Perinatal and Infant Mental Health Programme Board minutes: 25 May 2022

Attendees and apologies

Author:

• Alex Brown

Present:

• Hugh Masters, Chair, PNIMH-PB, Scottish Government
• Anne McFadyen, Chair, IMH-IAG, Scottish Government also Infant Mental Health Lead, Perinatal Mental Health Network Scotland, NHS National Services Scotland
• Sally Amor, Child Health Commissioner, NHS Highland
• Rach Barlee, Participation Officer, Maternal Mental Health Scotland
• Marita Brack, Director, Psychology of Parenting team, NHS Education for Scotland
• Alex Brown, Assistant Programme Manager, NHS National Services Scotland
• Roch Cantwell, Vice Chair, PNIMH-PB, Scottish Government also Lead Clinician, Perinatal Mental Health Managed Clinical Network, NHS National Services Scotland
• Ruth Christie, Workstream Lead Children, Young People, Families and Relationships, Scottish Government
• Kirsten Coull, Consultant Clinical Psychologist, NHS Lothian
• Aman Durrani, Consultant Perinatal Psychiatrist, Royal College of Psychiatrists
• Fiona Fraser, Consultant Clinical Psychologist, NHS Greater Glasgow and Clyde
• Rebecca French, Everyone’s Business Campaign Coordinator for Scotland, Maternal Mental Health Alliance
• Sarah Hallam-Stewart, Change and Improvement Manager, NHS Fife
• Heather Kelly, Assistant Director, Aberlour
• Ann Marie Kennedy, Team Leader, Change is a Must, Perth and Kinross Council
• Karen Lamb, Head of Specialist Children's Services, NHS Greater Glasgow and Clyde
• Marion MacAulay, Chief Social Work Officer, Social Work Scotland
• Kat Masterson, Participation Officer, Maternal Mental Health Scotland
• Nashwa Matta, Associate Specialist in Paediatrics, NHS Greater Glasgow and Clyde
• Susan McConachie, Regional Nurse Consultant, NHS Lothian
• Eileen McKenna, Associate Director, Royal College of Nursing
• Chris Miezitis, Co-Director, Father's Network Scotland
• Lucy Morton, Scotland Development Lead, Parent-Infant Foundation
• Alison Robertson, Consultant Clinical Psychologist, NHS Greater Glasgow and Clyde
• Helen Sloan, Regional Nurse Consultant, NHS Greater Glasgow and Clyde
• Joanne Smith, Policy and Public Affairs Manager, NSPCC Scotland
• Harri Waugh, Perinatal and Early Years Mental Health Team Lead, Scottish Government

In attendance

• Alastair Douglas, Perinatal and Early Years Mental Health Team, Scottish Government
• Nadia Abu-Hussain,Strategy and Coordination Team, Scottish Government
• Jean Carwood-Edwards, Chair of 3-5s Task and Finish Group, Children and Young People’s Mental Health and Wellbeing Joint Delivery Board, Scottish Government
• Meg Ferguson on behalf of Leanne Anderson, Fund Support Officer, Inspiring Scotland
• Karen Grant on behalf of Ross McGuffie, Perinatal and Infant Mental Health Project Manager, NHS Lanarkshire
• Katy Lister, Perinatal and Early Years Mental Health Team, Scottish Government
• Irene Permaul, Perinatal and Early Years Mental Health Team, Scottish Government
• Mark Richards, Strategy and Coordination Team, Scottish Government
• Katherine Robertson on behalf of Lauren Kennedy, Senior Nurse for Mental Health, NHS24
• Kelsey Sclater, Perinatal and Early Years Mental Health Team, Scottish Government

Apologies:

• Jeff Ace, Chief Executive, NHS Dumfries and Galloway
• Leanne Anderson, Performance Advisor, Inspiring Scotland
• Lizzy Archibald, PNIMH Service Development Adviser, Scottish Government
• Helen Cheyne, Professor of Maternal and Child Health Research, University of Stirling
• Andrew Dawson, Professional Lead for Child Psychotherapy, NHS Greater Glasgow and Clyde
• Douglas Guest, Head of Development, Home-Start Scotland
• Linda Jardine, Director of Children and Family Services, Children 1st
• Catriona Johnson, Associate Programme Director, NHS National Services Scotland
• SallyAnn Kelly, Chief Executive, Aberlour
• Lauren Kennedy, Lead Nurse for Mental Health and Learning Disabilities, NHS24
• Jacqueline Kerr, Assistant Chief Officer, NHS Greater Glasgow and Clyde
• Ross McGuffie, Chief Officer, Health and Social Care, NHS Lanarkshire
• Clare McGuire, Head of Programme, NHS Education for Scotland
• Helen Minnis, Professor of Child and Adolescent Psychiatry, University of Glasgow
• Katherine Morton, Consultant Psychiatrist, NHS Lanarkshire
• Marie Claire Shankland, Programme Director, NHS Education for Scotland
• Judy Thomson, Director of Psychology, NHS Education for Scotland

Items and actions

Welcome, apologies and housekeeping

Hugh Masters (Chair) welcomed everyone to a joint meeting of the Perinatal and Infant Mental Health Programme Board (PB) and the Infant Mental Health Implementation and Advisory Group (IAG), which is chaired by Anne McFadyen. Deputies and apologies were noted as above.

The minutes were agreed as an accurate representation of the March 2022 PB meeting. With amendment to a naming error and a spelling mistake, the minutes of the April 2022 IAG meeting were also agreed. Both documents will be made available on the group's page.

Programme board update

The core working group and SG policy team held a full day planning meeting at the start of May 2022. The current focus is reporting on what the PB has delivered, what difference that has made, what is still to be done, and a set of recommendations for sustaining the progress and further developments after March 2023, when the PB is due to end. A draft of that report will be discussed at the 31st August 2022 PB meeting. With input from PB members, the report will be finalised and shared with the Minister for Mental Wellbeing and Social Care by November 2022.

Service development

The SG is currently reviewing all 2022-2023 budget plans in light of recent confirmation that Covid-19 recovery funding will not be provided by the UK Government this financial year, hence putting significant pressure on existing Health and Social Care budgets. For that reason, SG are pausing any further confirmation of 2022-2023 funding. SG recognise that this may delay some activity planned for this financial year, but it is important that spending plans are fully reconciled with the budget that is available. The SG have asked those working in statutory services to let them know if this will result in any serious short-term risks.

Lizzy Archibald, Service Development Adviser, and others are engaged in face-to-face visits with the new and enhanced clinical teams in the Health Boards, to be followed up by online meetings between the Programme Board and the NHS board Executive Leads. More information on Health Board service developments will be presented at the August 2022 PB meeting.

Action: Lizzy Archibald

Mother and baby unit options appraisal consultation

Irene Permaul (Senior Policy Officer, SG) advised that the Mother and Baby Unit (MBU) in-patient capacity options appraisal consultation closes on 31st May 2022. Over 180 responses had been received at the time of the meeting. The Perinatal and Early Years Mental Health policy team ran stakeholder engagement events throughout May and have appointed a supplier to conduct the consultation analysis, which aims to be completed by August 2022.

Supporting women, reducing harm

Roch Cantwell (PB Vice-Chair) advised that the Supporting Women, Reducing Harm event took place on 28th April 2022. Roch thanked Inspiring Scotland for facilitating the event, which was successful in bringing together over 300 people from lived experience, statutory and third sector services. Analysis of feedback and engagement from the day will inform the development of a short life working group to continue progress in this area.

Mental health strategy refresh

Harri Waugh (SG Team Leader) welcomed Nadia Abu-Hussain and Mark Richards from the SG Strategy and Coordination team who are working on the refresh of the 2017-2027 Mental Health Strategy, and upcoming consultation.

Nadia advised that the Strategy was being refreshed in light of the impact of the Covid-19 pandemic on everyone’s mental health over the last two years. Phase 4 of the refresh includes the launch of a public consultation, and Nadia will inform the PB when this goes live. Mark outlined the scope of the refreshed Strategy, which would be widened to include wellbeing and prevention. An accessible account of the most up to date evidence on mental health in Scotland provides the basis for the overall direction of the Strategy, as well as informing actions. The Strategy is underpinned by a series of outcomes that have been developed through stakeholder engagement events. The Strategy and Coordination team aim to publish the refreshed Strategy by the end of 2022.

Anne McFadyen (Co-Chair) and Joanne Smith (NSPCC) emphasised that the needs of infants and young children should be prominent in the Strategy. Nadia advised that the team would be engaging with children and family services over the summer. Mark asked PB members to identify gaps and priorities by responding to the public consultation when it is launched. Mark committed to follow up with Anne and Joanne regarding the importance of including early years in the Strategy.

Action: Mark Richards

Infant mental health - where are we now?

There was discussion on the position paper, shared ahead of the meeting, on creating Infant Mental Health (IMH) systems, models of service, national progress, challenges and risks. Most Health Boards have started developing a specialist IMH service, though teams are very small in some areas. Anne McFadyen (Co-Chair) highlighted the importance of monitoring progress, and of the Parent-Infant Foundation development meetings where professionals can share learning and challenges with each other.

There was group discussion on the viability of small IMH teams and building resilience through integrated models of service delivery. Karen Lamb (Head of Specialist Children's Services) stated that NHS Greater Glasgow and Clyde had not anticipated the demand across all agencies in relation to their new IMH team, and the Co-Chair committed to follow this up with Karen outside of the meeting.

Action: Anne McFadyen

Voice of the infant subgroup

Kat Masterson (Participation Officer) co-chairs the Voice of the Infant subgroup with Anne McFadyen. The subgroup’s key objectives are;

• to produce a clear statement on the Scottish Government’s position on the rights of the infant
• to create a stand-alone Infant Pledge, and work closely with Maternal Mental Health Scotland and the Perinatal Mental Health Network to ensure that there are links to the Women and Families Pledge
• to produce ‘Best Practice Guidelines’ on how to take account of the infant’s views and their rights in all IMH services
• to disseminate and use material developed to promote knowledge and understanding of the importance of infant mental health

Kat advised that smaller working groups have been established to take forward the first three objectives. The Rights working group are developing a position statement based on the United Nations Convention on the Rights of the Child (UNCRC). The guidelines working group are linked in with The Promise and the Children and Young People’s Commissioner Scotland to develop Best Practice Guidelines for all professionals and practitioners working with families. The guidelines will include what is meant by ‘infant voice’, how to consider infant rights and participation, examples of good practice, and an evaluation checklist.

The Pledge working group will be developed after the Rights and Guidelines working groups as their outputs will inform the Infant Pledge commitments.

Third sector

There was group discussion on the role of the third sector in delivering IMH interventions across Scotland, and it was emphasised that third sector organisations require 6 months’ notice of future funding to allow for planning of services and to support recruitment and retention of staff.

Harri Waugh advised that the portfolio of third sector organisations funded through the Inspiring Scotland PIMH Funds and members of the PNIMH Equalities and Workforce subgroups have been asked to submit their thoughts on future third sector funding and effective ways to support integration of services. Harri asked PB and IAG members to also return comments around implementing sustainable and integrated third sector services, to inform SG planning.

Action: All

3-5 year olds task and finish group

The Co-Chair welcomed Jean Carwood-Edwards (Professional Adviser, SG) who chairs the 3-5 year olds Task and Finish Group of the Children and Young People’s Mental Health and Wellbeing Joint Delivery Board. Jean advised that the group’s task is to work jointly with the PB to consider what is currently available and what is required to support the mental health and wellbeing of 3-5 year olds across Scotland, and to produce recommendations for action by the end of 2022.

A grant has been given to Early Years Scotland who have been communicating with children and families, parents and carers, and members of the early learning and childcare workforce in several local authorities. This engagement work, along with other areas of research, will inform the final recommendations. Jean agreed to share the engagement feedback when available, and her presentation slides from the meeting.

Action: Jean Carwood-Edwards

Any other business

Sally Amor is leaving her post as Child Health Commissioner in NHS Highland, so will step down as North of Scotland representative for the PB. The Chairs thanked Sally for her enthusiasm and input to the PB since 2019, and wished her all the best in her new role in NHS Ayrshire and Arran.

Next meetings:

Wednesday 3rd August 2022 - Infant Mental Health Implementation and Advisory Group

Wednesday 31st August 2022 – Perinatal and Infant Mental Health Programme Board