Perinatal and Infant Mental Health Programme Board minutes: 30 March 2022

Attendees and apologies

Author:

• Alex Brown

Present:

• Hugh Masters, Chair, Scottish Government
• Leanne Anderson, Performance Advisor, Inspiring Scotland
• Lizzy Archibald, PNIMH Service Development Adviser, Scottish Government
• Rach Barlee, Participation Officer, Maternal Mental Health Scotland
• Alex Brown, Assistant Programme Manager, NHS National Services Scotland 
• Roch Cantwell, Vice Chair, NHS National Services Scotland 
• Ruth Christie, Workstream Lead Children, Young People, Families and Relationships, Scottish Government
• Emma Currer, National Officer, Royal College of Midwives
• Aman Durrani, Consultant Perinatal Psychiatrist, Royal College of Psychiatrists
• Fiona Fraser, Consultant Clinical Psychologist, NHS Greater Glasgow and Clyde
• SallyAnn Kelly, Chief Executive, Aberlour
• Kat Masterson, Participation Officer, Maternal Mental Health Scotland
• Susan McConnachie, Regional Nurse Consultant, NHS Lothian
• 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
• Helen Sloan, Regional Nurse Consultant, NHS Greater Glasgow and Clyde
• Joanne Smith, Policy and Public Affairs Manager, NSPCC
• Judy Thomson, Director of Psychology, NHS Education for Scotland

In attendance:

• Ross Cowan, Perinatal and Early Years Mental Health Team, Scottish Government
• Sina Currie on behalf of Marion MacAuley, Senior Nurse Manager for Children’s Services, Social Work Scotland
• Karen Grant on behalf of Ross McGuffie, Perinatal and Infant Mental Health Project Manager, NHS Lanarkshire
• Katy Lister, Perinatal and Early Years Mental Health Team, Scottish Government
• Elaine Paterson, Public Health Intelligence Adviser, Public Health Scotland
• Irene Permaul, Perinatal and Early Years Mental Health Team, Scottish Government
• Katherine Robertson on behalf of Lauren Kennedy, Senior Nurse for Mental Health, NHS24
• Christina Smiley on behalf of Sheila Gordon, Managing Coordinator, Perinatal Counselling Services, CrossReach
• Debby Wason, Principal Public Health Intelligence Adviser, Public Health Scotland

Apologies:

• Sally Amor, Child Health Commissioner, NHS Highland
• Helen Cheyne, Professor of Maternal and Child Health Research, University of Stirling
• Sheila Gordon, Director, CrossReach
• Catriona Johnson, Associate Programme Director, NHS National Services Scotland
• Lauren Kennedy, Lead Nurse for Mental Health and Learning Disabilities, NHS24
• Marion MacAuley, Chief Social Work Officer, Social Work Scotland
• Ross McGuffie, Chief Officer, Health and Social Care, NHS Lanarkshire
• Marie Claire Shankland, Programme Director, NHS Education for Scotland
• Harri Waugh, Perinatal and Early Years Mental Health Team Lead, Scottish Government

Items and actions

Welcome, apologies and housekeeping

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

The minutes were agreed as an accurate representation of the January 2022 meeting.

Scottish Government policy t

Perinatal mental health inquiry recommendations

Katy Lister (Senior Policy Officer) advised that the Health, Sport and Social Care Committee have published their recommendations from the inquiry on perinatal mental health in Scotland. The Committee debate in parliament took place on 29th March, and can be watched online. The Scottish Government (SG) Perinatal and Early Years Mental Health Policy Team provided an in-depth response to the report, and Katy agreed to check whether that can be shared with the PB ahead of being published by the Committee.

Action: Katy Lister

Mother and baby unit options appraisal

Irene Permaul (Senior Policy Officer) advised that the consultation on how to increase Mother and Baby Unit (MBU) provision launched on 28th February and closes on 31st May 2022. At the time of the meeting, there had been 117 responses to the consultation through Citizen Space.

Stakeholders have been asked to express interest in engagement events to promote the consultation and have facilitated discussion, which can be recorded and included in the consultation analysis. Irene asked the PB to contact perinataloptionsappraisal@gov.scot with relevant organisations or groups who would like to be involved. SG will be hosting small group discussions in May, which will be available for public registration through Eventbrite. Notes from the discussions will be included in the consultation analysis, which should be available by the end of July with the aim that the full options appraisal will be carried out over Summer so the Minister can make a decision on additional MBU beds by Autumn 2022.

Supporting Women Reducing Harm

Roch Cantwell (Vice Chair) advised that the ‘Supporting Women Reducing Harm’ (SWRH) event will take place on 28th April 2022, and the invite was circulated with meeting papers. The event has had a large number of registrations and will be facilitated by Inspiring Scotland who intend to use online tools to ensure participation and engagement from health professionals, SG Policy and people with lived experience. The Minister for Drugs Policy, Ms Constance, and the Minister for Mental Wellbeing and Social Care, Mr Stewart, have agreed to introduce and close the event respectively. Ministerial approval has also been granted for a short-life working group to take forward policy outputs from the event.

Programme evaluation plan

Debby Wason and Elaine Paterson (Public Health Scotland) are coordinating the PB evaluation. Elaine advised that Public Health Scotland (PHS) used learning from the Evaluability Assessment and stakeholder workshops to develop the overall evaluation plan for the programme. The objectives of the plan are to assess if;

• women in the perinatal period are able to access appropriate mental health care services in a timely manner
• primary caregivers are able to access appropriate mental health care for their infant in a timely manner
• practitioners in contact with young families understand the importance of mental health in the perinatal period for both mothers and babies and are able to appropriately identify, support and refer women and infants who may need more specialist intervention
• women and families receive appropriate early intervention care and support including referral into more specialised services if necessary

The PHS plan sets out seven evaluation studies, each of which will have a Project Initiation Document to explain the individual approach;

• analysis of existing data
• clinical note review
• survey/interviews with women and their families in the perinatal period
• survey/interviews with practitioners who work with women and their families in the perinatal period and/or with infants in the very early years
• mapping existing services
• monitoring and recording of progress of implementing the programme
• literature reviews of women’s mental health in the perinatal period and of infant’s mental health

Some studies will be carried out by PHS and others will be commissioned to external groups. PHS have been developing the invitations to tender, which they hope to issue early in the 2022-23 financial year. Further updates will be provided at future PB and Monitoring and Evaluation subgroup meetings.

Action: Public Health Scotland

In the initial monitoring process agreement with Health Boards, PHS were not named as an organisation who would have access to the monitoring data. The SG Policy team are in contact with information governance colleagues about how to share the data with PHS going forward, and it was agreed that a meeting would be organised to discuss this further.

Action: Lizzy Archibald, Policy Team, Public Health Scotland

Lizzy Archibald (Service Development Adviser) and the SG Policy team are monitoring the service developments happening in every Health Board and have an overview of areas with functioning teams, of services who are launching in a phased way, and of services still under development. Lizzy advised that the information collected from meetings and the monitoring returns is collated and analysed within the Board Progress Updates (BPUs). Currently the BPUs are concentrated on staffing and accessing services. Going forward, the aim is to focus on how services are functioning and wider capacity in terms of regional working and engagement with the third sector and people with lived experience. The BPUs will be refined and shared publicly when approval has been granted by the Boards.

Karen Grant (Project Manager, NHS Lanarkshire) asked about the data that Health Boards should be collecting at a local level to align with and feed into the monitoring and evaluation process, and Debby encouraged all Boards to consider ways of capturing the difference the services have made to women, infants and families. Anne McFadyen (Infant Mental Health Lead) highlighted the importance of learning from the smaller quality improvement and evaluation projects being carried out in NHS Lanarkshire and other Health Boards. It was agreed that Lizzy would follow up with Karen about data collection and evaluation.

Action: Lizzy Archibald and Policy Team

The Vice Chair, in his role as Lead Clinician for Perinatal Mental Health Network Scotland (PMHN), advised that the network’s clinical audit system was going live in the coming days, and would be rolled out to all Health Boards in a carefully managed fashion to ensure teams have capacity. PMHN will be in touch with the Boards in due course.

The Chair emphasised that the PB focus going into the final year of the programme was on what has been achieved, what difference has been made, what is still to be done and how to make that sustainable.

Subgroup progress and next steps

Monitoring and evaluation

Anne McFadyen advised, on behalf of the subgroup Chair Helen Cheyne, that Monitoring and Evaluation meetings have focused on guiding and supporting the PHS plan, as outlined earlier in the meeting. The Infant Mental Health Implementation and Advisory Group (IMH-IAG), which Anne Chairs, has an Evaluation and Research subgroup that have also met recently with PHS. It has been agreed that the remit of the two evaluation subgroups will remain separate, and they will retain a close working relationship with each other and PHS.

Anne mentioned that a paper on inequality and IMH, and a paper on perceived barriers and enablers to setting up IMH services, written by members of the IMH Evaluation and Research subgroup, were going to be published next month in the World Association of Infant Mental Health (WAIMH) online journal titled ‘Perspectives in Infant Mental Health’.

Equalities

Helen Sloan and SallyAnn Kelly co-Chair the Equalities subgroup. Helen advised that the subgroup has representation from statutory services, third sector, education and lived experience, but members are concerned that the group is not diverse enough. In recent meetings, organisations supporting women and families with protected characteristics have presented training information and research findings to the Equalities subgroup in ‘spotlight sessions.’ The emerging themes have been around accessibility of services for hard to reach families, sustainability of third sector funding, specialist service provision, inclusive language and translation services. There has also been rich discussion on training opportunities for statutory and third sector services, on coproduction with people with lived experience, and on having clear links with anti-poverty initiatives.

The upcoming priority for the subgroup is to develop and agree questions for the Health Boards to understand their current practice around women and infants with protected characteristics, and to help inform recommendations to improve equality and diversity in service development and delivery.

Workforce and sustainability

Alex Brown (Assistant Programme Manager) gave an update on the recent and upcoming work of the Workforce and Sustainability subgroup. It was noted that Selena Gleadow-Ware (Royal College of Psychiatrists) and Susan McConachie (Regional Nurse Consultant) had recently taken over from David Pickering-Gummer as co-Chairs of the subgroup. Alex and the Chair gave thanks to David for his input and contribution to the work of the PB.

At the last meeting, Susan presented an analysis of the Nursing workforce in NHS Borders, Fife, Forth Valley, Highland, Lothian and Tayside, and committed to take forward the four recommendations from the report with the other two Nurse Consultants. Selena has agreed to develop a similar piece of work on the Psychiatry workforce by September 2022. Fiona Fraser (Consultant Clinical Psychologist) offered to update the subgroup on the psychology workforce project being carried out by the PMHN Psychological Therapies forum.

Health Board monitoring process

Lizzy Archibald advised that statutory service development continues to progress, and is monitored by Lizzy and the SG Policy team using the BPUs, as mentioned earlier in the meeting. Due to requests from Health Boards around pandemic restrictions, the visits that had been planned for May onwards have been postponed. The in-depth, in-person visits were intended to replace the need for a written monitoring return in this reporting period. Lizzy will continue to meet with teams and individuals from all Board areas on an informal basis, and the SG Policy team will agree and issue information to Boards on the monitoring process for this financial year. It was agreed that Health Board service development would be discussed further at the August PB meeting.

Action: Lizzy Archibald and Policy Team

Any other business

Rach Barlee, who has recently joined Maternal Mental Health Scotland as Participation Officer for the PB, was introduced and welcomed to the group. Rach will be working alongside Kat Masterson.

Next meetings:

• 25 May 2022 – joint meeting with the Infant Mental Health Implementation and Advisory Group
• 17 August 2022