Perinatal and Infant Mental Health Programme Board minutes: 28 May 2019

Attendees and apologies

Author

• Ms Abi Connolly and Ms Kirstin Davidson            

Present

• Mr Jeff Ace (TC), Chief Executive (via VC), NHS Dumfries and Galloway
• Dr Roch Cantwell, Lead Clinician Perinatal Managed Clinical Network, NHS National Services Scotland
• Ms Ruth Christie, Head of Children & Young People’s Mental Health Improvement Team, Scottish Government
• Ms Abi Connolly, Business Support Administrator (minutes), NHS National Services Scotland
• Ms Kirstin Davidson, Business Support Administrator (minutes), NHS National Services Scotland
• Dr Aman Durrani, Consultant Perinatal Psychiatrist, Royal college of Psychiatrists
• Dr Fiona Fraser, Consultant Clinical Psychologist, Perinatal Mental Health Services, Glasgow City Health and Social Care Partnership
• Ms Lorna Greene, Policy Officer Royal College of Nursing Scotland, deputising for Theresa Fyffe
• Professor Ann Holmes, Chief Midwifery Advisor and Associate Chief Nursing Officer, Scottish Government
• Dr Lesley Jackson, Lead Clinician, National Neonatal Network
• Ms Catriona Johnson, Programme Associate Director, National Services Division
• Ms Sally Ann Kelly, Chief Executive,  Aberlour
• Ms Katy Lister, Children & Young People’s Mental Health Improvement, Team Scottish Government
• Mr Hugh Masters, Chair, Scottish Government
• Dr Anne McFadyen, Infant Mental Health Lead, Perinatal Managed Clinical Network for Infant Mental Health
• Ms Rebecca McPherson, Children & Young People’s Mental Health Improvement Team, Scottish Government
• Ms Lesley Metcalf, Senior Programme Manager, National Services Division
• Dr Mary Ross-Davie, Director, Royal College of Midwives
• Ms Marie Claire Shankland, Programme Director, National Education for Scotland
• Ms Helen Sloan, Chair Maternal Mental Health Scotland, Maternal Mental Health Scotland
• Ms Clare Thompson, Change Agent, Maternal Mental Health Scotland
• Ms Judy Thomson, Director of Psychology, National Education for Scotland
• Ms Carolyn Wilson, Lead Policy Officer Family Nurse Partnership, Child Health & Early Years

Apologies

• Mr Alex McMahon, Executive Director, Nursing, Midwifery and Allied Healthcare Professionals
• Mr John Wood, COSLA
• Ms Karen Ozden, Chief Nurse & General Manager REAS, Mental Health Nurse Leads Scotland
• Ms Jackie Kerr, Assistant Chief Officer for Adult Services, Health and Social Care Partnership
• Ms Theresa Fyffe, Director,  Royal College of Nursing

Items and actions

Welcome, apologies and introductions 

Hugh Masters (Chair) welcomed everyone to the Perinatal and Infant Mental Health (PNIMH) Programme Board meeting. 

Apologies were noted as above for the purpose of the minutes. 

Minutes of previous meeting and matters arising 

The minutes of the previous meeting (Tuesday 30 April 2019) were agreed as an accurate record of the meeting. 

It was noted that Mary Ross-Davie (Director, Royal College of Midwives) had been present and that her name had been recorded incorrectly.

Action: National Services Scotland Team to add Mary Ross-Davie to the attendance list and update the record.

Mr Masters reiterated the importance of the work of PNIMH Programme Board and its focus on building on and steering existing work. 

Update from NSS 

Catriona Johnson (Programme Associate Director, NHS National Service Scotland) set out the role of National Services Division (NSD), as commissioners, in ensuring equitable access to high quality services for the people of Scotland. This included responsibility for managing delivery of the Perinatal and Infant Mental Health Programme. She highlighted that the Perinatal Mental Health Network (PMHN) was one of thirty national networks commissioned and held to account by NSD on behalf of NHS boards and Scottish Government. While, in terms of governance the lines of accountability for the PMHN and the Perinatal and Infant Mental Health Programme were different, as illustrated in the draft Terms of Reference v0.10, there were obvious links between the two structures and their delivery plans.

Roch Cantwell (Lead Clinician for PMHN), was a member of the PNIMH Programme Board and work had already been undertaken to establish mechanisms for ensuring work was shared and not repeated.

Catriona Johnson highlighted five immediate priorities for NSD in relation to the PNIMH:

• appoint the programme team 
• finalise the programme scope and structure 
• align the PNIMH and PMHN delivery plans and schedules 
• produce a communication strategy 

• establish robust systems and processes (based on existing NSD mechanisms) for progressing the PNIMH Delivery Plan and monitoring how the money was spent in regions, boards and communities and within NSD to support the programme 

Hugh Masters thought it was important to note that a team from NHS NSS would manage the project rather than Scottish Government. 

Carolyn Wilson (Lead Policy Officer Family Nurse Partnership, Scottish Government) queried if the minutes and meeting correspondence would be published and available to the public and Catriona Johnson confirmed that once the website was set up then all information would be uploaded. 

Aman Durrani (Perinatal Psychiatrist, Royal College of Psychiatry) asked how much of the budget was to be managed by NSD and it was confirmed that it would equate to 1% (approximately) £500,000 over the four year period. Hugh Masters emphasised the need for transparency regarding the finances. 

Members of the group were introduced to Lesley Metcalf (Programme Manager who would take up her position within NSD as the PNIMH Programme Manager on Monday 1 July 2019. 

Update from Managed Clinical Network 

Roch Cantwell explained that further to publication of the Needs Assessment Report the PMHN had developed a work plan to guide the next phase. This would be overseen by a PMHN steering group. Roch Cantwell emphasised the need for good communication between the  Network and the Programme Board to avoid duplication or missing anything. He explained that the two existing Mother & Baby Units (MBUs) would be working closely together which would be beneficial to the clinicians as they could share experiences and support the work of the Network.

The PMHN had refreshed its structure to reflect the workplan going forward; here would be a major focus on Care Pathways, ensuring a woman’s care was delivered effectively and efficiently as possible, including: 

• looking at existing services for substance misuse 
• specialist perinatal assessment tools to ensure consistency across Scotland
• ensuring information gathered throughout Scotland was consistent
• peer working – almost all work was in conjunction with other groups 
• develop the design of the woman and family pledge and disseminate it for display as a poster in maternity unit

The network was working on an educational event and was keen to do this in conjunction with the Programme Board.

Anne McFadyen (Infant Mental Health Lead, Perinatal Mental Health Network) stated that each Health Board should appoint a Lead Practitioner with responsibility for Parent/ Infant mental health.

Judy Thomson (National Director of Psychology Training, National Education Scotland) was of the view that the existing partnership between NES and PMHN would strengthen and become a network of trainers. She highlighted the need to monitor investment in the workforce arising from the PNIMH Programme and ensure funding was used for the intended purposes. Jeff Ace (Chief Executive, NHS Dumfries and Galloway) explained that responsibility for creating a monitoring framework would lie with Scottish Government. 

Roch Cantwell advised that although the work plan was finalised, the timescales were not and further discussion was required. 

Update from NHS Education for Scotland 

Judy Thomson provided an update on the work that National Education Scotland (NES) had carried out to date and plans going forward. NES had produced a Perinatal Mental Health Curricular framework in collaboration with the PMHN and other stakeholders which sought to make best use of existing resources.

Judy Thomson explained their focus was to develop a resource similar to that used by Children and Adolescent Mental Health Services (CAMHS) which would build on trauma and psychological therapies. Work was underway to augment the psychology workforce by providing training for psychological therapists and a multi disciplinary workforce. NES wanted to ensure the existing workforce had allocated protected time and new staff had adequate supervision and coaching. It was anticipated that a blended model, using a mixture of online and face to face learning, would be developed and to be delivered locally .

Thousands of staff had received “Solihull Approach” training, which had been well received by social care and education staff, and it was hoped that this would be made available to Perinatal Mental Health practitioners. 

Ann Holmes (Associate Chief Nursing Officer) queried how the training would fit in with Midwife and Nurse undergraduate learning and training and it was noted that “Solihull Approach” training was already being rolled out.

Clare Thompson (Maternal Mental Health Scotland Change Agent) reported that presentations from women with ‘lived experience’ had been well received by delegates at past training events and should be considered. She suggested that if women preferred not to feature in recorded material their experience could be portrayed by actors. Marie Claire Shankland (Programme Director, National Education for Scotland) explained NES planned to form a reference group which would include people with lived experience. Hugh Masters emphasised the need to ensure this work was linked with the Programme Board and to use existing groups rather than set up new ones.

Sally Ann Kelly (Chief Executive, Aberlour) highlighted that most of the conversation had been directed toward the training of the health workforce, despite many women turning to social care or the Third sector for support. Judy Thomson agreed that a whole system approach was needed and that the training should be extended beyond healthcare. Judy Thomson explained that NES had committed a 0.4 WTE resource to the project until the end of the current financial year, although it was anticipated that the work would extend beyond this. She anticipated that NES would seek funding through the Programme Board to resource the ongoing work and that a proposal would be brought to the July Board. Ann Holmes noted that there were existing online training resources that Third Sector colleagues could access as required.

The absence of representation from Integrated Joint Board (IJBs) was noted and Jeff Ace agreed it was important to have a Chief Officer as a member. An invitation had been extended to Nurse Directors and apologies had been received for this meeting. 

Support for lived experience 

Ruth Christie (Head of Children & Young People’s Mental Health Improvement Team, Scottish Government) told the group that, since the last meeting, discussions had taken place with Clare Thompson of Maternal Mental Health Scotland, and the Mental Health Alliance based in England. A proposal had been invited for a framework to enable Change Agents to support the work of the Programme Board and wider work, including the PMMHN. It was anticipated the proposal would seek funding for an Engagement Officer for two days per week with the aim of extending the contribution of Change Agents to include participation in media coverage and training events as a means to raise the Perinatal Mental Health profile at a Scottish and National level. This was seen as an opportunity to create a Champions Network and the detailed proposal and confirmation of costs was scheduled for discussion at the Programme Board meeting on 2 July 2019. 

Clare Thompson suggested that while gathering of qualitative data enhanced understanding, it was important that the women involved were appropriately supported.

Ruth Christie provided an update on the Children and Young people taskforce; she explained that the Chair had stepped down for reasons of ill health and there had been ongoing discussions with the Task Force members and COSLA to consider next steps. It was anticipated that there would be more information in the coming weeks.

Terms of reference 

Item requiring change.

It was noted that the membership list would be updated.

Hugh Masters requested that any further comments were to be submitted by Friday 14 June 2019. 

Action: programme board members

Action plan 

Hugh Masters aimed to draft a high level action/ delivery plan to be signed off by the Minister for Mental Health by the end of July 2019. The group was asked to provide feedback by Friday 14 June 2019. An update would be provided at the next meeting.

Action: Programme Board Members

AOCB

Roch Cantwell asked if the group were still seeking Academic representation, even if they were not be able to attend all meetings, and it was agreed this would be encouraged and that geographical location should not be seen as a barrier.

Date and time of next meeting 

Tuesday 2 July 2019 2pm to 3.30pm