1.  Delivering for Mental Health Geoff Huggins and Alex McMahon 28 March 2007

2.  Timeline 1997 – Framework for Mental Health Services in Scotland 2000-2003 – MH and Well Being Support Group visits 2004 – Sandra Grant report (in context of implementation of MH Act) 2005 – review of mental health as a clinical priority – Delivering for Health published 2006 – Delivering for Mental Health published

3.  Mental Health Policy  4 Populations – 5 million; 1-2 million; 50- 100,000; 500  4 Approaches – legislation; population health; service development; support for change

4.  Clinical Priority Review  mental health act implementation success  good work around stigma and on population health But  improving and developing treatment services ?

5.  Issues  Underdeveloped care pathways  Need to develop better integrated care  ‘First contact’ interventions often weak  Acute inpatient increasingly challenging  Service and quality standards not always in place  Gaps in particular service areas  Policy approach not driving improvement  Outcome measures for mental health not in place

6.  Strengths  Workforce committed to offering a high quality service  Act implementation process effective – showed that focus on objectives works  Doing Well experience positive  Data sources developing and improving  Good momentum on stigma and discrimination  Better evidence and knowledge base

7.  DfH Mental Health Commitments  ICPs for main diagnoses (ahead of schedule)  deciding how to roll out Doing Well programme (done)  crisis standards (done)  national/regional specialist services (done)  milestones for CAMHs Framework (done)  forensic services (on course, but NOS?)  Mental Health Delivery Plan (delivered)

8.  National Delivery Plan  small number of valuable, measurable and deliverable commitments  some national deliverables, some local  2010 time horizon  performance management  support for change

9.  Process  national group drawn from range of interests (feeding back into other groups)…  three national stakeholder events…everything on the web…  meeting anyone, anywhere, anytime, nothing excluded BUT!!!  commitments must be measurable, valuable and deliverable

10.  Outcomes  Behaviours and culture still the big issue for patients and carers  Drivers/Expectations:  Equality, non-discrimination, diversity  Social Inclusion, ‘section 26’  Recovery  Rights and Liberties – ‘Millan Principles’  Trust and respect fundamental (and also for staff…)

11.  Objectives  Better patient and carer experience of services  Better response to depression, anxiety, stress  Improved capacity in identifying those at risk of suicide  Improved physical health of those with mental illness  Better management of long-term conditions  Reduce inappropriate admissions and readmissions  More comprehensive specialist services  Health/substance abuse co-morbidity better addressed

12.   14 commitments… but also national NHS targets…to force the pace of change  reduce acute inpatient readmissions  stop year on year growth in anti- depressant prescribing

13.  Support for Change  creation of Mental Health Delivery and Services Unit – January 2007  Benchmarking framework about to be issued – May 2007  leadership programme – 24 April 2007 – 6 board areas involved  delivery collaborative in place from Septemberl 2007 – NHS GG&C

14.  Performance Management  building on act implementation process but also using new NHS targets  Implementation Board in place  Talking to Chief Executives in May  Implementation visits Spring and Autumn  Accountability Reviews in Summer  Reporting into Delivering for Health process

15.  Challenges and risks?  Maintaining engagement and trust with partners  Retaining focus on the commitments and targets  CAMHS agenda is very challenging  Making sure the benefits are delivered in the real world