Minutes of the Forensic Mental Health Services Managed Care Network Advisory Board meeting on Friday 11 December in Stirling Management Centre, Stirling
Present: Mrs Andreana Adamson, Chief Executive (Chair)
Dr Stella Clarke, Regional Lead, SEAT
Dr David Hall, Regional Clinical Representative, West
Mr Willie Manson, National MAPPA Co-Ordinator
Mr Martin Montgomery, Regional Lead, West
Dr Margaret Morrison, Psychiatric Adviser, Scottish Government
Mr Colin Poolman, Scottish Partnership Forum
Mr Harry Stevenson, ADSW
Dr Lindsay Thomson, Medical Director
Mrs Mary Weir, NSF Scotland
In Attendance:
Ms Yvonne Gailey, Chief Executive, Risk Management Authority
Miss Vivienne Gration, Forensic Network Manager (Secretary)
Dr Morag Slesser, Board Member, Risk Management Authority
Dr Anne Smith, SPR with Dr Thomson
1. Apologies for absence and opening remarks
Apologies were noted from Geoff Huggins, Karen Williams, Willie McFadden, Willie Black, Tom White, Andrew Fraser, Annie Ingram and John McGinley.
The Board noted that this would be John McGinley’s last meeting due to his retirement and thanked him for his contribution over recent years. Colleagues from the Scottish Forum of Forensic Clinical Psychologists are in the process of voting for a new representative who will join the Board next year.
2. Minutes of the last meeting
Mary Weir corrected that NSF do not change their name until May 2010.
Members also noted that there had been a discussion under Any Other Business at the last meeting which was not reported. The discussion was in regard to provision of employment or meaningful activities for patients in the community. Members heard that employment for forensic patients is often patchy and Margaret Morrison confirmed that for restricted patients, although meaningful action is part of health plans, employment is practically non existent for this group of patients.
Andreana Adamson reported that there is a study in Tayside in relation to this. Harry Stevenson will agreed to investigate with ADSW network and feed back. Martin Montgomery has an employability report for Glasgow patients that he can share with the Board.
Action: Harry Stevenson/Martin Montgomery
With this amendment and addition, the minutes were agreed as an accurate record.
3. Matters arising
Members noted the written update.
Leading Change – member agreed that it would be interesting to have a showing of the team’s DVD at the next meeting.
Action: Vivienne Gration
Drug & Alcohol Report & Protocols – These were received on 5 December and will be consulted on early in the New Year.
4. The Risk Management Authority
Given recent changes to the RMA, the new Chief Executive, Yvonne Gailey gave a short presentation outlining changes to strategic direction and implications for relationship with Forensic Network. In current financial climate partnership working becomes increasingly beneficial. Morag Slesser, RMA Board member also attended. A copy of the presentation is attached for information.
During the discussion that followed members heard that the Forensic Network and RMA have had a very close relationship over the past few years, particularly in terms of development and delivery of training and educational materials.
Yvonne Gailey confirmed that to date there were 41 Orders of Lifelong Restriction (OLR); this is higher than the expected 10 – 15 per annum but by reviewing and logging information about each case the RMA is not concerned with overuse. There may be opportunities for joint research on these 41 cases between the Network and RMA.
The RMA currently have 14 assessors, and would like more. Of these assessors roughly half work within NHS and the other half within SPS. Some time ago the Forensic Network and RMA had some exploratory meetings about proposals to have accredited assessors work included into organisational job plans as there can be benefits to organisations as well as individuals. This is something that RMA may wish to explore further in the future.
Regarding Risk Assessment and Management across Agencies, particularly within the MAPPA framework RMA is looking to develop a tiered approach so that agencies can all contribute within their own competencies.
Members noted that there can be difficulties in accessing forensic clinical psychology services for reports in some areas and questioned whether there is any way to influence change in this area. The Network’s Personality Disorder report offers a potential solution in suggesting joint working between health and criminal justice agencies. Raj Darjee’s role with the Network goes some way towards this and may prove successful in influencing change and innovation at a regional and local level. Willie Manson explained that a report should be forthcoming shortly from Roger Houchin about the provision of psychological reports.
Mary Weir asked about the provision of risk assessment before offending and what is being done in terms of preventing offending by young people who may be known to services for some time before they offend. Yvonne Gailey suggested that the Government’s policy on reducing reoffending highlights the need for early intervention; this is quite removed from the RMA agenda but that initiatives such as the Violent Reduction Unit with its public health approach will hopefully have an impact.
Members agreed potential areas for collaboration between Forensic Network and RMA might be: Assessors; training and education; research and potential developments of closer links between health and criminal justice via MAPPA. In order to move forward it will be important to communicate and meet regularly.
5. Chief Executive Report
Members noted the written paper and Andreana Adamson added the following comments:
Carers Conference – The conference was well attended and well organised, carers have suggested that the next conference might be hosted by The State Hospital.
Forging the Future Event – The conference on 30 November was a follow up to the International IAFMHS conference in June. It had a relaxed atmosphere and feedback was very good. It was unfortunate that some areas were unable to send delegates due to financial constraints. The Keynote Speech was from Frances Elliot, Chief Executive of NHS QIS and focussed on the potential to develop the quality agenda across the Network. Andreana Adamson will provide an update on progress to the next meeting.
Action: Andreana Adamson
6. Medical Director Report
Members noted the written paper and Lindsay Thomson added the following comments:
Risk Strategy Group – This is an active group with a large agenda to consider how to use existing resources better and provide guidelines to services, two particular themes that are currently being examined are risk screening tools and training. The group will provide a full report to the next meeting. Stella Clark suggested that there is a lack of awareness in Boards about what is needed for Forensic Services and the importance of risk assessment and management particularly for psychology, community services and MAPPA. Lindsay Thomson agreed to provide a presentation to the next Scottish Association of Medical Directors Meeting and Stella Clark will make necessary arrangements
Action: Lindsay Thomson/Stella Clark
Prison Group – This group is also looking a maximising resource. They have established the current provision of mental health services across prisons, there is little consistency. The group are currently working on a report to the Board outlining what is currently in place and providing a comparison with what is in place in the community to help establish standards across Scotland. James Taylor from SPS is a member of the group and it links with the SPS Mental Health Sub Group. Margaret Morrison asked for a copy of the remit of the Prison Group. Viv Gration will ensure a copy is sent.
Action: Viv Gration
SPS Healthcare – Andreana Adamson and Lindsay Thomson have a meeting with John Ross of SPS on Monday 14 December. To date the project focus has been on primary healthcare, it is hoped that this meeting will help to add focus to mental health services. Members heard from David Hall that Dumfries and Galloway is to be a pilot for the transition.
Personality Disorder Pilot – Plans are still in place for a potential pilot with Corntonvale working with Sainsbury Centre for Mental Health with a focus on borderline personality disorder. This is not the original group highlighted in the original Network PD Report. Feedback from Scottish Government is that Harry Burns has agreed to discuss further with Geoff Huggins, Margaret Morrison will keep the Board up to date on any progress.
Long Term Care Group – The group has met once to date and intends to provide a full report to the June 2010 Board meeting.
7. Update from Forensic Network Health Inter-Regional Planning Group
Members noted the written paper and that Stella Clark is current chair. The group discussed at their last meeting the Forensic Way Forward procedures and will consider learning disabilities and female services. Members heard that the national LD unit was considered at NHS Chief Executives and the proposal for national designation was unsuccessful. The matter will be discussed again at future Chief Executive meeting. Financial constraints mean that there is little support for the proposal.
8. School of Forensic Mental Health
Members noted the written paper and Lindsay Thomson added the following comments:
Masters Modules – NES have agreed to provide the School with £20,000 to fund the development of two masters modules, these will be in Risk and Legislation.
New to Forensic – New to Forensic continues to go from strength to strength, however funding from NES has ceased and the school will have to start charging boards for the programme. The school will continue to subsidise funding for the programme for one more year at a reduced cost of £50 per person from April 2010 – April 2011 thereafter the cost will be £100 per person. The School is working with Scottish Health Innovations Limited (SHIL) to develop a robust framework for sharing the programme with other jurisdictions and potential development of e-learning version.
Fronto-Temporal Dementia Education Programme – Members noted the programme has been circulated as a Chief Medical Officer Letter and noted that there is very low prevalence of FTD, a consultant might only see one or two cases throughout their career.
National Research Group – There was positive discussion at the event on 30 November about the development of a national research group for the Network. Its aims would be to encourage research across disciplines, agencies and regions. Jamie Pitcairn has been meeting with research colleagues across the country and has had very positive discussions. There are plans to link with other research networks such as the Mental Health Research Network and Jamie will be well placed to build these links.
AMP Refresher Training – The School has submitted a response to tender for the development and delivery of AMP Refresher training to the Scottish Government. The format outlined in the tender is for seven courses (1 general and 6 specialist) however some areas of Royal College of Psychiatrists are unsure of this format. We await feedback from Scottish Government.
9. Regional Update
Members noted the written update. Lindsay Thomson expressed thanks to regional partners on behalf of The State Hospital for their support in helping the hospital reach its target of 141 before the start of phase 2 of redevelopment. There was considerable effort across the regions which was greatly appreciated.
10. Admission Referrals
Admissions Criteria across level of security - Building on the work of Dr Tom White for the Inter Regional Group on the development of admissions criteria for medium secure services Andreana Adamson suggested expanding the remit of the group to include other levels of security. Tom was not present at the meeting so Viv Gration will discuss this with him.
Action: Viv Gration
Child Referrals to High Security – Over the last couple of months The State Hospital has had a number of referrals for under 18s. Ed Finlayson, Head of Social Work at The State Hospital is developing a protocol which may be helpful for medium secure services. Members agreed this should be shared with Inter Regional Group.
Action: Viv Gration
11. Any Other Business
Quality of Legal Advice to RMOs – Margaret Morrison advised that Scottish Government Legal Department can advise her, but not RMOs and it has come to her attention that RMOs are not utilising services of Central Legal Office because of concerns about the quality of advice. Margaret is working with solicitors from CLO to increase their knowledge of restricted patients, by implementing an induction programme and offering them opportunity to shadow her during visits. Margaret is also hoping to arrange, via the Scottish Government Legal Department, for a single point of contact in CLO. Members suggested that the New to Forensic Programme may be helpful to legal colleagues and also heard from Lindsay Thomson that CLO often go to Scottish Government Legal Department for advice about restricted patients, it may be beneficial for CLO to contact private firms to offer advice.
Support for Staff working with difficult patients – Members heard from Margaret Morrison that this service was set up some time ago and to date there have no referrals from teams. It was suggested that perhaps Margaret Morrison would be in a position to make referrals on behalf of teams if she identifies any difficulties during her visits.
12. Date of Next Meetings
Meetings will be held between 1000am and 1230pm on the following days:
Friday 12 March 2010Friday 11 June 2010
Friday 10 September 2010
Friday 10 December 2010 / SPS College, Polmont
SPS College, Polmont
SPS College, Polmont
SPS College, Polmont
Minutes
Forensic Board – 11 December 2009 Page 1 of 5