Mental Health and Wellbeing Strategy: Leadership Board minutes - August 2024

Attendees and apologies

Maree Todd MSP, Minister for Social Care, Mental Wellbeing and Sport – Joint Chair

Councillor Paul Kelly, Spokesperson for Health & Social Care, COSLA – Joint Chair

Stephen Gallagher, Director of Mental Health, Scottish Government

Dr Alastair Cook, Principal Medical Officer for Mental Health (representing the multidisciplinary group of Professional Advisors to the Scottish Government)

Julie Humphries, Deputy Director, Tackling Child Poverty & Financial Wellbeing, Scottish Government

Claire Renton, Deputy Director, Employability, Scottish Government

Richard Foggo, Director of Population Health, Scottish Government

Eddie Fraser, Solace lead for Health and Social Care, COSLA

Nicola Dickie, Director of People Policy, COSLA

Eddie Follan, Chief Officer, Health and Social Care, COSLA

Gary Jenkins, State Hospital, representing Board Chief Executives

Caroline Cameron, Chief Officer North Ayrshire, representing HSCP Chief Officers

Alison White, Chief Officer West Lothian, representing HSCP Chief Officers

Lee Knifton, Chair of Scotland’s Mental Health Partnership

Alan Webb, Chief Officer of Third Sector Dumfries and Galloway, representing the Scottish Third Sector Interface (TSI) Network

Laura Kerr, Head of Policy and Workforce, Social Work Scotland

Margaret Callander, Unison, representing NHS National Staff Side

Mhairi Selkirk, Unite, representing NHS National Staff Side

Peter Johnston, Consultant Pathologist, NHS Grampian, representing the Academy of Colleges and Faculties

Catherine McWilliam, Nations Director, Institute of Directors Scotland

Gordon Johnston, Chair of Voices of Experience (VOX) Scotland

Angela Jackson, Diverse Experience Advisory Panel 

Hussein Patwa, Diverse Experience Advisory Panel 

Rebecca Hoffman, LGBT Health and Wellbeing, representing the Equality & Human Rights Forum

Monique Campbell, See Me, representing the Equality & Human Rights Forum

Ally Winford, Mental Health Directorate, Scottish Government

Hannah Axon, Policy Manager, COSLA

Cristina Pecheanu, Policy Manager, COSLA

Items and actions

Welcome and introduction

The Minister for Social Care, Mental Wellbeing and Sport, as co-Chair, welcomed everyone to the first meeting of the Mental Health and Wellbeing Strategy Leadership Board and thanked everyone for their willingness to participate. 

The Minister and Councillor Kelly highlighted that this board is the first of its kind in terms of the oversight of national mental health policy in Scotland. It is a place where members can openly discuss key matters and work through any issues arising.

The Minister asked members to send any conflicts of interest to the Secretariat after the meeting.  A ‘conflict of interest’, was defined as “a situation in which a person or organisation is involved in multiple interests, financial or otherwise, and serving one interest could involve working against another. Typically, this relates to situations in which the personal interest of an individual or organisation might adversely affect a duty owed to make decisions for the benefit of a third party”. 

These will then be added to the Register of Interests Log by the Secretariat. 

Context setting

Ally Winford, Head of Mental Health Strategy and Co-ordination Unit, Scottish Government, and Hannah Axon, Policy Manager at the Convention of Scottish Local Authorities (COSLA) set the context for the Leadership Board as the first agenda item.

Discussion

• COSLA co-chair - with regards to membership, where would Police Scotland fit into this board with regards to the work they’re doing around Mental Health   
• Scottish Government (SG) Director for jobs & wellbeing economy - what is the connection with Public Health Scotland
• Institute of Directors (IoD) Scotland – it will be important to have clear routes of dissemination of information and updates to relevant groups
• NHS National Staff Side - highlighted that there was no representative from NHS Education for Scotland on the board and suggested that it may be helpful to include them.  They also queried why Heads of Psychology (HoPs) were also not represented on the board
• SG Director of Mental Health - there are different ways in which the board can engage meaningfully with different stakeholders at different times. For example, policing and mental health currently sits within the unscheduled care team in the Scottish Government. This discrete area of work could be brought to the board to show what the workstream looks like and what progress is being made
• Academy of Colleges and Faculties - faculty members may wish to feed in on more specialist matters and wondered if there was a list of advisory groups who may be asked to participate
• Diverse Experiences Advisory Panel - advised that they were happy to work with anybody individually or with the group. For example, if there is additional information that we would like from particular groups, it may be that there is someone within their group who can provide advice on a particular topic
• need to keep the membership tight and work through governance links to access wider networks

Actions

• board members to send a note of any conflicts of interest not shared to date to the Secretariat
• Director of Justice and Director of Safer Communities, Scottish Government, to provide advice regarding where Police Scotland would fit into this board with regards to the work they’re doing around Mental Health. This includes the  related governance, ensuring relevant links are made with this
• Secretariat to provide board with a list of advisory groups
• board members to send the Secretariat any examples of best practice for the running of other similar Groups
• board members to send any thoughts to the Secretariat on advisory groups they think are essential, which should receive information directly from the Leadership Board   

Terms of reference and membership

The Minister introduced the terms of reference paper (LB(24)01-01) and membership list, which members had received in advance of the meeting, and invited members to comment and agree both.

The board was asked to:

• approve the terms of reference and membership

Discussion

• NHS National Staff Side - the role of trade unions should be acknowledged to a greater extent in the terms of reference.  There may be recommendations or work from this board that relates to workforce specifically so it would be helpful to include that in the governance structure section. For example, issues from this board might have to be considered by Scottish Workforce and Staff Governance (SWAG) and is not highlighted on the governance diagram
  • Voices of Experience (VOX) Scotland - queried the following paragraph in section 3 of the Terms of Reference (TOR) – ‘oversee the financial framework for delivery, and support consideration of the prioritisation of resources’
  • Joint chair - it was confirmed that the board’s remit is not to make financial decisions but will support with prioritisation and creativity given the challenging financial context we currently face. Important to be realistic and work together as a board to ensure we can deliver on the Strategy and delivery plan   

Actions

• Secretariat will make changes to the terms of reference in line with discussion, and as requested in written feedback from board Members.  This will be presented at the next meeting, noting which changes were also received by email
• Secretariat will clarify where board members represent interests beyond their own organisation (for example NES and HoPs being represented by Dr Alastair Cook, Principal Medical Officer for Mental Health)

Monitoring and evaluation for Scotland’s Mental Health and Wellbeing Strategy

Jane Ford and Matt Smith from Public Health Scotland (PHS) introduced the work they have been doing on monitoring and evaluation of the Strategy (LB(24)01-02).

The board was asked to:

• agree that monitoring and evaluation of the Strategy should be progressed
• agree on the proposed theory-based approach for monitoring and evaluation as laid out in the PHS summary paper
• discuss and agree the recommended next steps for monitoring and evaluation proposed by PHS. These include exploration of which areas of the Strategy should be prioritised for evaluation, areas where existing evaluation can be used, and areas where new mechanisms for evaluation are required
• agree on the creation of a data and evidence group to progress work on behalf of the Leadership board

Discussion

• several board members volunteered to be involved in this work to avoid duplication and make connections.  It will be important to differentiate between evaluating the Strategy and actually knowing whether we are making a difference to the mental health and wellbeing of the people of Scotland. We should ensure we connect in to other evaluation strategies and programmes of work, such as Child Poverty and Delivery of the Housing Strategy
• COSLA Director of People Policy - there is a lot of data and monitoring being pulled together across all of the systems and PHS can bring richness to analysing datasets that we don’t normally put together. There is lot of bits of data being collected across the whole system including through third sector and there may be an innovative way to collate and distil this effectively. Part of the next piece of work could include identifying what is currently being collected, and what parts of this could be joined together to provide useful information
• COSLA Co-Chair – sought clarity around who would undertake the evaluation work and how it would be resourced 
• Voices of Experience (VOX) Scotland - timing of the evaluation work is going to be very important as we will soon be looking at a second delivery plan. We should not just be looking backwards but looking forwards at what we want to do next. We need to ensure we are going to be measuring the right things and know what impact we are making. It was also noted that there is not enough data over a whole range of inequality measures to be able to make sure that we don’t end up in a position where we improve the overall mental health and wellbeing of the population but widening inequalities at the same time. Need to think about this from the start when considering monitoring and evaluation    
• Health and Social Care Partnership (HSCP) Chief Officer - this may be a chance for us to review whether the data we are counting/collecting is accurate and appropriate.  Often with data requests, there is not an ask to stop counting specific things, only ever an ask for new things. There needs to be an understanding of what should be counted and whether what we are currently counting is useful.
• Scotland’s Mental Health Partnership - supportive of the proposal if we can broaden the involvement with those of lived experience and organisations on the front line in the next step.  Support the suggestion to focus on a number of really essential things and there is support across the third sector to do a few things well.  Need to consider looking at the economic impact of this work.   Having that lens on an economic aspect might be really helpful for making the case for continuing specific actions  
• Scottish Third Sector Interface (TSI) network - important to have evidence of what is already happening and what we’re already doing to show the effectiveness of the strategy and the impact on people’s lives.  How can we capture those third sector organisations that are locally based who are providing the everyday support, that doesn’t look like a service intervention for example. Will the data and evidence group develop a simple framework for other organisations to use, to recognise where their work contributes to mental health and wellbeing and how we can build a national picture of all of the collective work?
• NHS National Staff Side - this is the first time the Workforce Health and Safety Report states that stress and other associated mental health conditions is the largest single factor for employees to be absent from work.  We need to work on this as it is a cost to the organisation and the country
• Diverse Experience Advisory Panel - is there a timeframe for how quickly the data collection is going to happen as we want to be able to capture evidence from the right people and may have to ask those questions now

Actions

• the board agreed that monitoring and evaluation of the Strategy should be progressed as outlined in the PHS paper
• the board would like more detail on the theory-based approach highlighted in the paper
• the board agreed to the recommended next steps outlined in the paper to explore which areas of the Strategy should be prioritised for evaluation, areas where existing evaluation can be used, and areas where new mechanisms for evaluation are required
• the board agreed that a data and evidence group should be established to progress this work on behalf of the Leadership board
• secretariat to circulate the full PHS Technical Report to members by request

Mental Health and Wellbeing Delivery Plan Progress Report

Siobhan McDill, Mental Health Portfolio Office, Scottish Government, provided a summary and high level breakdown of the actions delivery status with a specific focus on areas of risk.

The board was asked to:

• provide feedback on content and format to inform future reporting

Discussion

• the board were broadly content and found the content and format helpful
  • there was discussion around who owns the actions, and the need for this to be reflected in the information provided, especially when doing the prioritisation exercise
  • it would be helpful to see the co-dependencies of each action across the piece, and not just within Mental Health.  There is a lot of programme reporting on other programmes and it would be helpful as a board to see
  • board chief executives - With regards to the completed actions, it would be helpful to see how they have been delivered and could be used for shared learning about ideas and initiatives elsewhere. We also need to think about what have we achieved and what do we need to do next for the completed actions
  • HSCP chief officer - Due to the financial situation it was raised that things might start to get scaled back in local areas and therefore we may see more reds and ambers in future reports so it will be important to establish what the real priorities are moving forward
  • useful to have the workforce action plan in the same format as the progress report, recognising the importance of the workforce

Actions

• the Portfolio Office will consider the proposed revisions to the report ahead of the next board, incorporating them as far as possible
• consideration will also be given to how suggestions align with wider proposed approaches to monitoring and evaluation

Any other business

• Scotland’s Mental Health Partnership - there may be an opportunity for efficiencies in the monitoring and evaluation work – e.g. with the existing Population Health Framework.  The data and evidence group might also want to take a small manageable remit in pulling together the evidence that is live and sharing it with the group

Close

• the Minister thanked everyone for attending and contributing to the discussions
• the date of the next meeting is likely to be in December 2024 and will be confirmed in due course