Adult Mental Health Services Implementation Advisory Group

Adult Mental Health Services Implementation Advisory Group

Wednesday 15th September 2004 – Marine Hotel, Aberystwyth

Attendees:

Jeff Williams (Co-chair)Peter Martin

Gareth BartleyPeter Meredith-Smith

Mark BoulterLynette Morgan

John CarterAllan Swales

Phill ChickMichelle Thomas-Luisi

Paul ClarkeBill Walden-Jones

Ruth CoombsMark Winston

Margaret EllisRon Woodall

Martin HerbertTom Woods

Sue HuntSophie Yates

Roy Jones

Apologies:

Lindsay FoysterLyn Ward

Peter LawlerSarah Watkins

Pat Vogt

1. Welcome, opening remarks and apologies

Jeff Williams, as co-chair, welcomed the group to the meeting. Apologies were then given, as listed above. Ruth Coombs attended in place of Lindsay Foyster.

1. Minutes and Action Points from the last meeting

The minutes of the last meeting, held on Wednesday 16th June, were agreed to be accurate. The Action Points were all discharged, and the following points noted:

• Peter Martin put forward to Steve Ashcroft the group’s concerns about the lack of engagement with the voluntary sector re. the Baseline Assessment. He agreed to speak to Bill Walden-Jones (Hafal) and Lindsay Foyster (Mind) and pick up this area in the report.

• The matrix of attendance at IAG meetings has been completed. The group now needs to decide on steps to take, and noted a particular problem with regards to LHB representatives. It was suggested that the issue be raised with all stakeholders to let them know that repeated non-attendance may lead to another rep being found. Jeff reiterated that sending a deputy is perfectly acceptable, providing there is consistency and a different deputy is not sent each time. Peter Martin suggested that the group could advise the Minister to distribute a letter to the stakeholders.

Action: Peter Martin to draft a letter for the Minister to send out affirming the importance of the group and outlining the need for consistent attendance.

• Phill has put together a report which takes in the discussions at the IAG meeting held on 16th June ’04 regarding the risks of delayed or non-implementation of priority areas in the NSF. This report has been distributed and will be further discussed at a future meeting.

1. Ongoing issues – brief update on current status

IAG co-Chair post

Joan Whelan has left her job at Unllais, and can no longer continue in her role as co-chair of the IAG.The Minister has asked that a new co-chair be appointed to work with co-chair Jeff Williams. Peter Martin emailed all members of the group to ask that anyone who is interested informs Sophie by 4pm on 17th September if they would like to be considered for the position of IAG co-chair. The Minister will then make the appointment.

Innovations in Care

Maria Gallagher has sent a letter out announcing that IiC is to start work in the area of Mental Health. The IiC Steering Group has decided that the focus should be on implementation of Standard 7 of the NSF, specifically Care Pathways.

Paul Clarke noted that certain elements of the Risk Workshop (at the IAG on 16th June ’04) fit into this area, e.g. Key Actions 10 and 27. The work could be fed into the IiC work.

Action: IAG co-chairs to invite Maria Gallagher to the next IAG meeting (on 8th December ‘04) in order that she and Phill can give a more in-depth briefing on the Innovations in Care work.

Baseline Assessment

Steve Ashcroft could not attend this IAG meeting, but instead briefed Peter Martin on the progress that has been made to date. The fieldwork is now nearly complete. Three areas still have to hand in their self-assessment forms.

The last of the workshops being held in each LHB area will be on 15th October ’04. Following this a draft report on each local area will be produced, and issued within four weeks of the workshop being held there. Four weeks will then be allowed for stakeholders to send in their comments, and then a full report will be drawn up. This is still on course to go to the Welsh Assembly Government by the end of December ‘04.

Stigma

NPHS is developing a methodology for Standard 1 of the NSF, which will be applicable across the age ranges of Mental Health services. Jane Hutt has met with Mind to discuss this area of work, and they may be working with NPHS on the project.

1. Service User and Carer Involvement – Launch of Guidance

The Minister announced the launch of the ‘Stronger in Partnership’ Guidance at the US Network AGM on 3rd September 2004. This document will be published in the next few weeks.

‘Stronger in Partnership’ looks at Involving Service Users and Carers in the design, planning, delivery and evaluation of mental health services in Wales, and includes a charter and a checklist by which organisations can determine to what extent they are facilitating genuine user and carer involvement. It will be sent out to LHBs, Trusts, Social Services and User and Carer Groups and is in the form of Policy Implementation Guidance.

Roy played the group a tape on which he had recorded his observations regarding the involvement of service users and the problems that many experience. The following points were made:

• Roy has experienced problems with his local planning team, and feels that his views are not taken account of or listened to.
• That certain organisations run for the benefit of service users and carers are not run democratically.
• A big issue for many service users who attend meetings is the lack of support before and after such meetings. Whereas professionals return to the office, and can distance themselves more easily from the issues that have been raised, many users return home and have no-one to talk to. In this way meetings can be detrimental to their health and wellbeing.
• Service users and carers often do not have administration or financial support to attend meetings. Immediate reimbursement of travel expenses is essential in order that they can continue to participate in meetings.
• Service users and carers should be recognised for their skills and expertise, which are unique and should be fully utilised by professionals.

Phill agreed that investment should be made to allow users and carers to participate in meetings. They should always be reimbursed for travel expenses, and their limited resources taken into account. For example, if a limited number of documents are available then users and carers should be given them, as professionals are able to print large documents off from the Internet at no personal cost.

Phill also agreed that some kind of debrief would be very beneficial for attendees, as a means by which they could deal with frustration or emotions that are stirred up in meetings.

Action: A discussion on support for service users and carers at meetings is to be tabled for discussion at a future IAG meeting. This will include reflection upon the Stronger in Partnership guidance.

Peter Meredith-Smith informed the group that there are lessons to be learned from the Learning Disabilities IAG. This group has a great deal of support for user and carer members, including pre-meeting and debriefing sessions.

Ron noted that service users attending planning groups in North Wales are treated equally. Their views are sought and valued, although it appears that this is not always the case in South Wales.

Action: A slot is to be kept open on the agenda at each IAG meeting in which service users and carers can bring up issues that they wish to discuss.

1. Workforce Sub-group

The minutes of the Workforce Sub-group meeting held on 10th May have been distributed. A policy position paper is to be drawn up to go to the All-Wales Health and Social Care Workforce Steering Group on 11th October. This paper will set out what the Workforce Sub-group is, and detail its findings and proposed actions for tackling the workforce problems.

Action: Peter Meredith-Smith to draft the policy position paper and distribute it to the IAG for comment before the Steering Group meeting.

There is a Standard concerning workforce in the NSF, but no mechanism by which to measure it. Changes are needed in employment and recruitment within mental health services and the workforce as a whole desperately needs to be modernised. Long-term plans need to be put in place, but also short-term solutions, as the impact of, for example, the new Mental Health Bill is felt. It was pointed out that the Bill could be seen as positive for workforce development, as it may force action to be taken.

Sue reminded the group that any changes need to happen across the board. The problems apparent within adult services cannot be tackled in isolation.

The IAG Workforce Development Sub-group is now being held in abeyance until the Policy Position Paper has been seen by the Workforce Steering Group. It is hoped that this group will give some kind of steer, which would mean more joined-up working than if the IAG Sub-group attempted to tackle such issues alone.

1. Extraordinary IAG

A special IAG meeting will be held on 4th October to discuss the IAG’s response to the draft Mental Health Bill. The Bill was published on the 8th September. The Pre-Legislative Scrutiny Committee meets this week, and the call for evidence will go on until early November.

The Welsh Assembly is holding roadshows on the 28th and 29th September to act as information-giving sessions on the Mental Health Bill. There will also be question and answer sessions.

Bill reminded the group that its remit is the Adult Mental Health NSF. Therefore, the special IAG meeting should look at the draft Bill in the context of the NSF and how it fits in with the principles behind this framework.

The group decided that at the special IAG they would split up into smaller groups and look at the core themes of the Bill. A draft document needs to be produced after the meeting, which should not be drawn up by civil servants, as the views put forward must be those of the stakeholders, not the Welsh Assembly. It was suggested that Assembly officials act as independent recorders for each group.

Mark Boulter asked whether the IAG has an independent voice or is just to give advice to the Minister. Phill responded that the IAG acts as a conduit between the services and the Minister. As such its role is to inform and advise Jane Hutt. However, IAG members can send material to the PLS Committee individually or from organisations.

Action: Phill, Gareth and Bill to liase with one another and come up with questions / areas / key issues to discuss in relation to the Bill. These will be circulated to the IAG for comment by 27th September.

1. Social Exclusion Unit Report

IAG members were issued with a copy of the Social Exclsion Unit’s (SEU) report, ‘Mental Health and Social Exclusion’. Although the SEU’s remit is for England only, many of the actions are relevant throughout the UK, particularly those relating to benefits and employment.

This report was commissioned by the Office of the Deputy Prime Minister as part of the drive for improved Mental Health Services in England. It relates to Standard 1 of the Adult Mental Health Services NSF. The group watched a video, ‘In This World – Social Exclusion Unit film on mental health’ commissioned by ODPM. It illustrated some of the ways a number of people with mental health problems have overcome social exclusion.

Phill then gave a presentation entitled ‘Mental Health and Social Exclusion: Developing a Welsh Perspective’.

1. Discussion Groups

Attendees split up into three discussion groups, to look at promoting social inclusion in Wales and the SEU’s Action Plan and its impact on Wales. They concentrated on five key questions:

• What do members think of the content of the Social Exclusion Unit Report?
• Where does the report fit strategically with the Adult Mental Health Strategy and NSF?
• How can we achieve delivery at a national and local level in Wales?
• What are the key messages to government?
• What are the key messages to local services?

Action: Phill to note the groups’ findings, and use to help formulate a plan of action to take social inclusion agenda forward in Wales.

1. Any Other Business

The Extraordinary IAG meeting, which will focus on the group’s advice to the Minister regarding the draft Mental Health Bill, will be held on 4th October at the Metropole Hotel in Llandrindod Wells.

Action: Peter Martin to invite Steve Ashcroft to attend the next IAG and present the Audit Commission’s findings, as their full report is due out around this time.

Action: Peter Martin to invite Maria Gallagher to attend the next IAG to discuss Innovations in Care.

Action: Peter Martin to invite Lyn Harris, the lead on the NPHS Mental Health Promotion work, to attend the next IAG or give and update on it that can be reported back.

Due to the number of different reports on which updates are needed at every IAG, Bill suggested that a standing list be created which can be given out at the beginning of each meeting and updated by Assembly staff as work progresses. This should also include progress against NSF standards.

Action: Peter Martin to create a standing list of progress on mental health related work for the next IAG meeting.

The next ordinary IAG meeting will be held on Wednesday 8th December. Venue to be arranged at a later date.

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