Veterans: Veterans Mental Health and Wellbeing Implementation Board minutes - September 2022

Attendees and apologies

• Charles Winstanley, Chair
• Maura Lynch, Scottish Government
• Jane Menzies, Combat Stress
• Martin Bell, NHS NSS Director of Primary Care
• Sharon Findlay, Defence Primary Healthcare Services
• Jim Miller, NHS Chief Executive
• Neil Morrison, Veterans Scotland
• Michelle Ramage, Veterans First Point

Apologies

• Mairi McKinley, NHS Fife
• Eddie Follan, COSLA
• Alastair Cook, Scottish Government
• Thelma Bowers, North Ayrshire HSCP
• Eric Fraser, Ex-Veterans Commissioner
• Susan Bomphrey, Scottish Government

Items and actions

Introductions

CW welcomed Jim Miller to the board and invited the board to introduce themselves.

Venture Trust presentation

Alastair Pringle, the CEO of the hosting organisation Venture Trust, delivered a short presentation on their work.

Apologies

CW noted that with only eight board members present, the meeting did not have the quorum. He proposed that the provisional decisions made during the meeting by those attending be taken to the absent board members in order to become board decisions.

Actions: The board agreed with CW’s proposal.

Declarations of interest

No conflicts of interest were declared.

Minutes of last meeting

CW asked the board to review the draft minutes of the 15 June 2022 meeting.

Action: No inaccuracies were raised. The board approved the minutes.

Budget update 

ML informed the board that the Scottish Government is currently undergoing an emergency budget review, due to conclude at the end of September. The review might result in cuts to the budget for the implementation of the Veterans Mental Health and Wellbeing Action Plan. ML advised that funding for the See Me campaign was secure and that frontline services and organisations Scottish Government had commitments to would be prioritised.

Due to financial uncertainty, ML asked for the board decisions to be made in principle.

Action: The board agreed to ML’s suggestion.

SF asked what was at risk in case of cuts. ML advised that the implementation team would be protected this year. 

CW asked the board for a general agreement to draw the funds remaining in the budget towards navigator pilots, website and comms, information technology solutions, and research and evaluation.

Action: The board agreed to direct the remaining budget towards the proposed areas.

Implementation team recruitment update

Jane Menzies reported challenges in recruitment for the three full time positions on the implementation team. Several candidates dropped out before interviews.

The board offered to circulate information about the vacancies in their networks.

Action: Jane Menzies will forward details of the next advert for these positions so that they can be shared across the networks of board members.

Emerging proposals for system design

Jane Menzies presented a proposal for the design of the veterans’ mental health service and the timeline for the phase one of its development, covering the period until 1 April 2023. The work undertaken in this period will include developing performance baseline, and sourcing, defining and training navigators in preparation for the pilot launch of the service on 23 March 2023. Veterans are to be involved at all stages.

Jane Menzies raised the question of whether the service should offer help with all mental health issues faced by veterans or only those related to their time in the military. MR and Jim Miller observed that in many cases it is difficult to make a clear distinction. MR shared that the presenting mental health difficulties of veterans who access V1P services most commonly relate to both service and non-service attributable issues, for example, adverse childhood experiences. These are treated by the same clinician, within the same episode of care.

Jane Menzies asked the board how to best engage with primary care. MB reminded members that primary care is broader than GPs, it also includes optometry, dentistry and pharmacies.

MR confirmed that V1P peer support workers could become navigators as part of their role is signposting. However, peer support also involves providing an intervention to veterans within a supportive peer relationship. There are HR considerations involved in any potential change to the new role.

CW explained that health boards without V1P will need to nominate navigators from NHS staff or third sector.

Navigators for the pilot to be recruited from various regions.

Data and IT

CW asked the board whether resources should be committed to developing a system for joining up digital data or whether different solutions such as paper passports should be considered.

Action: The board agreed not to commit to spending any funds on an IT system at this stage and to for the time being focus on manual solutions.

Research hub

Dr Gerri Matthews-Smith, an independent academic advisor to the board, was unable to attend the meeting due to an emergency.

She will be invited to the next board meeting.

Any other business

NM presented his paper Developing a Vision for a Scottish Veterans’ Mental Health Service, highlighting the need to assess the demand for the service and proposing ideas for its development and final shape.

The board noted NM's views.

Date of next meeting

The next meeting will take place via Microsoft Teams on 15 December 2022.

Action: The board agreed to the proposed schedule of meetings and to alternate in-person and virtual meetings.

Action: Health board representatives from the Highlands and Scottish islands regions to be invited to one of the virtual meetings.