Adult secondary mental health services - quality standards: consultation

Consultation

Part 1: Questions On All Of The Standards

This part of the consultation asks questions about all of the standards which you can find on pages 8 to 22.

If you have less time to complete the consultation, you may wish to focus on section called 'General standards questions'. It contains six questions which will allow you to feedback on the standards overall. This part of the consultation may be of the most interest to people who have experience of using services. The other sections in the consultation ask more detailed questions on each theme and may take more time to complete.

1. How far do you agree that the standards will improve the experiences of people using secondary mental health services?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

2. How far do you agree that the standards will improve the outcomes of people using secondary mental health services?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

3. How far do you agree that the standards clearly set out to individuals, their families and carers what they can expect from a secondary mental health service?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

4. We know that currently not everyone has the same experiences or outcomes when they engage with mental health services. We want these standards to help make sure that services meet everyone's needs whoever you are and whatever your background. How far do you agree that the standards will help do this?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

5. Do you have any suggestions for how the standards could go further to help ensure that services meet everyone's needs regardless of who they are or their background?

6. Are there any other areas of mental health services in which you think these standards could apply outside of adult secondary services? If so, which services?

7. Please share with us any of your thinking on your answers above and give us your views on the standards overall.

Part 2: Access Questions

Parts two to six of the consultation ask more detailed questions on each theme and may take more time to complete.

This part of the consultation is about access. The Access Standards can be found on page 8.

8. How far do you agree that the standards within this theme will improve the experiences of people using secondary mental health services?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

9. How far do you agree that the standards within this theme will improve the outcomes of people using secondary mental health services?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

10. How far do you agree that the standards within this theme clearly set out to individuals, their families and carers what they can expect from a secondary mental health service?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

11. Do you think there is anything missing from the Access standards?

12. We know that currently not everyone has the same experiences or outcomes when they engage with mental health services. We want these standards to help make sure that services meet everyone's needs whoever you are and whatever your background. How far do you agree that the Access standards will help do this?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

13. Do you have any suggestions for how the Access standards could go further to help ensure that services meet everyone's needs?

14. Please share with us any of your thinking on your answers above and your views on Access standards overall.

Part 3: Assessment, Care Planning, Treatment and Support Questions

This part of the consultation is about Assessment, Care Planning, Treatment and Support. The standards on Assessment, Care Planning, Treatment and Support. Can be found on page 10.

15. How far do you agree that the standards within this theme will improve the experiences of people using secondary mental health services?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

16. How far do you agree that the standards within this theme will improve the outcomes of people using secondary mental health services?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

17. How far do you agree that the standards within this theme clearly set out to individuals, their families and carers what they can expect from a secondary mental health service?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

18. Do you think there is anything missing from Assessment, Care Planning, Treatment and Support standards?

19. We know that currently not everyone has the same experiences or outcomes when they engage with mental health services. We want these standards to help make sure that services meet everyone's needs whoever you are and whatever your background. How far do you agree that the Assessment, Care Planning, Treatment and Support standards will help do this?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

20. Do you have any suggestions for how the Assessment, Care Planning, Treatment and Support standards could go further to help ensure that services meet everyone's needs

21. Please share with us any of your thinking on your answers above and your views on Assessment, Care Planning, Treatment and Support standards overall.

Part 4: Moving between and out of services Questions

This part of the consultation is about Moving Between and Out of Services. The Standards on Moving between and out of services can be found on page 12.

22. How far do you agree that the standards within this theme will improve the experiences of people using secondary mental health services?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

23. How far do you agree that the standards within this theme will improve the outcomes of people using secondary mental health services?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

24. How far do you agree that the standards within this theme clearly set out to individuals, their families and carers what they can expect from a secondary mental health service?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

25. Do you think there is anything missing from the Moving between and Out of Services standards?

26. We know that currently not everyone has the same experiences or outcomes when they engage with mental health services. We want these standards to help make sure that services meet everyone's needs whoever you are and whatever your background. How far do you agree that the Moving between and out of services standards will help do this?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

27. Do you have any suggestions for how the Moving between and out of services standards could go further to help ensure that services meet everyone's needs?

28. We know that substance use and mental health difficulties can be co-occurring. We want to ensure that people with both a mental wellbeing concern and substance use receive access to treatment that is tailored to their needs. How far do you agree that we should include a specific standard on support for those with substance use issues within these standards?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

29. What should a standard around substance use contain?

30. Please share with us any of your thinking on your answers above and your views on the Moving between and Out of Services standards overall.

Part 5: Workforce Questions

This part of the consultation is about the Workforce. The standards on Workforce can be found on page 13.

31. How far do you agree that the standards within this theme will improve the experiences of people using secondary mental health services?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

32. How far do you agree that the standards within this theme will improve the outcomes of people using secondary mental health services?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

33. How far do you agree that the standards within this theme clearly set out to individuals, their families and carers what they can expect from a secondary mental health service?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

34. Do you think there is anything missing from the Workforce standards?

35. We know that currently not everyone has the same experiences or outcomes when they engage with mental health services. We want these standards to help make sure that services meet everyone's needs whoever you are and whatever your background. How far do you agree that the Workforce standards will help do this?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

36. Do you have any suggestions for how the Workforce standards could go further to help ensure that services meet everyone's needs?

37. Please share with us any of your thinking on your answers above and your views on Workforce standards overall.

Part 6: Governance and Accountability Questions

This part of the consultation is about Governance and Accountability. The Standards on Governance and Accountability can be found on page 14.

38. How far do you agree that the standards within this theme will improve the experiences of people using secondary mental health services?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

39. How far do you agree that the standards within this theme will improve the outcomes of people using secondary mental health services?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

40. How far do you agree that the standards within this theme clearly set out to individuals, their families and carers what they can expect from a secondary mental health service?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

41. Do you think there is anything missing from the Governance and Accountability standards?

42. We know that currently not everyone has the same experiences or outcomes when they engage with mental health services. We want these standards to help make sure that services meet everyone's needs whoever you are and whatever your background. How far do you agree that the Governance And Accountability standards will help do this?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

43. Do you have any suggestions for how the Governance And Accountability standards could go further to help ensure that services meet everyone's needs?

44. Please share with us any of your thinking on your answers above and your views on Governance and Accountability standards overall.

Part 7: Implementation and Measurement

This part of the consultation contains more detailed questions seeking initial views on what services will need do to implement the standards and how we might measure the standards. While we welcome everyone's views across the whole consultation, this part of the consultation may be of most interest to people with experience of working in or running services.

Implementation Question

45. Overall, what support do you think services will need to implement the standards?

Measurement Questions

A key aim of the standards is that they are measurable. By measuring the standards, we will be able to celebrate and share good practice, identify any issues and drive improvement in services. We will work with services to ensure that measurement doesn't add unnecessary burden and findings are used in a supportive way.

We are proposing that the standards are measured in two ways:

Firstly, by services across the country filling out a self-assessment tool to collect information and data to find out how the standards are being implemented across their services.

A self-assessment tool is a way for services to gather information to allow them to evaluate how well they are meeting the standards. The tool will allow services to provide evidence to show that they are meeting the relevant standards, supporting them to recognise good practice and make necessary improvements to the services that they deliver.

It is proposed that this self-assessment would be a continual way to drive improvement in services over time. The number and frequency of self-assessments is still to be decided.

Secondly, we propose another way to measure performance, by collecting and publishing data on a number of indicators.

An indicator is information collected across the country that provides a measure of how well services are meeting the standards. Service providers will be asked to submit data on these indicators, which will be analysed and published to allow the Scottish Government and the public to understand how services are performing against the relevant standards and how well they are delivering for the people who use them.

It is proposed that this data on indicators would be collected, analysed and published on a regular basis. The frequency of collection is still to be decided.

46. How far do you agree that some of the standards should be measured using a validated self-assessment tool?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

Please explain the thinking behind your choice.

47. How far do you agree that some of the standards should be measured using a range of indicators?

Strongly Agree

Agree

Neither Agree or Disagree

Disagree

Strongly Disagree

48. Please explain the thinking behind your choice.

We have included a few examples of ways we could measure the standards.

We are keen to gather your views about these initial suggestions, as well as any other suggestions you may have of how to evidence the successful implementation of the standards and measure progress against them.

In 2023, we will undertake further targeted engagement on measurement with key stakeholders following this consultation. Partners will have further opportunities to feed into this process of adapting and refining the self-assessment tool and indicators before they are agreed.

Suggestions for Possible Self-Assessment Questions

		Relates to standard(s)
	Access
(a)	How have services ensured that information is accessible, culturally sensitive and trauma informed? E.g., engagement with people with lived experience of using adult secondary mental health services.	1.1, 1.4, 1.8, 1.9, 1.10, 1.11
(b)	Do services gather and monitor waiting times data?	1.3, 1.6, 1.12
	Assessment, Care Planning, Treatment and Support
(c)	What choices are available to people who use services for accessing services? E.g., face-to-face, digital, telephone.	2.7, 2.11
(d)	What data on protected characteristics is currently collected and how is this used to inform the planning and delivery of services?	2.16
	Moving between and Out of services
(e)	What data about delays in moves between services is available and what does this tell us?	3.5, 3.6
(f)	What communication is provided about discharge and reengagement with services?	3.1, 3.3, 3.4, 3.7
	Workforce
(g)	What data about staff training, including diversity and trauma training is available and what does this tell us?	4.1, 4.4, 4.5, 4.7, 4.9
(h)	What wellbeing support is available to staff?	4.2, 4.3, 4.9
	Governance and Accountability
(i)	How is patient feedback gathered and how is it used to inform improvements in how services are planned and delivered?	5.1, 5.4, 5.5
(j)	What have recent external scrutiny inspections found and what actions have consequently been taken?	5.8

49. Please give us your views on these possible questions to include in the self-assessment. Please provide any further suggestions for self-assessment questions you may have.

Suggestions for Possible Indicators

		Relates to standard(s)
	Access
(a)	Proportion of people who agree with the statement: "I was treated with kindness, compassion, dignity and respect when accessing services."	1.5
	Assessment, Care Planning, Treatment and Support
(b)	Proportion of people who agree with the statement: "I was asked about my needs and my personal circumstances and requirements were considered in planning my care and treatment."	2.2, 2.4
(c)	Proportion of people treated in the community compared to inpatient settings.	2.6, 2.12
(d)	How long people stay in inpatient settings.	2.6, 2.12
(e)	Proportion of people in mental health services seen for at least 1 month that show improvement in any personal outcome measurement over the previous month.	2.15
	Moving between and Out of services
(f)	Proportion of people whose referral included a copy of their care plan.	3.1, 3.2, 3.7
(g)	Proportion of people whose move out of services is delayed, and average length of delay.	3.5, 3.6
	Workforce
(h)	Mental Health workforce staffing levels and skill mix.	4.1, 4.5, 4.6

Please Note: We have not included a waiting times target as an indicator. This is following feedback during stakeholder engagement to date, that highlighted the wide range of services within adult secondary mental health which means that establishing one waiting times target would not be appropriate or helpful. We would, however, be grateful for any further views.

50. Please give us your views on these suggestions for possible indicators to include. Please provide any further suggestions for indicators you may have.

51. We know that currently not everyone has the same experiences or outcomes when they engage with mental health services. We want these standards to help make sure that services meet your needs whoever you are and whatever your background. How would you suggest that we support services to reduce inequalities in the outcomes and experiences of people who use services, including in the measurement of the standards?