PAPER SEC/14/13
Minutes of the Royal College of Psychiatrists in Scotland, Executive Committee Meeting held on 21 February 2013 at 2.00pm in theJohn Barclay Room, RCSEd, Edinburgh
1. Attendance and Welcome to New Members
Dr Peter Rice (Chair); Dr Alastair Cook (Vice-Chair); Dr David Christmas (Finance Officer);Dr Sally Bonnar; Dr David Brown; Dr Roch Cantwell; Dr Sandra Duke; Dr Jude Halford; Dr Ross Hamilton; Dr Angela Haselgrove; Dr Nick Hughes; Dr Johan Leuvennink; Dr Michelle McGlen; Dr Susan Miller; Dr Gary Morrison; Mr Dougie Pickering; Dr Andrew Robinson; Mr John Sawkins; Dr John Taylor; Dr Andy Williams
In attendance
Ms Karen Addie
Mrs Angela Currie (minutes)
New Members
Dr Peter Ricewelcomed Dr Gary Morrison, Chair of the Old Age Faculty in Scotland to the meeting.
2. Apologies
Apologies for absence were received from Dr Roger Blake; Dr Malcolm Bruce; Mr Ivan Carnegie; Dr Moira Connolly; Dr John Crichton; Dr Anita Ganai; Mr Alan Gow; Dr Claire Kenwood; Dr Ros Lyall; Dr Robin McGilp; Dr Lorna McWilliam; Dr Audrey Morrison; Dr Debbie Mountain; Dr Stephen Potts; Dr John Russell; Dr Carol Wilson
3. Minutes of the previous meeting (Paper SEC/34/12)
The minutes of the meeting held on 22 November 2012were accepted as a true and accurate record.
4. Matters for Discussion and Decision
(i) Meetings Secretary Report
Dr Debbie Mountain had given her apologies for the meeting. Dr Peter Rice highlighted that the RCPsychiS are still looking for trainee submissions for the Summer meeting on 17th May 2013. He asked the Committee to encourage anyone who is interested to submit an abstract before the end of March. He went on to confirm that the Autumn meeting will be held in the Carlton Hotel in Edinburgh on 27 September 2013 and the Winter meeting for 2014 will be held in the Radisson Blu Hotel in Glasgow again on Friday 31st January.
(ii) Faculty Reports
a. (Paper SEC/35/12)
Dr Ricereferred to the written Faculty reports which had been circulated in advance of the meeting with the agenda and thanked everyone who had submitted a report on this occasion. Dr Rice highlighted the Medical Psychotherapy Faculty who had recently adapted the planning of their meetings to make them more financially sustainable. Dr Rice said he was very grateful to them for making these changes for the benefit of the RCPsych in Scotland. He then went on to give congratulations to Dr Neil Masson who had recently taken on the post of Vice Chair of the General Adult Faculty.
(iii)National Procurement of Clozapine – Health Monitoring Update
Dr Peter Rice reported that this guideline is now complete. Dr Johan asked the Committee to endorse the standards before sending them back to the manufacturer. It will then be up to the Health Boards to implement.
Dr Roch Cantwell praised the work that had been done on this already but highlighted that reproductive health was not mentioned in the guidelines. He suggested at the onset of using clozapine that there is a discussion about reproductive health. Dr Leuvennink said he could add a line about this but also pointed out to the Committee that the standards were a minimum requirement, not a multi guideline, and the Working Group had been mindful of this during the process.
The Committee discussed whether the language of the guidelines was clear enough. Dr Christmas referred to the smoking status and suggested changing the frequency from “at least annually” to every visit. The Committee also discussed lifestyle advice with regards to the blood pressure parameter. Dr Leuvennink agreed to look at these and make small changes.
Dr Peter Rice suggested that the standards could now be disseminated through the Scottish Government. Dr Johan Leuvennink said he thought that the manufacturer and the Royal Pharmaceutical Society would disseminate. Dr Alastair Cook suggested that they could be sent in the form of a letter from the Chief Medical Officer to the Health Boards. The Committee agreed.
(iv)Specialist Clinical Services for Doctors and Dentists with Mental Health and Addiction Problems Update
Dr Peter Rice confirmed that this piece of work is currently with the Scottish Association of Medical Directors. The RCPsych in Scotland would like to continue to be involved in the process and so if anyone is interested they should contact Angela Currie or Karen Addie at the RCPsych in Scotland.
(v)Mental Health Strategy
a. Parliamentary Debate (paper SEC/04/13)
Ms Karen Addie reported that the recent parliamentary debate had been very positive and lots of people had mentioned the Cross Party Group on Older People. The slides from Dr Gillian McLean were also referred to on a number of occasions during the debate. There was some controversy surrounding the topic of anti depressant prescribing and the RCPsych in Scotland has decided to have this as a topic at the upcoming Liberal Democrat conference. It has been agreed that Jim Hume will Chair the meeting. He is the new health spokesperson for the Scottish Liberal Democrats and he has also been asked to prepare a briefing paper in advance of the meeting. Dr David Christmas said the upcoming fringe meeting was a good opportunity to address concerns and replace them with facts about combined treatment with psychological therapies.Mr Dougie Pickering asked how cost effective anti-depressants are. Dr David Christmas confirmed that a recent thread study on mild depression did highlight them to be more effective (and cost effective) but that was in the case of mild depression. He added that treatment should always be about a range of therapies offered by skilled therapists.
Dr Peter Rice thanked Ms Karen Addie and Ms Rebecca Middlemiss for their hard work on this.
(vi) Copyright and Licensing Issues
Dr Peter Rice confirmed that there was no further update on this item at present.
(vii) Election of Chair and Executive Committee Members 2013
Dr Peter Rice confirmed that the process of nominations had closed last week and the new Executive Committee Members appointed are as follows:
Dr Roger Blake
Dr Paul Cavanagh
Dr Paul Morris
Dr Werner Pretorious
Dr Carol Robertson
Dr Rice also announced that Dr Alastair Cook would be taking up the post of Chair of the RCPsych in Scotland after the Summer meeting in May. Dr Rice congratulated Dr Cook on the appointment and confirmed that the RCPsych in Scotland would subsequently now be looking to fill the position of Vice Chair. He added that there is also still one vacancy for an Executive Committee Member and papers for both these posts would be going out soon to the Membership. Any Member or Fellow of the College can stand and so Dr Rice asked the Committee to encourage applicants for both these posts.
(viii) Update on Proposals re Tribunals
Dr Johan Leuvennink referred to the RCPsych in Scotland response to the Tribunals Reform Consultation last year and confirmed that most of the fears expressed by the RCPsych in Scotland can be reassured. The specific requirements for Mental Health Tribunals will not change. They will continue to be the same Tribunals with the same panel members, following the same tribunal rules. Any changes made will be “behind the scenes” to improve the efficiency of the service. He went on to report that Mental Health Tribunals will not share a chamber with other Tribunalsandthere would be no cross ticketing across chambers. Dr Johan Leuvennink then spoke about the new 2-tier system and the appeals processand reiterated that the administrative support surrounding all of this would not change.
(ix) Engagement process to develop future Scottish Government strategy on prevention of suicide and self harm(SEC/10/13)
Dr Peter Rice confirmed that this letter was for information and guidance on this had been drafted.
(x) MWC Formal Advisory Committee
Dr Peter Rice informed the Committee that the RCPsych in Scotland still requires a volunteer for this Committee. Mr John Sawkins confirmed that he had attended the recent inaugural meeting along with representatives from various interest groups. He added that the next meeting was scheduled for September.
(xi) Proposal from ID Faculty on improving the formal process for ensuring all College documents are checked for jurisdiction relevance
Dr Fabian Haut had raised this issue with the RCPsych in Scotland but had given his apologies for the meeting today. Ms Karen Addie reported on his behalf that the Intellectual Disability Faculty had recently held a strategy day with a good spread of consultants and trainees. They had expressed concern about policy documents from the College in London and how they are not always relevant to Scotland or the other Celtic Divisions. They suggested developing a checklist to highlight areas such as trust/boards, legislation etc or to state clearly, if necessary, that the document is relevant to England only. Dr Peter Rice asked the Committee for their thoughts on this.
Dr Halford expressed concern that there was a risk that this could just “tartanise” a document and suggested that there may need to be something more than a checklist in the initial stages of writing. Dr Alastair Cook agreed but said he thought it might be worth doing some initial work on a checklist and then bringing it back to the Executive Committee to review. Dr Peter Rice agreed.
5. Reports from External Committees and Bodies – Matters of Note
(i)Report from Service User Representatives(paper SEC/05/13)
Mr John Sawkins referred to the VOX Members Meeting in December and the talk from Graham Morgan on the subject of his attitude to medication.
Mr Morgan had spoken at the meeting about his reluctance to take his medication because he said he felt it changed who he was. Dr Rice agreed that this was concerning and reported that SAMH had sent a review to the RCPsych in Scotland of some of their service users on medication. This had highlighted the lack of sufficient discussion with psychiatrists prescribing medication and Dr Rice said members need to know that this is still an issue.Dr John Taylor suggested block purchasing the medication leaflets nationally for patients and giving them written information to take away. He also spoke about the availability of pharmacists to patients and thoseon ward and community teams who can provide information and support to patients regarding medication. Mr Pickering spoke about his own experience of changing medication but not knowing enough about what he was changing to and highlighted the internet as a useful resource. Dr Christmas said that psychiatrists should be empowering people to push for more information. Mr Pickering said he was aware that as a service user he did not always share all his concerns or symptoms with his psychiatrist and he was not sure how that issue could be overcome. Dr Alastair Cook highlighted that all of this forms part of the Scottish Patient Safety Programme. Dr Peter Rice suggested that this was an area the RCPsychiS should keep a close eye on.
(ii)Report from Carer Representatives (paper SEC/06/13)
Apologies were received from both Mr Ivan Carnegie and Mr Alan Gow. Dr Rice expressed his thanks for Mr Gow’s written report.
(iii)Cross Party Group on Mental Health of the Scottish ParliamentPaper SEC/11/13
Dr Rice confirmed that the new Chair of this Group is Malcolm Chisholm and asked Ms Karen Addie to update the Committee on the Group’s activities.
Ms Karen Addie reported that the next meeting will take place on 13 March 2013 and the topic is mild to moderate mental health problems. The British Association of Counselling and Psychotherapy will be speaking to the Group. The meeting following that will take place in May 2013 and the topic is Long Term Conditions.
Dr Roch Cantwell asked about the membership of the group. Ms Addie confirmed that there are currently 109 people on the mailing list which is made up of representatives of national organisations, smaller groups and also individuals. She added that they are public meetings and so anyone can come as an observer, of which there are lots. Dr Peter Rice highlighted that many of the Cross Party Groups within the Scottish Government also cross over with the work of the CPG on Mental Health. He went on to say that Dr James Hendry is the current Secretary of the Group but has retired from clinical work and is only continuing in this role until a replacement is found. Dr Rice asked that if anyone is interested in this post they should contact Ms Karen Addie or similarly if they would like to come along or have ideas for topics then to please get in touch.
(iv)SIGN
Dr Peter Rice reported that the Schizophrenia Guidelines are due out on 22nd March and he is expecting details shortly about the launch event. He confirmed that SIGN is currently jointly chaired by Professor Andrew Gumley and Dr Mark Taylor.
Dr David Christmas said he was finding it increasingly difficult to attend these meetings due to the timing of them and asked if there was anyone else on the Committee who would be keen to commit or in a better position to do so. Dr Rice suggested that one of the newly appointed Executive Committee Members might be able to take this on.
(v)Scottish Academy of Medical Royal Colleges
Dr Peter Rice confirmed that Dr John Colvin had been re-elected for a further year as Chair of the Scottish Academy of Medical Royal Colleges. Dr Alastair Cook will join the Scottish Academy this Summer when he takes over as Chair of the RCPsych in Scotland.
6. Reports from College Committees – Matters of Note
(i)Mental Health (Care and Treatment) (Scotland) Act 2003
a. Refresher Training
Dr Peter Rice confirmed that he and Dr Moira Connolly would be meeting with NES the following Monday with a proposal that NES take on the training, both the refresher element and training for new AMPs. Dr Alastair Cook would be dialling in for the meeting. Dr Alastair Cook noted that current training provided by Walkgrove is very expensive and it is hoped a new way of delivering training can be identified soon. He said the view from the Medical Managers is that with NES coordinating then this training could be delivered within the NHS. Dr Cook pointed out that Medical Managers would rather release individuals through the NHS for training than through Walkgrove. Dr John Taylor highlighted the lack of quality assurance at the moment with Walkgrove and said if NES took on the training then they would ensure that it was quality assured and it would get better over time. Dr Alastair Cook agreed and noted that if the training becomes statutory through law then it would be better provided through NES who would ensure quality assurance.
(ii)Workforce Planning
Dr Peter Rice confirmed that the RCPsych in Scotland should have the workforce report finalised soon. He also confirmed that Dr Roger Blake would be leaving the Workforce Group soon and so a successor is required. Dr Alastair Cook confirmed he will cover Dr Blake’s post in the meantime but he noted that he envisages the Regional Advisers taking more of the workforce role on in the future.
(iii)Finance and Budget
Dr David Christmas confirmed that the RCPsych in Scotland had approximately £37k at the end of the year. £8k of this will be spent this year largely on discounts for trainees and medical students at College events. Dr Christmas said it was his concern that the RCPsych in Scotland was not promoting these discounts well enough. Dr Rice asked the Committee if the information about the discounts for trainees was widely known.
Dr Nick Hughes suggested that relying on only the PTC to reach the trainee membership might not cover everyone. Ms Addie confirmed that the RCPsych in Scotland does mass email all trainees on the College database but that perhaps they are not reading these emails. Dr McGlen said she thought the recent Winter meeting was very well advertised. Dr Peter Rice noted that different Faculties were doing different things with regards to what they offer delegates in terms of meeting fees and suggested standardising.
Mr John Sawkins raised the issue of the £5k funding for the Mental Health Arts and Film Festival. Ms Karen Addie confirmed that the College in London had so far refused to fund this from the central budget.
Dr David Christmas said he would welcome more information with regards to the College Development Fund and what it can be used for. It was his understanding that all income is taxed by London at a rate of 15% which was to generate enough money in the bank for the move to new premises. He then asked if this 15% was still justified now that the College has money for the move to the new building at Prescot Street.
Dr Peter Rice reported that there is now a blog up on the College website for the new premises at Prescot Street. The College in London is asking Members for their ideas of what is needed there. The message so far from Scotland is that the Scottish Members want good meeting facilities. Dr Rice asked the Committee to let the RCPsych in Scotland know if they have any further ideas. Dr Roch Cantwell spoke about the travelling costs spent by Scottish Members and suggested the College could look at that. Dr Rice confirmed that the RCPsych in Scotland is currently working on a proposal to extend the office space in Edinburgh to accommodate a meeting area for Committees and a Members room. Ms Karen Addie said the proposal includes videoconferencing facilities. Dr Sally Bonnar said she thought that bookable meeting facilities in Edinburgh would be very well utilised. Dr Ross Hamilton agreed and added with regards to training events, it would be extremely cost effective to use these facilities to train. Ms Karen Addie pointed out that Scotland is the only Division of the College that does not have access to free meeting facilities.