Main Fund process. Harri thanked Inspiring Scotland and the panel for their hard work and expertise.

Kaylie Allen (Head of Funds, Inspiring Scotland) advised that a key part of the Small Grants Fund assessment process was for the panel to consider gaps in the PIMH Main Fund, in terms of service provision and geographical area, to ensure a well-rounded portfolio. In total, 47 proposals were submitted. 18 had been recommended by the panel and, subject to approval from the Minister, details of the successful organisations will be released publicly in October.

PIMH Main Fund progress report

Kaylie advised that the PIMH Main Fund progress report (October 2020-March 2021) had been drafted and was available to share with PB members. Inspiring Scotland agreed to provide more information on the report, and on the outcomes of the Small Grants Fund, at the next meeting.

Action: Inspiring Scotland

Infant mental health

Anne McFadyen chairs the IMH Implementation and Advisory Group (IAG) which has made significant progress in addressing the ten IMH actions in the 2020/21 Delivery Plan.

Anne reminded the group that IMH service development was being rolled out in a phased way; five Boards are engaged in wave 1 and wave 2, and four Boards have expressed interest in wave 3. Anne, with input from the IAG, has written an IMH Service Development Guide and recently met with the wave 3 Boards to provide support and advice. As allocations move towards the NRAC amount, Anne and the SG Policy Team will continue to meet with all Boards to discuss standalone and embedded IMH services, and transition planning for after the life of the PB.

Alison Robertson, Consultant Clinical Psychologist, and Nashwa Matta, Associate Specialist in Paediatrics, have worked hard on a clinical care pathway for premature babies and infants with complex health problems. The pathway is being piloted in NHS GG and C, and hopefully will be rolled out across the country. In addition, NHS Education for Scotland (NES) have developed an online course to help professionals address the needs of these infants.

The IMH Evaluation subgroup have oversight of a number of projects and some research. A medical student on the research team recently submitted a paper to the Journal of IMH about the narrative research carried out with stakeholders in NHS Lanarkshire about their views of IMH. The research team are conducting focus groups with the stakeholders that were interviewed. The academic lead for General Practitioners (GPs) has expressed interest in developing a focus group for Deep End GPs on their understanding of IMH.

Anne is working with PHS on the third round of the Covid-19 Early Years Resilience and Impact Survey, which will launch at the end of September 2021. The survey will provide more information about the impact of Covid-19 on infants.

Parentclub had to stall the development of the ‘Wellbeing for Wee Ones’ resource but will be taking the next phase forward soon.

Anne advised that the third sector representatives on the IMH-IAG are meeting separately to consider how to engage with and voice their priorities to the group.

SallyAnn Kelly passed on the feedback that some third sector colleagues want clarification on how the Third Sector fits into PB plans and conversation. It was agreed that Anne and the other PB group leads would consider if third sector organisations are adequately represented and involved in their groups, and further opportunities for engagement.

Action: Programme Board Group Leads and SG Policy Team

Participation Officer update

Clare Thompson advised that Maternal Mental Health Scotland were in the process of interviewing for a second Participation Officer with a focus on IMH, fathers and co-parents, and marginalised families. Post-meeting note: Kathryn Masterson has been appointed to this post, and will start at the beginning of October 2021.

Clare is working with the Experts by Experience reference group to develop sessions for Health Boards on good and bad engagement experiences.

Clare continues to work with Fathers Network Scotland, and Amina Muslim Women’s Resource Centre. Some pieces of art work from the ‘Invisible Truths’ project have been used in NES training sessions as a prompt for discussion.

Supporting Women, Reducing Harm

Roch Cantwell, as Clinical Lead for Perinatal Mental Health Network Scotland (PMHNS), advised that the ‘Supporting Women, Reducing Harm’ report had been published that morning. The report is a review of services for substance-using women and their infants in pregnancy and the postnatal period, and includes recommendations for service development.

The primary action from the report is to hold a stakeholder meeting, jointly organised by PMHNS and relevant SG Policy Teams, with wide involvement from individuals and agencies with professional expertise, and those with lived experience, to begin the identification of a model of service delivery for this group. It is hoped that the stakeholder meeting will be held before March 2022.

Helen Cheyne requested to be involved in this work going forward, and advised that the National Institute for Health Research and a team at King’s College London had recently funded Helen to look at pathways of services for women who use substances. Sally Ann Kelly mentioned that Aberlour are also developing an approach that will be submitted to Scottish Government in the next couple of weeks. The Chair requested to hear more about both projects at the next PB meeting.

Children and Young People’s Mental Health and Wellbeing Joint Delivery Board

The Chair attended a recent meeting of the Children and Young People’s Mental Health and Wellbeing Joint Delivery Board’s task and finish group that is focusing on the mental health and wellbeing of 3-5 year olds. Ruth Christie advised that the Joint Delivery Board is part of the SG Mental Health Transition and Recovery Plan, and was put in place to oversee the improvement and implementation of changes to children and young people’s mental health services. The Joint Delivery Board has eight deliverables, and a task and finish group associated with each. The deliverable for the 3-5 year olds group is to work jointly with the PB to consider what service provision is currently available and produce recommendations for further action. Ruth agreed to share papers from the recent task and finish group meeting, and asked Anne McFadyen, and other interested PB members, to input into that work going forward.

Action: Ruth Christie

Any other business

A written update from NHS Education for Scotland was circulated after the meeting, and can be shared separately on request.

Next meeting

Wednesday 24th November 2021.