Infant Mental Health Implementation and Advisory Group minutes: 17 June 2020

Minutes from the meeting of the group on 17 June 2020.


Attendees and apologies

Author

  • Alex Brown

Present

  • Anne McFadyen,(Chair), Perinatal Mental Health Network (PMHN) Infant Mental Health Lead PMHN Managed Clinical Network (MCN)
  • Marita Brack, Programme Director, Psychology of Parenting, NHS Education for Scotland (NES)
  • Alex Brown, Programme Support Officer, National Services Scotland (NSS)
  • Ruth Christie, Head of Perinatal and Early Years Mental Health Team, Scottish Government (SG)
  • Iona Colvin, Interim Director and Chief Social Work Advisor, Children and Families Directorate, SG
  • Lynn Cuddihy, Clinical Nurse Manager, NHS Dumfries & Galloway
  • Matt Forde, National Head of Services, NSPCC Scotland
  • Rachel Fraser, Clinical Psychologist, Scotland Coordinator, Parent Infant Foundation (PIF)
  • Judith Gemmell, Change and Improvement Manager Infant Mental Health, NHS Fife
  • Linda Jardine, Director, Children and Family Services, Children First
  • Katy Lister,Perinatal and Early Years Mental Health Team, SG
  • Hugh Masters, Chair Perinatal & Infant Mental Health (PNIMH) Programme Board, SG
  • Nashwa Matta, Associate Specialist in Paediatrics,NHS GGC / Royal College of Paediatrics and Child Health
  • Ian Nicol, Programme Manager, NHS Lanarkshire
  • Liz Nolan, Assistant Director, Aberlour Child Care Trust
  • Juan Perez-Olaizola, Consultant Child and Adolescent Psychiatrist, Royal College of Psychiatrists, NHS Forth Valley
  • Alison Robertson, Consultant Clinical Psychologist, Maternity and Neonatal Services, NHS GGC
  • Moira Shulman, Head of IMH and Child Psychotherapy, NHS Fife
  • Harriet Waugh, Senior Policy Manager, Perinatal and Early Years Mental Health, SG
  • Carolyn Wilson, Team Leader, Supporting Maternal and Child Wellbeing, SG

Apologies

  • Andrew Dawson, Professional Lead for Child Psychotherapy, NHS Greater Glasgow & Clyde (GGC)
  • Helen Minnis, Professor of Child and Adolescent Psychiatry, University of Glasgow
  • Graham Shulman, Consultant Child and Adolescent Psychotherapist, NHS Lanarkshire

Items and actions

Welcome and apologies

Anne McFadyen (Chair) welcomed everyone to the third Infant Mental Health Implementation and Advisory Group (IMH-IAG) meeting. The Chair acknowledged the cancellation of the April meeting and thanked the group for coming together virtually by Microsoft Teams. Apologies were noted as above.

Review of minutes and outstanding actions

The Chair reviewed the minutes from the February meeting. It was agreed that Hugh Masters would pursue finding midwifery representation for the group through colleagues at Best Start.

Action: Hugh Master

Juan Perez-Olaizola agreed to speak with colleagues at the Scottish Royal College of Psychiatrists regarding an adult mental health representative to join the group.

Action: Juan Perez-Olaizola

The Chair confirmed that the Evaluation subgroup had met on three occasions, and would meet again soon for further discussion of evaluation and impact data.

Chair’s update

The Chair advised the group that although work had slowed down as COVID-19 management was prioritised, the 2020 to 2021 Delivery Plan would soon be finalised and published.

The first task following delivery plan publication was to find out what stage health boards and partners were at in their plans to develop multiagency infant mental health (IMH) services, with or without a specialist team. Virtual visits by the PNIMH programme board team to board areas would take place in July and August (dates to be confirmed.) The visits were an opportunity to assess each board’s state of readiness for service development.

The Chair advised that the 2020 to 2021 budget was less than originally anticipated but they hoped to be able to fund some board areas this year, with applications from NHS Lanarkshire and Fife considered first.

The Chair acknowledged that evaluation was a challenge. The Evaluability Assessment report produced by Health Scotland provided some guidance, and a data catalogue had been developed and needed refining. The IMH-IAG Evaluation subgroup would take account of this and also work proposed by the NSPCC to carry out an in-depth needs assessment in NHS Lanarkshire (please refer to section eight.)

Nashwa Matta and Alison Robertson had agreed to develop a service model to address the needs of neonates and older infants with complex needs. Alison gave a brief update on the progress of this work, and agreed to have a draft paper to view at the next meeting.

Action: Alison Robertson and Nashwa Matta

NHS Education for Scotland (NES) have progressed the development of online training resources. The first two modules (‘Introduction’ and ‘Keeping the Baby in Mind’) of the Essential Perinatal resource are live on TURAS. The next two modules (‘Interventions’ and ‘Assessment’) are currently in development. It was clarified that these modules were aimed at specialist practitioners working in a perinatal mental health service.

Marita Brack advised that the Solihull Approach online programs were now openly accessible to all families and practitioners in Scotland, with over 5000 registered learners so far.

It was agreed that Nashwa would have an offline discussion with Marita regarding the videos used in the resource.

Action: Nashwa Matta

Lynn Cuddihy informed the group of a trial which had taken place in Dumfries & Galloway which looked at delivering the Solihull programme in schools, establishing an awareness of Solihull principles from a young age. Colleagues were meeting later in June with NES to discuss a further roll out of this work.

PNIMH Programme Board delivery plan update

Hugh Masters gave an update on the work of the PNIMH programme board since the group last met. He acknowledged that much work had been delayed due to the COVID-19 pandemic, but the team were progressing all possible areas. He thanked the members of the group that were involved in the COVID-19 Response Hub for their engagement and suggestions.

As well as the NES modules and Solihull resources already mentioned, recent highlights include:

  • the third sector fund run by Inspiring Scotland generated massive interest, and a decision making panel was in development
  • the 2020/2021 PNIMH delivery plan incorporated the IMH and perinatal plans into one document to ensure they are considered alongside each other, and aimed to be published by the end of June
  • participation Officer has established an Experts by Experience reference group to consider the engagement of women and families with lived experience in the work of the PMHN managed clinical network and the PNIMH programme board
  • peer Support report waiting on final approvals before publication
  • Health Scotland Evaluability Assessment report finalised, and considering next steps for evaluation

Hugh advised that the current focus was on the organisation of meetings in July and August with the PNIMH Executive Leads from each regional Health Board to discuss development of community perinatal mental health teams (CPMHTs) and IMH services.

Update from NHS Lanarkshire

Ian Nicol, deputising for Graham Shulman, gave an update on the work progressed by NHS Lanarkshire with 2019 to 2020 funding. He advised that an IMH group had been developed with PNIMH Executive Lead, Ross McGuffie, and a 2020 to 2021 funding proposal had been drafted.

He informed the group of the development of an IMH indicator set which would advise professionals when to have concerns. A LearnPro module will also be developed.

Ian advised that a service level multiagency group had been set up, which included lived experience representation. They also aimed to bring together a lived experience focus group.

Update from NHS Fife

Judith Gemmell and Moira Shulman gave an update from NHS Fife. They advised that they needed to revisit implementation plans and governance structures in view of COVID-19. 

Judith stressed that the team were keen to engage with stakeholders but a previously planned event had been cancelled, reducing their opportunity to develop a participation framework. They were considering how best to engage with communities, women and families through a virtual format.

A communication plan was being developed to spread awareness, and a leaflet produced to detail what services can feasibly be delivered at this time.

Iona Colvin asked how the planning of both boards related to the wider children's services plans for each area. Judith responded that in Fife the Child Health Management Team participated in children services planning; the children services Senior Manager was Chair of the partnership group.

IMH funding

The Chair instigated discussion on the regional Health Boards’ readiness for investment.

Joanne Smith asserted that a Needs Assessment was necessary to map the disparity of need across the board areas. The Chair agreed that equity was paramount when developing IMH services, but also emphasised that resources were limited and should be dispersed rationally.

Rachel Fraser asked if it was possible to capture current levels of expertise and training through the board visits, and the Chair agreed that this should be included as part of the meeting to inform development going forward.

The Chair invited comment on the table attached as appendix to the Chair’s update paper, which detailed considerations for IMH funding.

Action: All

Liz Nolan stressed the need to ensure infants with a disability were considered in the development of services, and offered links to potential participation support.

NSPCC needs assessment proposal

The Chair invited Joanne Smith to talk about the NSPCC needs assessment proposal, and noted that it should be considered as a draft paper.

Joanne explained that the NSPCC team were looking to work alongside the PNIMH programme board to create a model in all board areas to ensure money is used efficiently and targeted to those most in need. She advised the approach would be to identify current levels of need through exploration of available data, based on child and parent vulnerability. It was intended that this work would be carried out in one board area initially, and it had been agreed that NHS Lanarkshire was the most appropriate place to start. The NSPCC aimed to produce a concise report that would summarise need and accompanying methodology, and give a sense of the environment in which services are to be developed.

It was hoped that the NSPCC team would be supported by a steering group made up of national experts, the board PNIMH Executive Lead, and potentially academic partners from the USA. Joanne acknowledged that eight weeks to carry out this data gathering exercise was a tight timescale, which highlighted the importance of experts to interpret the data and provide a rounder picture of what IMH service needs were in one area.

Rachel Fraser asked if the format of the needs assessment could be designed to make it easily replicable in other board areas at a later date.

The Chair agreed that a detailed picture in one board could act as a marker for other areas to consider the applicability of the methodology to their locality.

AOB

Parent Infant Foundation (PIF) Proposal

The Chair invited Rachel Fraser to talk about the draft PIF proposal. Rachel emphasised that although the proposal had been recently shared, further discussion with funders needed to take place before wider circulation.

Rachel explained that PIF is a third sector organisation that supports the development of IMH services, and had recently funded a post in Scotland. PIF have submitted a proposal to provide consultation and support to boards that are considered to be in the next ‘wave’ of IMH readiness.

COVID-19 effect on children and young people response group

Iona Colvin advised that she was co-chairing a group focused on the Scottish Government response to COVID-19 management for children and young people. The leadership group included representatives from across the sector, and reported into weekly ministerial meetings. Recently, the group has been considering the impact of substance abuse, and there is a recognition that many children can be identified as vulnerable.

Iona highlighted the large amount of work to be done on the response to the dramatic rise in domestic abuse, and the expected rise in childcare protection concerns, over the COVID-19 period. The Chair thanked Iona for this update, and all members for attending the meeting.

Next meeting: 26 August 2020

 

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