Perinatal and Infant Mental Health Programme Board: delivery plan - September 2021 to September 2022

2021/22 Delivery Plan Actions

Coproduction with women, their infants and families

Women & Families Maternal Mental Health Pledge: “I am fully involved and at the centre of my care so I can make the best decisions for me, my pregnancy and my infant’s future health.”

Action 1:

We will further develop the Participation Officer role and support Health Boards to embed a co-production approach to service development, delivery and improvement.

How we will take this forward:

Following on from the successful work undertaken by our Participation Officer to date, we have recently appointed a second Participation Officer to support our continued focus on infant mental health, working with a strategic approach to empower women, infants and families to be at the centre of their care.

The Participation Officers will further enhance the role of the Experts by Experience group by supporting Boards and other local delivery structures to engage women, infants and families in a meaningful and proportionate manner.

We will also monitor the success of local Boards in embedding the principles of co-production in the development and delivery of perinatal and infant mental health services and facilitate the sharing of good practice across different localities and sectors.

Action 2:

We will implement the Peer Support Action Plan.

How we will take this forward:

Following on from the publication of the Perinatal Mental Health Peer Support Action Plan in March 2021 we have been working with Inspiring Scotland to identify key actions to take forward over the coming year.

These include:

• In February 2022 we will hold the first annual peer support event in February 2022 to share good practice and promote peer working.

• We will monitor the uptake and development of peer support work funded via the Third Sector Fund and identify and share current good practice and resources to support further development of quality peer support provision across Scotland

• Fund peer support workers as core members of specialist Mother and Baby Units and specialist community perinatal mental health teams and evaluate this work.

Workforce education, development and sustainability for perinatal and infant mental health

Women & Families Maternal Mental Health Pledge:

“I am confident that the staff who care for me have the right knowledge and skills.”

“I am given advice and care if I have a pre-existing mental health problem”

“I will be able to access talking therapies quickly if I need them.”

Action 3:

We will ensure that staff from all sectors and professions working in specialist perinatal and infant mental health services and in universal services have a clear plan of training and skills acquisition around perinatal and infant mental health, building on the successful development of initiatives such as the NHS Education Scotland Essential Perinatal and Infant Mental Health resource.

How we will take this forward:

NHS Education for Scotland will develop a learning programme by October 2021 that will further enhance staff development across all relevant sectors and disciplines. This will ensure that all staff at Specialist level (those working in Mother and Baby Units, specialist Community Perinatal Mental Health, Maternity/Neonatal Psychological Interventions and Infant Mental Health) can track their learning progress through the seven Essential Perinatal and Infant Mental Health modules and access follow on training and webinars.

Additional single discipline training e.g. for Psychiatrists, Psychologists, Midwives, Health Visitors, Occupational Therapists, Mental Health and Nursery Nurses will be developed where necessary, following evaluation of the Multidisciplinary Team training. 

Roll out of the Institute of Health Visiting Perinatal and Infant Mental Health Champions training will continue to ensure Champions are available in every Health Board, and that Champions deliver training locally to Health Visitors, Midwives, Family Nurses and other primary care team members.

Staff working outside health services and in the third sector will be provided with information on perinatal and infant mental health services and referral pathways. Inspiring Scotland will work with the Programme Board and Perinatal Mental Health Network Scotland (the National Managed Clinical Network) to support local areas to create links between statutory and non-statutory services and take forward an integrated approach across service development and training.

Action 4:

We will ensure that services working with women and infants, and their families, are able to offer a range of psychological interventions appropriate to need.

How we will take this forward:

Over the life of the Programme Board, we have invested in a range of education and learning resources via NHS Education for Scotland Psychology and supported three training programmes to increase the perinatal and infant mental health workforce.

By the end of 2022/23 there will be an additional 30 Clinical Associates in Applied Psychology and 10 additional Cognitive Behavioural Psychotherapists in the workforce, as well as 15 additional trainees on the Doctorate in Clinical Psychology 3 year training course, and 1 additional Child Psychotherapist in training.

In addition, we will carry out the following:

Offer NHS Education for Scotland psychological interventions training to Perinatal Mental Health Midwives in Maternity and Neonatal psychological interventions services to increase access to psychological interventions for women and infants in maternity and neonatal services.

Continue to deliver the training recommendations of the NHS Education for Scotland Infant Mental Health Training Plan across universal services and specialist teams.

Roll out an online infant mental health training module for staff working with infants with neonatal complications.

Monitor and evaluate the delivery of psychological interventions across all services in collaboration with the Perinatal Mental Health Network Scotland.

Work with Inspiring Scotland to provide support to recipients of the Perinatal and Infant Mental Health Fund, Small Grants Fund and the wider Perinatal and Infant Mental Health portfolio. This will help ensure services are provided in an informed and evidence based manner.

Work with Perinatal Mental Health Network Scotland to create a pathway to provide continuity of care for women and their partners/co-parents who experience loss or trauma in relation to pregnancy and childbirth whilst engaged with Perinatal and Infant Mental Health services.

Action 5:

We will support Health Boards to continue to develop Perinatal and Infant Mental Health services which can deliver expert care.

How we will take this forward:

Continue the funding of Mother and Baby Units, specialist Community Perinatal Mental Health teams, Maternity and Neonatal Psychological Interventions services and Infant Mental Health services across Scotland. The newly appointed Perinatal and Infant Mental Health Service Development Adviser will work closely with Health Boards to ensure that progress on service development is maintained.

Monitor and evaluate the development and delivery of specialist Perinatal and Infant Mental Health care. This will be done with a focus on outcomes and ensuring that lived experience is at the heart of service development and ongoing provision.

Equality and tackling stigma

Women & Families Maternal Mental Health Pledge:

“I will be looked after by experts, no matter where I live in Scotland.”

“I am able to discuss my mental health without fear of being judged.”

Action 6:

We will undertake specific action to ensure that groups identified as marginalised or disadvantaged in the Equality Impact Assessment have equitable access to services that are responsive to their specific needs. In addition, we will support measures to reduce stigma and increase public and professional awareness of perinatal and infant mental health.

How we will take this forward:

The Perinatal and Infant Mental Health Third Sector Fund successfully launched in 2020 and seeks to reduce stigma and increase access to support. We will work with Inspiring Scotland to continue to support the development of third sector provision and resources across Scotland for perinatal and infant mental health.

Publish the Raising Awareness Strategy in Autumn 2021 to drive Programme Board activities to improve awareness, increase understanding and reduce stigma associated with perinatal and infant mental health.

Building on the Perinatal Care Pathways work developed by Perinatal Mental Health Network Scotland, we will work with the Network and voices of experience to develop a suite of care pathway animations to inform women and families about access to expert care.

Work with Parent Club and partners to raise awareness of the 'Wellbeing for Wee Ones' resource for all parents and explore areas where further information is needed.

Following publication of Perinatal Mental Health Network Scotland report 'Supporting Women, Reducing Harm: Review of services for substance-using women and their infants in pregnancy and the postnatal period', deliver a stakeholder event (March 2022) to develop recommendations on standards of care and service development for women and their infants impacted by substance use in the perinatal period.

In conjunction with the Equalities Sub-Group we will set out priorities to address the issues of marginalisation and inequitable access to services highlighted in the Equality Impact Assessment and through engaging with voices of experience. Alongside protected characteristics this will include a specific focus on parity of support to infants; foster and kinship carers and care-experienced parents, as well as the needs of fathers/co-parents and those experiencing the impact of substance use.

Action 7:

We will support the development of regional structures to ensure that Boards work together to provide equity of access to expert care across the country.

How we will take this forward:

Publish a guidance paper on regional working for perinatal and infant mental health services, and work with the lead regional, and other Boards to implement a regional infrastructure. This will deliver equity of access to specialist community assessment and care, with specific focus on island, rural and more remote populations.

Support Inspiring Scotland to provide a developmental role to the third sector in expanding awareness of what other third sector and statutory services exist and how to access them (both locally and nationally) using the Perinatal and Infant Mental Health Third Sector Services Directory and engagement with Perinatal and Infant Mental Health Fund portfolio.

Action 8:

We will ensure that women and their infants experience equity of access to specialist inpatient care, wherever they live in Scotland.

How we will take this forward:

We will issue a public consultation on clinical care for high level, complex mental health difficulties by the end of 2021.

Review the Mother and Baby Unit Family Fund to ensure it continues meets the needs of families visiting relatives in Mother and Baby Unit care.

Ensure existing pathways into inpatient care allow for equity of access for all women and infants.

Recovery and ensuring a systems approach

Women & Families Maternal Mental Health Pledge:

“My family are given information and support for themselves and to support me.”

“My baby will have parents who have good mental health support.”

Action 9:

We will establish a programme of evaluation on the outcome of investment in Perinatal and Infant Mental Health. We will feed back findings and examples of good practice to Health Boards and third sector to drive the development of local services.

How we will take this forward:

We will work with Public Health Scotland to commission and evaluate the programme, and set in place an Evaluation Implementation Framework by end of 2021.

Via the monitoring and evaluation sub-group, develop mechanisms to ensure findings of the evaluations drive good practice and service development in local areas.

Action 10:

We will develop a transition and legacy plan to ensure sustained investment in and development of perinatal and infant mental health services beyond the life of the Programme Board.

How we will take this forward:

The work of the Workforce Sub-group will critically examine current issues and future needs around workforce and sustainability.

Develop a transition and legacy plan for both perinatal and infant mental health for the conclusion of the Programme Board, which includes service sustainability and further development of regional collaboration.

This plan will consider the steps needed for Perinatal and Infant Mental Health provision to sustain services beyond the lifetime of the Programme Board. We have started this process by agreeing £8 million funding on an earmarked recurring basis to extend beyond the life of the Programme Board, giving Health Boards the ability to plan for the future of services longer term.

Action 11:

We will ensure that future developments take into account additional needs and learning resulting from the Covid-19 pandemic. This will include a specific focus on equalities and ensuring that services and support are able to meet the needs of all women and families who require it.

How we will take this forward:

We will take forward the Small Grants Fund to support smaller third sector organisations to develop innovations in service delivery and tackle emerging issues related to the impacts of Covid -19.

Following work by the Programme Board to ensure that perinatal services were in the first rollout of the online Near Me appointment service, and implementation of Computerised Cognitive Behavioural Therapy for perinatal services, we will continue to work to embed digital approaches where appropriate. We will link closely with ongoing digital and online innovations, especially those that support the needs of remote and rural communities.

Conduct a review of peer reviewed literature on Perinatal and Infant Mental Health before and during the Covid-19 pandemic.

Action 12:

We will communicate effectively with women and families as well as professionals, services and the public to ensure that improvements in service development and delivery are effectively communicated and that it is clear how and where to access services.

How we will take this forward:

In collaboration with Perinatal Mental Health Network Scotland - share best practice across Health Boards to bring professionals together to share knowledge and learning, and aid service development across Scotland.

The Participation Officers will work with the experts by experience groups to ensure Boards have the knowledge, skills and understanding to develop and deliver services collaboratively with women, infants and families, ensuring they have access to the right information when they need it.

Boards should use this insight to ensure that parents and families are aware of services and their rights and entitlements to support in the perinatal and early years period, and what support is available in their local area.

We will also enhance the Programme Board web presence, use Twitter to communicate and engage with stakeholders, and promote resources available online through Perinatal Mental Health Network Scotland and other Programme Board partners.

We will continue to work with Boards to provide feedback on service development progress and, by September 2022, we will publish a progress overview including allocations made across the various funding streams since the Programme Board was convened in 2019.

Continue to collate and map the changes and improvements to service delivery as monitoring information is returned from Health Board areas, with a view to publishing an interactive map after the life of the Programme Board.