Independent Oversight and Assurance Group on Tayside's Mental Health Services minutes: 28 February 2022

Attendees and apologies

Present

• Fiona Lees, Chair of the Oversight and Assurance Group
• Fraser McKinlay, Member of the Oversight and Assurance Group
• David Williams, Member of the Oversight and Assurance Group
• Greg Colgan, Chief Executive, Dundee City Council
• Phil Davison, Divisional Commander, Tayside, Police Scotland
• Thomas Glen, Chief Executive, Perth and Kinross Council
• Stuart Lyall, Director of Finance, NHS Tayside
• Margo Williamson, Chief Executive, Angus Council

Apologies

• Grant Archibald, Chief Executive, NHS Tayside

Secretariat

• Stephanie Cymber, Mental Health Division, Scottish Government

Items and actions

Welcome

The Chair welcomed attendees and thanked Stuart Lyall for deputising for Grant Archibald at today’s meeting.

Minutes from the previous meeting

The minutes from the previous meeting on 26 January 2022 were agreed.

There were two matters arising. The first was in relation to integration and it was agreed to discuss that under agenda item four, on the next phase of the work programme.

The second was an outstanding action for Tayside Executive Partners to provide the Oversight Group with a copy of their letter to Clare Haughey, dated 1 June 2020, regarding the review of integration schemes.

Quarterly report - reflections and discussion

The Chair invited comments on the Oversight Group’s first quarterly report. No feedback was offered.

The Chair thanked Tayside Executive Partners (TEP) for their submission dated 2 February which had resulted in changes to a number of recommendations in terms of the RAG rating and accompanying narrative. The Chair, on behalf of the Oversight Group, reiterated their view that all issues identified were capable of being addressed and their commitment to work with the TEP to that end.

Work Programme - next phase

The Chair emphasised the Oversight Group’s aim to take a level of assurance on progress and that it is for Tayside Executive Partners to prioritise where they are focusing efforts. The enormity of the task to enact change through Living Life Well was recognised, as well as Tayside Executive Partners having other priorities to deliver, out with the mental health space.

The Chair explained that the next formal review of progress will take place at the end of April, with the Oversight Group’s second quarterly report submitted after the council elections. Thereafter, the next review stage will be the end of July with a final report from the Group at end of October.

The Oversight Group signalled five key areas where they want to do an in-depth review - some have been explored already, particularly integration, and are well advanced so the group intend to look at those again at the next meeting in March.

The Oversight Group will also take some time away from the monthly meeting schedule to explore workforce (structure and responsibilities, staff engagement, developing future workforce) which will also be a priority when looking at the evidence repository with colleagues from NHS Tayside on 3 March. The other areas are patient safety and culture and engagement - looking at these on a more granular basis to better understand the current operating context, the impact of improvement and action now underway.

For each theme, the Oversight Group will produce a mini work programme, and share those with Tayside Executive Partners, over the course of the next week. In respect of culture and hearing more about relationship building through the work partners are undertaking with Columba 1400, the Oversight Group invited Tayside Executive Partners to an informal discussion about this over supper before summer recess.

It was noted that all of this work is taking place in context of Council elections so the Oversight Group will continue to be mindful of that. Mapping out meetings for the remainder of this engagement was agreed as:

• end-March: focus on integration to reflect on the draft revised scheme which is being presented to the NHS Board and Councils before public consultation
• end-May: focus on patient safety - after new council colleagues have settled in
• end-June / early-July: focus on culture and engagement
• end-August: focus on workforce

It was agreed that the Secretariat would contact Tayside Executive Partners to identify future meeting dates. It was noted that there is currently no intention to hold a meeting in September but this will be kept under review as business progresses. The end of October will be the final meeting to coincide with the Oversight Group’s final report.

Tayside Executive Partners were in agreement with this approach and welcomed sight of the work programmes in due course. Discussion followed on the connection between the repository review and the themed work plans; and how this approach will complement the structures of governance and accountability that there discussed at the previous meeting.

There were questions about what ongoing reporting is required in terms of how Tayside Executive Partners can best articulate evidence and progress, and what messages are needed that give assurance. It was agreed that statements of progress, based on work undertaken and evidence held in the repository, are what is needed. The Oversight Group stated that they would also welcome knowing what areas Tayside Executive Partners are prioritising. It was noted that, in the short term, the focus is on providing the new draft integration scheme to elected members.

Further discussion highlighted that the review of integration schemes is nearly complete and will provide clarity about responsibility and accountability, what the delivery landscape looks like and what reporting and scrutiny will be. It was suggested that the Tayside Executive Partnership, as a group, would therefore be time limited as there are other forums to deliver work going forward, focusing on outcomes and being more informed by lived experience.

In looking again to the end point, the Oversight Group recommended that Tayside Executive Partners produce their own report at the end of the process. This would be for a wider audience, starting with their acceptance of all recommendations and their understanding of same; what action had been taken and achieved; on what basis confidence and assurance has been taken and what future monitoring will look like as part of business as usual.

Review of children and young people recommendations

There was discussion about the neurodevelopment hub with the Oversight Group enquiring about the level of assurance that Tayside Executive Partners are taking that this discreet service is within a wider universal service offer.

In terms of Child and Adolescent Mental Health Services (CAMHS), Tayside Executive Partners explained that they receive regular updates from the multi-agency TRIC (Tayside Regional Improvement Collaborative) group. The Oversight Group noted how strong the multi-agency partnership is and that it had received a number of awards. It was suggested that the Oversight Group meet some of the people involved.

Latest data showed that 40% of referrals to CAMHS could be redirected elsewhere. Tayside Executive Partners are looking at what other frontline services could be deployed to support the Getting it Right for Every Child (GIRFEC) agenda so that young people do not continue to be referred to a finite service when alternatives may be available (such as peer to peer support and parental support).

Discussion continued around the broader agenda in terms of mental health links to justice and the prison service which has an impact in the wellbeing and children space. Also discussed was taking a joined up partnership approach to care pathways and ensuring continuity of care, particularly if individuals are transitioning between services.

It was agreed to follow up separately, and in more detail, on the specific questions from the Oversight Group around the Trust and Respect recommendations relating to children and young people’s mental health services, out with this meeting.

Date of next meeting and arrangements for future meetings

It was agreed that the next scheduled meeting on 30 March is no longer suitable and the Secretariat would be in touch with Tayside Executive Partners to identify an alternative date.

Any other relevant business

No further points for discussion were raised under AOB.

The Chair thanked attendees for their time and brought the meeting to a close.