Adult secondary mental health services: consultation analysis

8 Governance and accountability

8.1 Introduction

Part six of the consultation asked seven questions on the governance and accountability standards.

8.2 Question 38

Table 8.1 provides the quantitative response to Question 38.

This shows that a majority of all consultation respondents who answered Question 38 either agreed or strongly agreed (66%) that the standards within this theme will improve the experiences of people using secondary mental health services.

Base = 82 (individuals = 44 and organisations = 38)

Tables may not total 100% due to rounding

8.3 Question 39

Table 8.2 provides the quantitative response to Question 39.

This shows that a majority of all consultation respondents who answered Question 39 either agreed or strongly agreed (61%) that the standards within this theme will improve the outcomes of people using secondary mental health services. A relatively large proportion of respondents neither agreed nor disagreed (29%) with this statement.

Base = 82 (individuals = 44 and organisations = 38)

Tables may not total 100% due to rounding

8.4 Question 40

Table 8.3 provides the quantitative response to Question 40.

This shows that over two-thirds of all consultation respondents who answered Question 40 either agreed or strongly agreed (69%) 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.

Base = 82 (individuals = 44 and organisations = 38)

Tables may not total 100% due to rounding

8.5 Question 41

Over two-fifths (45%) of all consultation respondents answered Question 41 which asked respondents whether they think there is anything missing from the governance and accountability standards.

Theme 1: A repeat of the key themes

Some respondents (individuals and all organisation sub-groups) repeated points they made to earlier consultation questions – see Section 2.5 for more detail (for example, more detail on how the standards would be delivered, monitored, and audited, and adequate funding and workforce development).

Theme 2: There should be a range of ways to gather the views and experiences of people with lived experience

A few respondents (individuals, Health Boards, HSCPs and services, mental health and other organisations) felt that there should be a variety of ways for people with lived experience of using adult secondary mental health services to provide feedback on their experience of accessing and using such services - including a clear complaints process.

These respondents suggested that different mechanisms may be required to secure the meaningful engagement of people with lived experience (including those who are seldom heard) – this could include both formal and informal engagement methods. It was also considered important that service users were provided with reassurance around confidentiality and data protection.

Theme 3: Scope for the standards to be improved or strengthened

A few respondents felt that the governance and accountability standards as set out in the consultation document could be enhanced or further strengthened in some way.

The points raised were generally single points, and included that:

• the governance and accountability standards could benefit from greater emphasis on the involvement of people with lived experience and their families and carers
• services should provide information about the role of the Mental Welfare Commission as a safeguard for the rights of people with lived experience at an early stage in the access to services
• the standards could be extended to include listening to and learning from issues raised by staff and others - the Scottish Public Services Ombudsman note that that this feedback is often linked to that received from service users and can also be essential in areas where service users are concerned to feedback directly
• the Scottish Public Services Ombudsman also note that the standards “will need to be supported by guidance for board members to help them apply them; understand what this will look like in practice; and how to assess and get assurance about their organisation against them”
• there was felt to be a significant read across between the governance and accountability standards and the Health and Social Care Standards – it was suggested that the Health and Social Care Standards could be used as a guiding framework

Specific comments about individual standards are set out in Appendix E.

8.6 Question 42

The Scottish Government recognise that currently not everyone has the same experiences or outcomes when they engage with mental health services. They want these standards to help make sure that services meet everyone’s needs whoever you are and whatever your background.

Table 8.4 provides the quantitative response to Question 42.

Feedback was mixed. Over half of all consultation respondents who answered Question 42 either agreed or strongly agreed (54%) that the workforce standards will help do this, and a large proportion of respondents neither agreed nor disagreed (33%) with this statement.

Base = 80 (individuals = 43 and organisations = 37)

Tables may not total 100% due to rounding

8.7 Question 43

Half (50%) of all consultation respondents answered Question 43 which asked respondents whether they had any suggestions for how the governance and accountability standards could go further to help ensure that services meet everyone’s needs.

Theme 1: A repeat of the key themes

Some respondents repeated points they made to earlier consultation questions – see Section 2.5 for more detail. For example, this includes:

• there needs to be a range of ways for people with lived experience to feed in their views and experiences and to provide feedback
• more detail would be required on how the governance and accountability standards would be implemented and measured
• transparency was considered important - the standards need to be written and communicated in a clear and accessible manner

8.8 Question 44

Almost half (48%) of all consultation respondents answered Question 44 which asked respondents to share any of their thinking on the answers provided to Questions 38 to 43, and their views on the governance and accountability standards overall.

From a review of the qualitative responses to Question 44, one theme emerged that has not already been captured above at Question 41 and Question 43.

Theme 1: Complaints can have negative impact on staff

A few individuals and mental health organisations noted that complaints can have a negative impact on the mental health and wellbeing of staff, and that it would also be important to manage expectations around delivery of the standards (for example, sufficient lead-in time, a phased approach to implementation).