Perinatal and Infant Mental Health Programme Board minutes: 12 October 2022

Attendees and apologies

Author

• Alex Brown, Assistant Programme Manager, NHS National Services Scotland 

Present

• Hugh Masters, Chair, PNIMH-PB Scottish Government
• Leanne Anderson, Performance Advisor, Inspiring Scotland
• Lizzy Archibald, Service Development Advisor, Scottish Government
• Rach Barlee, Participation Officer, Parent and Infant Mental Health 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
• Fiona Fraser, Consultant Clinical Psychologist, NHS Greater Glasgow and Clyde
• Rebecca French, Everyone’s Business Campaign Coordinator for Scotland, Maternal Mental Health Alliance
• Sheila Gordon, Director, CrossReach
• Lisa Malcolmson, Regional Nurse Consultant, NHS Grampian
• Carsten Mandt, Senior Programme Manager Scottish Perinatal Network, NHS National Services Scotland
• Kat Masterson, Participation Officer, Parent and Infant Mental Health Scotland
• Susan McConachie, Regional Nurse Consultant, NHS Lothian
• Anne McFadyen, Chair IMH-IAG, Infant Mental Health Lead Perinatal Mental Health Managed Clinical Network, Scottish Government, NHS National Services Scotland
• Ross McGuffie, Chief Officer, Health and Social Care, NHS Lanarkshire
• Clare McGuire, Head of Programme, NHS Education for Scotland
• Marie Claire Shankland, Programme Director, NHS Education for Scotland
• Helen Sloan, Nurse Consultant, NHS Greater Glasgow and Clyde
• Joanne Smith, Policy and Public Affairs Manager, NSPCC Scotland
• Harri Waugh, Perinatal and Early Years Mental Health Team Lead, Scottish Government

In attendance

• Heather Allison, Children, Young People, Relationships and Families, Scottish Government
• Martina Stanga, Children, Young People, Relationships and Families, Scottish Government
• Ross Cowan, Perinatal and Early Years Mental Health Team, Scottish Government
• Alastair Douglas, Perinatal and Early Years Mental Health Team, Scottish Government
• Katy Lister, Perinatal and Early Years Mental Health Team, Scottish Government
• Kelsey Sclater, Perinatal and Early Years Mental Health Team, Scottish Government
• Meg Ferguson, Fund Support Officer, Inspiring Scotland
• Sarah Hallam Stewart, Change and Improvement Manager, NHS Fife
• Rhona Matheson, Chief Executive, Starcatchers
• Angela McLaughlin, Developmental Psychologist, Butterfly Babies
• Liz Nolan on behalf of SallyAnn Kelly, Deputy Director, Aberlour

Apologies

• Roch Cantwell, Vice Chair, PNIMH-PB, Lead Clinician Perinatal Mental Health Managed Clinical Network, Scottish Government, NHS National Services Scotland 
• Maria Docherty, Executive Director, NHS24
• Aman Durrani, Consultant Perinatal Psychiatrist, Royal College of Psychiatrists
• SallyAnn Kelly, Chief Executive, Aberlour
• Lauren Kennedy, Lead Nurse for Mental Health and Learning Disabilities, NHS24
• Jacqueline Lambert, Director, Royal College of Midwives
• Eileen McKenna, Associate Director, Royal College of Nursing
• Carolyn Wilson, Head of Supporting Child and Maternal Wellbeing, Scottish Government

Items and actions

Welcome, apologies and housekeeping

Hugh Masters (Chair) welcomed everyone to the twentieth Perinatal and Infant Mental Health Programme Board (PB) meeting. Deputies and apologies were noted as above.

The minutes were agreed as an accurate representation of the August 2022 meeting and would be made available on the group's page.

Scottish Government team update

Harri Waugh (SG Team Lead) gave an update on behalf of the SG Perinatal and Early Years Mental Health policy team:

• the Mental Health Strategy consultation closed in September with over 400 responses. The Strategy team are in the process of having the wealth of information independently analysed. PB Leads have met with the team to provide input on how perinatal and infant mental health should be central to the refreshed strategy
• the Children and Young People’s Mental Health and Wellbeing Joint Delivery Board (JDB) will be finalising recommendations in early 2023, spanning across relationships, awareness, early learning settings, training, and clinical support. PB have been working with the JDB on the recommendations of the three-five year olds Task and Finish group
• the Options to Increase Mother and Baby Unit (MBU) Capacity consultation analysis has been published and the team have been working on next steps for the options appraisal. The procurement process received no bids so will be delayed. The team are exploring alternative options and want to ensure decisions are not rushed and communications are transparent going forward
• the ‘Families at the Centre’ event will be held online on 4th November 2022, facilitated by Inspiring Scotland. The event will act as a showcase for information about perinatal and IMH services across Scotland, to highlight resources in a way that promotes awareness, accessibility and a common understanding across families and professionals. Over 250 professionals had registered at the time of meeting
• the policy team are rearranging the Minister for Mental Wellbeing and Social Care’s visit to NHS Greater Glasgow and Clyde’s PIMH services, which could not take place last month
• Roch Cantwell (Vice Chair) is working closely with the three Nurse Consultants on the Regional Guidance paper and Regional Nurse Consultant role descriptor. The Nurse Consultants and the Vice Chair are bringing together the island health boards to discuss the best regional approach to meet their needs. Roch invited the group to return feedback and thoughts on this workstream and committed to provide an update at future meetings

SG faces significant financial challenges as a result of the current UK cost crisis. A number of factors including high inflation and lower than expected Covid-19 funding from the UK government have placed unprecedented pressures on Health and Social Care budgets. This has meant having to make very challenging decisions in order to remain within budget parameters.

This is having an impact on aspects of the Programme Board evaluation being taken forward by Public Health Scotland (PHS). The SG team are prepared for communications to organisations as soon as the budget is resolved. Additional concerns have been raised by stakeholders with regard to third sector funding for the following financial year and Harri acknowledged the critical 6 month period that makes this a priority for the third sector. Liz Nolan (Aberlour) raised significant concerns around the impact of waiting on grants, for third sector staff and for people accessing services and there was group discussion about the negative consequences of the unusual budget situation.

The Chair recently met with the Minister for Mental Wellbeing and Social Care who is very pleased with PB progress that had been outlined in the ‘Towards March 2023’ report submitted at the start of September. The importance of highlighting perinatal and infant mental health in the refresh of the Mental Health Strategy and ensuring links across policy was emphasised. Also discussed were the challenges of the ongoing budget review, in particular around the impact on the third sector, and the current issues surrounding the MBU additional capacity options appraisal. There was discussion around the structures needed to take the PB workstream beyond March 2023, and the reconceptualising of PIMH as ‘preconception to five years old’. The Minister wants close links with any proposed new structure and would like to see the voices of lived experience included in an integral and respectful way. Options to take this forward are being developed by the policy team over the rest of the year.

Joanne Smith (NSPCC) asked for an update on the development of the short life working group (SLWG) that had been announced at the ‘Supporting Women, Reducing Harm’ event on 28th April 2022. The Chair advised that this is a cross-cutting workstream that cannot be led by the Mental Health Directorate alone; other Ministers from relevant areas, such as Drugs Policy, must be engaged and commit their continuing support for the SLWG to be developed. The PB policy team do not have capacity with their existing full complement of work to progress this before March 2023, so the SLWG will be taken forward by the next iteration of the PB. Feedback collected at the event (as well as other papers) is prepared to inform the SLWG when it can be progressed, and the Inspiring Scotland blog post was mentioned. The Chair agreed the action to look into what can be communicated before March and to follow-up with the women with lived experience who took part in the event to acknowledge their input.

Action: Scottish Government policy team

Services update

Lizzy Archibald (Service Development Adviser) advised that information collected from the summer health board visits had been collated to provide a high level overview of updates that the SG team aim to publish this year, so that women, families and clinicians can see what services are available in their local area and across Scotland. Lizzy presented an example of a Service Update that would shortly be going out to the board Executive Leads for their approval to publish.

Meetings are taking place between PB leads and Executive Leads to follow up on any outstanding issues raised at the visits and to discuss innovative practice and the sustainability of the programme in local areas. Other meetings with a focus on the PIMH teams’ engagement with the third sector and people with lived experience are also being organised.

Voice of the infant subgroup

Anne McFadyen (Chair of Infant Mental Health Implementation and Advisory Group) presented on the Best Practice Guidelines (BPG) that are being developed by the Voice of the Infant subgroup. The BPG document (draft shared with meeting papers) outlines the Lundy model of participation and provides detailed practice suggestions on how to attend to the four concepts. The subgroup are discussing use of the new iteration of the Lundy model. The BPG also contains a good practice checklist and good practice examples from a range of professionals working with babies.

Kat Masterson (co-Chair of the subgroup) gave an update on the Infant Pledge, which is made up of 12 expectations about what a baby can expect from the adults around them. Written in simple language and from a baby’s perspective, this serves as a reminder to adults about their responsibilities with babies and encourages mindful commitment to consider the infants view and their rights and take action appropriately. At the suggestion of Sheila Gordon (CrossReach) Anne agreed to consider incorporation of the words ‘love’ and ‘nurture’ in upcoming amendments to the Infant Pledge.

Kat advised that the Infant Rights Statement is a work in progress as it links to the United Nations Convention on the Rights of the Child (UNCRC), which is yet to receive Royal Assent and become part of Scots Law. Meetings have been organised over the coming months to take this workstream forward.

Anne advised that the three documents will be published through SG when they are finalised and signed-off by the relevant policy groups. Anne and Kat asked the PB to provide thoughts and suggestions on dissemination, and any feedback on the draft BPG. The Chair, Anne and others in attendance at the meeting thanked the subgroup members for their input and productive work.

Third sector

Leanne Anderson (Inspiring Scotland) played a draft version of a video that is to be launched at the ‘Families At the Centre’ event on 4th November. The video aims to communicate the different types of support offered by the third sector organisations funded through the PIMH grants in an accessible and non-stigmatising way. It will be published on Inspiring Scotland’s webpage and promoted through Twitter.

Leanne also shared a draft progress report that communicates the combined work of the PIMH Small and Main grants funds; the headline figures of how many charities are supported and the impact of their work, how the work has contributed to the five fund outcomes, examples of the funded work and comments from families. The report is almost finalised, after receiving feedback from the funded organisations and the SG policy team, and Leanne will share the link when published.

Any other business

The Chair advised that the PB would have two more meetings in its current form – next on 14th December 2022 and last on 22nd March 2023.  The March meeting will hopefully take place in-person at a Scottish Government building, and the Chair has asked the subgroups to attend.