Draft Minutes of the Forensic Mental Health Services Managed Care Network Advisory Board Meeting on Monday 1 December 2003 in Stirling Royal Infirmary Conference Centre

Present:David Bolger, Head of Mental Health Division (Chair)

Andreana Adamson, Chief Executive, The State Hospital

Mike Scott, Association of Chief Housing Officers

Iain MacKenzie, Community Forensic Nurses Forum

Jim McNicol, Nurse Consultant, The State Hospital

Maureen Sturrock, Forensic Advisor, The Scottish Executive

Sandy Cameron, Association of Directors of Social Work

Sharon Stirrat, SOLACE

Nicola Hodelet, Forensic Psychiatrists Forum

Lyndon Braddick, Scottish Prison Service

In attendance:

Angela Robertson, Clinical Effectiveness Manager, The State Hospital

Vivienne Gration, Forensic Network Administrator (Minute Secretary)

1.Apologies

Apologies were received from Martin Kerrigan of Scottish Partnership Forum.

2.Opening Remarks

David Bolger opened the meeting by thanking members for attending this first meeting of the Network Advisory Board and gave some background on its development. He went on to inform members of the commitment of the Scottish Executive to the network, and also interest in the possibility of using it as a model for other services.

Members heard from Andreana Adamson about the workshop day held in Stirling in September and that the network’s success is dependent on links with key organisations. It is the responsibility of all members of the Board to feed back to their own organisations. Considering if any additional organisations should be included in the Board members it was agreed that the group should seek a representative from the Association of Chief Constables and general psychiatry. Andreana Adamson to approach for nominations.

Action: Andreana Adamson

It was also suggested that the voluntary sector should be represented at some level, perhaps within the regional groups. David Bolger agreed to consider which organisations would be most relevant.

Action: David Bolger

Andreana Adamson informed members of early plans for a wider reference group meeting possibly bi-annually that would involve users and carers.

3.Forensic Mental Health Services Managed Care Network

Members heard Andreana Adamson’s presentation on the background to the network and the overview plan for its development. The following key points were made:

  • The network should provide better accountability for the development of services and provide a structure for existing groups at regional and local levels
  • The Medical Director position should be appointed on 11 December. This will be a joint post between the network and The State Hospital
  • The Scottish Executive has provided part funding for the network; additional funds are expected from NHS Boards
  • There is a possibility that this board will commission arbitration for appeals about clinical or financial disagreements

Discussion followed with the following points being raised:

  • The test that the network system is working will be how patients move through services
  • Performance framework should help links with regional groups
  • Although the services only affect a small number of people gaps in services can cause wider issues
  • Gaining engagement from most areas is difficult because of the small number of patients involved
  • There is a need for positive communication about the network that may help with some public and press misunderstanding of mental health and the need for medium secure units.
  • There are lessons to be learnt from the consultation processes from West of Scotland and Glasgow and consideration is required on the Scottish Executive policies
  • Suggested that visits to The State Hospital have gone some way to address some people’s views of mental health and entrapped patients

4.Draft Role and Remit of Board

David Bolger explained that as the Network Board is currently in a development phase the draft remit has more advising and supporting statements than perhaps expected. It may be that this is reconsidered at a later stage but for now the authority must remain with the Health Boards and their partners.

Deputy Members

Members considered the question of deputies for members and agreed this would not be required. Members will have the opportunity to comment on questions to be raised before meetings if they are unable to attend.

Forensic School

Members agreed that point 4.8 should apply to all staff and not only psychiatrists.

Composition

It was suggested that the Board should include representation from psychology, but members heard that there had been concern expressed by the Scottish Executive that the group should not have too many Health Service representatives. Members should be assured that all disciplines are being represented within the working groups.

Resource Implications

It was agreed that the remit paper should include a point about resource implications.

Action: Andreana Adamson

Formal arrangements for providing advice

The question was raised of how the Board will formally provide advice to organisations and members heard that it is expected that this will take place through interim reports and reports to groups and through consultation on findings of working groups.

Outcomes/Objectives

Andreana Adamson and David Bolger agreed to consider the Performance Assessment Framework and what the objectives of the board should be.

Action: Andreana Adamson/David Bolger

Members approved the draft role and remit paper with the above amendments and additions.

5.Short-Life Working Groups

Members noted details of Phase I and II of the short-life working groups as outlined in Angela Robertson’s presentation.

Membership of the groups and copies of the slides will be circulated to members.

Action: Angela Robertson

Future Groups

It was agreed that there should be a working group considering services for Personality Disordered Patients, building on work already started in The Scottish Executive on needs assessments for these patients. It was also agreed a group is required to consider Information Protocols. It was suggested that Public Safety should also be considered as a group; members were assured that this area would be covered by the Needs Assessment project.

Action: Angela Robertson

Risk/Needs Assessment

With regard to the Risk/Needs Assessment Project it was noted that the SPS are in the process of developing a generic tool and it may be useful for the group. There is also useful information available from the MDO questionnaires from The Scottish Executive and the Women and Children’s Service survey.

Action: Angela Robertson

Reporting

It was agreed that reports from the working groups should be an agenda item at board meetings and that work plans or emerging issues should be circulated to members as required.

Action: Angela Robertson

6.Any Other Business

Visit to The State Hospital

Andreana Adamson invited members to visit The State Hospital at their convenience; members should contact her if they would like to arrange such a visit.

State Hospital Referrals Policy

The State Hospital currently has its referrals policy out for consultation; members were invited to review the policy with their colleagues and have comments back by end of December.

Northern Ireland

The question of where Northern Ireland might fit into the network was raised. Members heard that Northern Ireland are in the process of developing a Medium Secure Unit and although they were not consulted on “The Right Place, The Right Time” Andreana Adamson intends to contact them regarding the development of the network.

Action: Andreana Adamson

Managed Care Network Pilot Scheme

Members heard of the pilot scheme that has been underway for the last 6 months with four areas. There is a review available and it will be circulated to the board members. Jim McNicol is invited to give a presentation to the next board on the findings of the scheme.

Action: Jim McNicol

7.Dates of Future Meetings

Members agreed that the Stirling Royal Infirmary is a suitable venue and provisional dates are Friday 5 March, Friday 4 June, Friday 3 September, Friday 3 December.