Perinatal and Infant Mental Health Programme Board minutes: 28 January 2021

Attendees and apologies

Author

• Alex Brown             

Present

• Roch Cantwell, Vice Chair, NHS National Services Scotland
• Kaylie Allen, Head of Funds, Inspiring Scotland
• Sally Amor, Child Health Commissioner & North of Scotland representative, NHS Highland
• Hannah Axon, Policy Manager, COSLA
• Alex Brown, Programme Support Officer, NHS National Services Scotland
• Ruth Christie, Workstream Lead, Children, Young People, Families and Relationships, Scottish Government
• Amanullah Durrani, Consultant Perinatal Psychiatrist, Royal College of Psychiatrists
• Sheila Gordon, Director, CrossReach
• Sally Ann Kelly, Chief Executive, Aberlour
• Lauren Kennedy, Lead Nurse for Mental Health & Learning Disabilities, NHS 24
• Jacqueline Lambert, Professional Midwifery Advisor, Scottish Government
• 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
• Mary-Ross Davie, Director, Royal College of Midwives
• Marie Claire Shankland, Programme Director, NHS Education for Scotland
• Helen Sloan,  Nurse Consultant Perinatal Mental Health, NHS Greater Glasgow & Clyde
• Alley Speirs, Programme Manager, Perinatal Mental Health Managed Clinical Network, NHS National Services Scotland
• Judy Thomson, Director of Psychology, NHS Education for Scotland
• Clare Thompson, Participation Officer, Maternal Mental Health Scotland
• Harriet Waugh, Head of Perinatal and Early Years Mental Health Team, Scottish Government

In attendance

• Jemma Davis, Scottish Government
• Barbara Kennie, Scottish Government
• Katy Lister, Scottish Government
• Irene Permaul, Perinatal and Early Years Mental Health Team, Scottish Government
• Angela Davidson, Deputy Director for Mental Health Scottish Government
• Ross Sanderson on behalf of Eileen McKenna, Policy Advisor, Royal College of Nursing

Apologies

• Ann Holmes, Chief Midwifery Advisor & Associate Chief Nursing Officer, Scottish Government
• Eileen McKenna, Associate Director, Royal College of Nursing

Items and actions

Welcome, apologies and housekeeping

Roch Cantwell (Lead Clinician for the Perinatal Mental Health Managed Clinical Network) welcomed everyone to the eleventh Perinatal & Infant Mental Health Programme Board meeting, and apologies were noted as above. Roch advised that he would be acting Chair of the Programme Board until March 2021, whilst Hugh Masters was working with the Chief Nursing Directorate on the pandemic response.

PNIMH Programme Board update

Mother-baby unit options appraisal

Roch reminded the group of the recommendation in Delivering Effective Services for two to four additional Mother-Baby Unit (MBU) beds in Scotland. The short life working group, set up by the Programme Board in 2019, reported that there should be a more detailed options appraisal, and a focus on improving the access to community services before considering additional beds. Roch advised that work on this would be restarting now that health boards have begun development of community services. The first step is to update the evidence in the case for additional beds, and the second is to identify an appropriate site for those beds. Roch emphasised that the group also needed to consider an alternative to beds, in terms of intensive treatment, and keep all options in mind.

Workforce planning subgroup

Harriet Waugh (Head of Perinatal and Early Years Mental Health Team, Scottish Government) advised that David Pickering-Gummer (General Manager, NHS Lothian) had agreed to Chair the Workforce Planning subgroup. The group would first meet in early March 2021. The inaugural meeting would focus on identifying priority workforce and sustainability issues, and discussing key objectives for the group. 

Equalities subgroup

Harriet advised that the Equalities subgroup were focused on building on the work created from the Equality Impact Assessment (EQIA), and on identifying potential gaps in the current peer-reviewed literature. At the inaugural meeting on 16 December 2020, there was much discussion on fathers/partners/caregivers and their roles and experiences of equalities at the perinatal stage. Further references regarding this group would be included in the EQIA, which Scottish Government (SG) would then seek to publish. Any further information can be included in future iterations of the document.

The Equalities group would next meet on 17 February 2021.

Data and evaluation

The Evaluability Assessment, carried out by Public Health Scotland, recommended several separate but related studies in order to evaluate the work of the Programme Board, and this ranged from qualitative work and focus groups through to case note reviews. Rebecca MacPherson (SG Policy Team) is identifying and collating existing pieces of work alongside potential internal research studies, and progressing the data catalogue.

Small Grants Fund

The Third Sector Perinatal and Infant Mental Health (PIMH) fund, run by Inspiring Scotland, includes a small amount of funding (approximately £100,000 per annum) to support organisations that were not included in the main fund but are still making significant contributions towards PIMH. The additional funding aims to generate great value for money by supporting smaller organisations and encouraging innovative practice. The PIMH Small Grants Fund also has the capacity to support organisations that may not have been eligible to the main fund due to being unincorporated, as well as the ability to act upon any emerging priorities or gaps. The SG Policy Team were preparing a submission to the Minister for Mental Health outlining next steps for launching the fund, and working with Inspiring Scotland to explore ways in how to maximise the impact of that funding in the sector.

Health Board progress update

Harriet Waugh advised that the SG Policy Team would soon issue a health check to all health boards, aiming to identify priority issues, re-establish best points of contact and reiterate that the team can be available for any needed support ahead of the first formal monitoring report deadline in April 2021.

Alex Brown (Programme Support Officer, NHS National Services Scotland) introduced a map showing a breakdown of the funding allocations made to each health board within Specialist Community Perinatal Mental Health services, Infant Mental Health (IMH) services, Maternity and Neonatal Psychological Interventions (MNPI) services, and Third Sector services. The map detailed board specific outcomes and commitments in each regional area, and would be made available online after the launch of the SG website page. Alex advised that another iteration of the map was in development, alongside the return of the monitoring reports, to promote new services and relevant links to other organisations working in the sector.

Infant Mental Health

IMH Marketing Campaign

Harriet advised that the SG Policy Team and Anne McFadyen (IMH Lead, NHS National Services Scotland) were working with Parent Club on promoting the importance of IMH and the value of sensitive and responsive interactions to babies’ development. The campaign is comprised of two short videos with a variety of static images, directing people towards the Parent Club website where more information on infant mental health can be found. Harriet thanked all those who had provided input at short notice, and advised that the resource pack would be shared across the country to ensure widespread awareness of resources available to both parents and practitioners.

Sheila Gordon (Director, CrossReach) commented on the need to be inclusive of kinship, foster and other carers who can be vulnerable to exclusion from discussion about parents and families. Harriet committed to ensure that inclusive language was used in the campaign, and highlighted that the videos were not specific about who is interacting with the baby, so can be applied to all manner of relationships.

Action: Harriet Waugh

IMH Implementation & Advisory Group

Anne McFadyen advised that the group Terms of Reference had been updated at the last IMH Implementation & Advisory Group (IAG) meeting on 13 January 2021. It was agreed at that meeting that representatives from Father’s Network Scotland, Home-Start, and adult psychiatry would join the group membership.

Members of the IAG have progressed work with regard to vulnerable neonates (premature or sick babies), and were inputting into the development of a neonatal dashboard by the Perinatal Strategic Network. Anne advised that infant rights were central to ensuring equity of provision, reducing stigma and raising awareness. The IAG are attempting to articulate the value behind IMH systems and create a core set of ideas to underpin IMH service development across the country.

The IMH Forum, run through the Perinatal Mental Health Managed Clinical Network (MCN), are meeting for the second time on 1 February 2021 and will discuss data collection and NHS Education for Scotland (NES) IMH training.

The IMH Forum has had offers of help from the Parent Infant Foundation and the Institute of Health Visiting around supporting service development, but this work has been halted due to the pandemic. Whilst health boards have responded well to the rollout of funding, teams are being directed to COVID-19 management workforce plans which means that recruitment has been delayed.

Anne advised that the IAG were working with the NSPCC on a needs assessment that has produced some very detailed information about the levels of need in Lanarkshire. Progressing alongside this is a stakeholder research project that is collecting data on the attitudes of stakeholders and their beliefs on how developments should be taken forward.

Updates from programme board partners

Participation Officer

Clare Thompson (Participation Officer, Maternal Mental Health Scotland) advised that, to keep the conversation going around Peer Support, the 10+ submissions received after the October 2020 event had been reposted on the MMHS blog, and the SG Policy Team were continuing to develop a peer support action plan, with feedback from event attendees and experts by experience.

Clare updated the group on current participation opportunities:

• NHS Greater Glasgow & Clyde (GGC) are looking for input from people who have attended the Leverndale MBU on a walking routes project
• two members of the Experts by Experience (EBE) group have been welcomed to the MCN’s Clinical Audit System short life working group
• involvement opportunity for the EBE group to provide input to the work of NES
• the participatory art project, run by MMHS, has met for the third time. Meetings are facilitated online and planning takes place on WhatsApp, which has proved useful
• Clare recently met with Public Health Scotland to discuss research that may be carried out with organisations supporting Black and Minority Ethnic Women

Clare reiterated an offer of support to health board Leads and all those involved in service development, to assist in developing an engagement strategy, and making connections with EBEs and advocacy organisations.

Clare can be contacted at clare.thompson@maternalmentalhealthscotland.org.uk

NHS Education for Scotland

Marie-Claire Shankland (Programme Director, NES) gave an update:

• another 10 Clinical Associates in Applied Psychology (CAAP) began training in January 2021
• five additional trainees have begun the CBT training course since January. A number of the trainees are from primary care settings, and one from a specialist perinatal setting
• the Human Development Scotland Psychoanalytic Observation and Reflective Practice started in January with 10 practitioners
• 400 people have completed the introductory module of the seven Essential PIMH e-learning modules. The other six modules have been completed by over 100 people, from a variety of professional settings
• follow-on training from the Essential modules for MBU and perinatal staff is scheduled to be delivered in March. Clare Thompson and the EBE have been providing input on a series of case studies
• to support induction into specialist teams, NMAHP colleagues have developed webinars on complications in late pregnancy and the early perinatal period. The first of those webinars was delivered to Glasgow teams in January and was well received
• the Institute of Health Visiting has been commissioned to run PIMH Champions training. The first cohort of 20 practitioners from the North of Scotland will take place on 18 and 19 February. There will be two more trainings in 2021, with a total of 60 practitioners across the year
• 60 new practitioners have started the Warwick IMH online course. The course was oversubscribed, so there will be a further 40 places available in March
• 12 additional practitioners have joined the Solihull Approach Foundation Train the Trainer course
• NES colleagues Marita Brack and Kirsten Coull have been meeting with School Nurse and Health Visitor Leads to discuss Solihull Approach Foundation Level training
• the Solihull Approach Online course has had 8240 participants so far
• NES are continuing to support three practitioners in achieving their qualification in Video Interactive Guidance (VIG). The tender process to commission new training and supervision for VIG is ongoing

Perinatal Mental Health Managed Clinical Network

Roch Cantwell gave an update on the recent work of the MCN:

• Clinical Forum leads and co-chairs are keen for meetings to continue, and see the Forums as supportive rather than an extra burden
• all of the Role Definition papers are on track for completion, and will hopefully be published on the MCN website shortly
• the first animation, directed at women and families to help them understand the MBU care pathway, is complete. The MCN are aiming to release the pathways and animations altogether, in a few months time. Roch expressed his gratitude for the input received from EBEs in developing the animations and the accompanying descriptions
• Anne McFadyen and Shona McCann recently finalised a report on substance misuse in pregnant and postnatal women. The report was a review of current services, and the MCN are looking at the recommendations and considering next steps
• the MCN have been developing a clinical audit system (for specialist services, MBUs, community perinatal teams and MNPI services) dedicated to gathering data on perinatal mental health indicators. The dataset is close to completion, and will generate a lot of additional information on how busy services are and the quality of the work that they are providing

Roch encouraged the group to be sensitive to the demands on services whilst the pandemic continues, and to ensure people have time to focus on their core work. It is unlikely that Programme Board work will be dramatically altered or delayed, but it is important to ensure that we are not creating additional difficulties or demands in terms of our interface with clinicians.

Next meeting

Thursday 25 March 2021, 14:00 - 15:30.