Perinatal and Infant Mental Health Programme Board minutes: 24 November 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
• Leanne Anderson, Performance Advisor,  Inspiring Scotland
• Elizabeth Archibald, PNIMH Service Development Adviser, Scottish Government
• 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
• Fiona Fraser, Consultant Clinical Psychologist, NHS Greater Glasgow & Clyde
• Marsaili Fraser, Performance Advisor, Inspiring Scotland
• Sheila Gordon, Director, CrossReach
• Lauren Kennedy, Lead Nurse for Mental Health & Learning Disabilities, NHS24
• Kat Masterson, Participation Officer, Maternal Mental Health Scotland
• Anne McFadyen, Infant Mental Health Lead, Perinatal Mental Health Managed Clinical Network NHS National Services Scotland
• Clare McGuire, Head of Programme, NHS Education for Scotland
• Marie Claire Shankland, Programme Director, NHS Education for Scotland
• Helen Sloan, Nurse Consultant Perinatal Mental Health, NHS Greater Glasgow & Clyde
• Joanne Smith, Policy and Public Affairs Manager, NSPCC
• Clare Thompson, Participation Officer, Maternal Mental Health Scotland
• Judy Thomson, Director of Psychology, NHS Education for Scotland
• Harri Waugh, Head of Perinatal and Early Years Mental Health Team, Scottish Government

In attendance

• Jean Carwood-Edwards, Chair of 3-5s Task and Finish Group, Children and Young People’s Mental Health and Wellbeing Joint Delivery Board, Scottish Government
• Ross Cowan, Perinatal and Early Years Mental Health Team, Scottish Government
• Lisa Golds, Internship, Perinatal and Early Years Mental Health Team, Scottish Government
• Liz Nolan on behalf of SallyAnn Kelly, Deputy Director, Aberlour
• Irene Permaul, Perinatal and Early Years Mental Health Team,  Scottish Government
• Kevin Stewart, Minister for Mental Health and Social Care, Scottish Government
• Fiona Wilson, Perinatal and Early Years Mental Health Team, Scottish Government

Apologies

• Jeff Ace, Chief Executive, NHS Dumfries & Galloway
• Maria Docherty, Executive Director, NHS24
• Aman Durrani, Consultant Perinatal Psychiatrist, Royal College of Psychiatrists
• Catriona Johnson, Associate Programme Director, NHS National Services Scotland
• SallyAnn Kelly, Chief Executive, Aberlour
• Jacqueline Lambert, Professional Midwifery Adviser, Scottish Government
• Marion MacAuley, Chief Social Work Officer, Social Work Scotland
• Ross McGuffie, Chief Officer, Health & Social Care, NHS Lanarkshire
• Eileen McKenna, Associate Director, Royal College of Nursing
• David Pickering- Gummer, CAMHS, General Manager, NHS Lothian

Items and actions

Welcome, apologies and housekeeping

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

The Chair advised that the Minister for Mental Wellbeing and Social Care would be attending the meeting from 11am.

Alex Brown (Assistant Programme Manager) thanked the group for their feedback on the monitoring template, which was shared with the fourteen regional Health Boards at the end of October with a return deadline of 30 November 2021. Updates on service development across Scotland will be discussed at future meetings when all boards have submitted their reports.

Action: Scottish Government Policy Team

The Chair advised that he was meeting with PB subgroup leads, and updates on recent group activities would be on the agenda for the next meeting.

The minutes were agreed as an accurate representation of the September 2021 meeting.

Recent work and upcoming priorities

Harri Waugh (Head of Perinatal and Early Years Mental Health Team, Scottish Government) gave an overview of recent work:

• at a visit to Let’s All Talk North East Mums (LATNEM) on 11 October 2021, the Minister for Mental Wellbeing and Social Care announced the launch of the third sector Small Grants Fund (discussed later in the meeting), and the 2021-2022 Programme Board Delivery Plan
• Kat Masterson has started in post at Maternal Mental Health Scotland (MMHS) as Participation Officer (discussed later in the meting), and Ross Cowan has recently joined the SG policy team
• the Perinatal Mental Health managed clinical network (PMHN) published the ‘Supporting Women, Reducing Harm’ report in September 2021.The PMHN and the PB are jointly organising a stakeholder event for April 2022, which will involve Scottish Government (SG) policy colleagues from children and families, addictions, and mental health directorates. Roch Cantwell (PB Vice Chair, and PMHN Lead Clinician) highlighted that PMHN and Aberlour are facilitating focus groups in early 2022 with people with lived experience, to ensure that the event is co-designed and all relevant groups are involved in planning

Upcoming priorities:

• the tier four provision Options Appraisal is on track to go ahead in early 2022, and work is progressing on the public consultation
• terms and conditions of the Mother and Baby Unit Family Fund are being reviewed
• organising first annual Peer Support event in February 2022. Harri asked the group to get in contact with Fiona Wilson (Senior Policy Officer, SG) with any suggestions and input into the Peer Support Action Plan. The Chair advised that the SG policy team will be looking for support from PB members to progress the plan strategically
• Harri advised that the Health, Social Care and Sport Committee were undertaking a short inquiry into perinatal mental health, and the consultation closes on 24 November 2021. The Minister will provide evidence to that inquiry in mid-December, and the SG policy team are focused on providing a centered, unbiased briefing for the Minister. The Chair advised that this would be further discussed at the next PB meeting

Action: Scottish Government Policy Team

2021-2022 delivery plan

The Chair advised that the SG policy team met to consider each action from the 2021-2022 Delivery Plan (many previously mentioned or discussed later in the meeting), and have identified a series of high-level priorities under four themes (Co-production; Workforce, Education, Development and Sustainability; Equality and Tackling Stigma; Recovery and Systems Approach):

• the Chair commended the excellent training and educational work of NHS Education for Scotland (NES), and mentioned organising a meeting in the near future to plan longer-term goals and priorities
• the Vice-Chair mentioned that work continues on the Raising Awareness Strategy, the Wellbeing for Wee Ones work with Parent Club, and the PMHN Care Pathways
• a paper for Health Boards with guidance on defining job roles with regional dimensions, and collaborative working with smaller Boards, has been drafted by the Vice-Chair and will be made available in 2022
• work is progressing on the evaluation framework with Public Health Scotland (PHS), who are closely working with the Monitoring and Evaluation subgroup
• meetings are being organised in 2022 for further service development discussions with Health Boards. The SG policy team have been using internal documents to track progress in each area, and hope to agree a public facing version with the Health Boards at those meetings

The Vice-Chair introduced Lisa Golds (SG Internship) who is undertaking a literature review for the SG policy team, as recommended by the PHS Evaluability Assessment. Lisa advised that this review will focus on conceptualisations of infant mental health (IMH), measures of IMH (under five year olds) across service providers, and hopefully also the impact of the pandemic on IMH services.

Participation officers

The Chair and PB members expressed their best wishes and thanks to Clare Thompson for her inspiring work as Participation Officer with MMHS since 2019. Clare thanked the group for the opportunity to influence the work, and advised that she was leaving behind a package of information for the PB on how to engage with people in a respectful and meaningful way. Clare intends to record the suite of information as a video to help Boards and organisations with future participation activities.

Kat Masterson introduced herself as the new Participation Officer at MMHS, working with a focus on IMH, fathers/co-parents, and equalities. First two months in post have been busy, and Kat has focused on learning about IMH and working closely with Anne McFadyen (PB and PMHN IMH Lead).

Kat advised that the project initiated by Clare with Father’s Network Scotland will continue in 2022. Edinburgh University are facilitating focus groups and single interview sessions with fathers about their perinatal mental health experiences, and Masters Students will review the data then write a report to inform the PB.

Infant mental health

Anne McFadyen highlighted that IMH service development was continuing around the country, and discussions are taking place in those areas that progress has been slower. Anne reminded the group that IMH Clinical Forum meetings, and the Parent-Infant Foundation Development Community, are good places to share best practice and make connections.

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

Jean Carwood-Edwards (Professional Adviser, SG) chairs the three to five year olds Task and Finish group of the Children and Young People’s Mental Health and Wellbeing Joint Delivery Board. Hugh Masters and Anne McFadyen sit on that group as representatives from the PB. Jean advised that the remit of the Task and Finish group is to work jointly with the PB to consider what is currently available and what is required in the future to support the mental health and wellbeing of three to five year olds across Scotland. The group have been engaging with children and their families via focus groups and surveys, and aim to provide recommendations for further action to SG by December 2022.

Voice of the infant

Anne advised that she and Kat Masterson are planning to develop and co-chair a ‘Voice of the Infant’ subgroup, which will look at how to help services assess their service development from the babies’ perspective, and how to attend to infant rights and UNCRC requirements.

Action: Anne McFadyen and Kat Masterson

The Chair welcomed Mr Kevin Stewart, the Minister for Mental Wellbeing and Social Care, to the meeting. The Minister invited the group to ask questions after the Inspiring Scotland update.

Inspiring Scotland

Kaylie Allen (Head of Funds, Inspiring Scotland) advised that the PB third sector fund had been developed in response to the 2018 to 2019 Programme for Government commitment to support ‘the estimated 11,000 women who would benefit from third sector support such as counselling.’ The fund is split into two parts; the Main Grants Fund has granted 16 organisations an average of £60,000 per year, and the Small Grants Fund supports 18 smaller community focused organisations with grants of £12,000 over the next 18 months. Both funds were heavily oversubscribed, with a high standard of applications. Funded services are a mix of parenting support, peer support and counselling. The Small Grants Fund assessment process looked at gaps in the Main Grants Fund, both in terms of geography and supporting any particular areas of need, for example those working with fathers/co-parents and those with an IMH focus.

Main Grants Fund Progress Report

Marsaili Fraser (Performance Advisor, Inspiring Scotland) gave an overview of the learning from the first 6 months of the Main Grants Fund. The report was circulated with papers ahead of the meeting, and can be shared again on request. All 16 funded organisations reported on activities and impact from October 2020 to March 2021.

• relationships with statutory services are mainly good. Health Visitors, Midwives and GPs are recognising the value of the third sector and routinely relying on third sector support
• there are concerns around a growing number of referrals to the third sector and lack of capacity to meet increasing demand. With acute pressures on statutory services, third sector organisations are supporting greater numbers of women in crisis
• some of the smaller charities are unsure if they will be able to fund perinatal support staff after the three-year life of this fund, as it greatly impacts on their ability to plan services and retain staff
• the organisations measure their impact using standardised outcomes that Inspiring Scotland developed for the fund. A high proportion of parents are reporting that they feel less isolated following support, and similar numbers feel better able to meet the needs of their infants
• the organisations have adapted well to providing support through new means, such as video and telephone sessions. As lockdown has eased, most funded charities are offering a blended approach, as many feel a pressing need to offer face-to-face support
• funding has helped to establish new services or extend reach of services. Charities have also upskilled staff and volunteers, and enthusiastically engaged the with NES modules

Questions for the Minister and group discussion

Joanne Smith (Policy and Public Affairs Manager, NSPCC) asked the Minister if there were ambitions to revise the mental health strategy approach away from crisis-led investment and towards prevention. The Minister replied that a key area of work across all mental health services was the shifting focus from acute care towards preventative measures. Whilst that is also true for perinatal and infant mental health, acute services need further work to make sure they are accessible to everyone across the country.

The Minister mentioned that the Grampian Psychological Resilience Hub was an excellent example of good practice, and had recently won an NHS health award. The Minister emphasised the importance of using learning from the pandemic to raise the standard of interactions for those living in rural and island communities.

Sheila Gordon advised that CrossReach have less workforce capacity than before the pandemic, but with an increase in referrals from Health Visitors, GPs and psychiatric units. Sheila clarified that Lothian HSCP was the only local authority that provides funding to CrossReach, though referrals come in from every area. Sheila agreed to provide data for the Minister on the number of referrals coming into CrossReach from statutory services.

Action: Sheila Gordon

Hugh thanked the Minister and the group for attending the meeting and advised that the next PNIMH Programme Board would take place on Wednesday 26 January 2022, 10:30am – 12:00pm.