Chamber and committees

Follow-up from HSCS Committee meeting on 16 November - Minister for Mental Wellbeing and Social Care

Letter from Minister for Mental Wellbeing and Social Care - Follow-up from HSCS Committee meeting on 16 November, 6 December 2021

Dear Convener,

I would like to thank you for inviting me to attend the Committee’s meeting on 16 November. I appreciated the opportunity to discuss the current programme of work this Government is progressing and to outline my vision for the mental wellbeing and social care portfolio. I look forward to working closely with the Committee on these important issues as I have no doubt that mental wellbeing and social care will continue to be of keen interest to you across this Parliamentary session.

During the session, I undertook to write to the Committee with some further points of detail. I trust the additional information below is helpful.

CAMHS/Psychological Therapies TargetsGraphs illustrating performance against the waiting times target for CAMHS and Psychological Therapies (90% patients to start treatment within 18 weeks of referral) since June 2015 are attached at Annex A.

The effects of the pandemic can be clearly seen in the figures published in June 2020. However, since this point, performance has been on an upward trajectory, with June 2021 being the highest performance since December 2015.

I am very clear that long waits are unacceptable, and we remain committed to meeting our waiting times targets. We have already allocated approximately £40m to NHS Boards to improve CAMHS this year from our £120m Recovery and Renewal fund. £4.25m of that allocation is directly focussed on offering treatment to those already on CAMHS waiting lists this year, with a view to clearing all backlogs by March 2023.

This £40m of funding will be used to:

• Address CAMHS waiting times
• Implement the National CAMHS Service Specification, which sets out the levels of service that children, young people and families can expect from CAMHS across Scotland.
• Improve community CAMHS, with an expansion from age 18 to age 25 for targeted groups, and those who wish it.
• Provide access to out of hours assessments, intensive and specialist CAMHS services, which will benefit children and young people with complex needs, and their families, including in a home setting.

For adults, we have also invested £9m to enhance Psychological Therapies, including £5 million to address waiting times this year.

This investment is part of a longer term commitment to ensure that by 2026, 10% of frontline NHS budget is invested in mental health, with 1% directed specifically to CAMHS.

Although it will take time for this investment to be reflected in waiting times performance, we expect all Boards to meet the 90% waiting times standard. This will result in shorter waiting times and a better experience for individuals and families. To ensure this, we are continually reviewing services’ remobilisation plans, and closely monitor progress towards full compliance.

CAMHS Standards

The National NHS Scotland CAMHS Service Specification (the ‘Specification’), published in February 2020, outlines seven minimum service standards that children, young people and their families can expect from the NHS.  The Specification, which was developed in partnership with young people and their families, includes a number of aims, such as reducing both the waiting time for a first assessment appointment and the waiting time for any subsequent treatment.

The Specification was a product of the Children and Young People’s Mental Health and Wellbeing Programme Board (the ‘Programme Board’). Successful implementation of the Specification will meet recommendations from the Audit of Rejected Referrals and the Children and Young People’s Mental Health Taskforce.

In developing the Specification, the Programme Board engaged directly with a range of key partners, children, young people and their families to ensure it was informed by lived experience

From Spring 2021, the Programme Board was replaced by the Children and Young People’s Mental Health and Wellbeing Joint Delivery Board.  The Joint Delivery Board’s deliverables have been updated to meet new and ongoing priorities and agreed by Scottish Ministers and COSLA spokespeople.  One of their deliverables includes: developing a support programme to enable the implementation of the National CAMHS Service Specification.  Membership of the Joint Delivery Board can be found on its webpage (linked above).

School Counselling Report

I undertook to pass on a summary of the first reporting exercise completed by Local Authorities on our 2018/19 Programme for Government commitment to invest in access to school counselling services across education. The link to that report is below.

Access to counsellors in secondary schools: summary report - gov.scot (www.gov.scot)

Access to counselling support through secondary schools is now in place across Scotland. The Government continues to support our local authority partners with £16 million per annum in funding to ensure that every secondary school has access to counselling services. 

Wellbeing Hub for Health & Social Care staff and Unapid Carers

We all owe a debt of gratitude to the Health and Social Care staff and unpaid carers who work so tirelessly in support of others.  As members will be aware, the purpose of the National Wellbeing Hub is both to empower and encourage/support those individuals  to enhance their personal resilience and self-care, and to signpost and provide access to other relevant (evidence based) wellbeing and mental health resources and services.

The Hub’s principal focus is on prevention and early intervention. As at 23 November, there had been 140,391 users of the Hub since its launch in May 2020.

Feedback from partners has indicated that low mood and anxiety are key issues for staff and unpaid carers. As a result we have:

• increased the number of digital (eCBT) mental health apps available from 3 to 4, with the inclusion of one (Silver Cloud) specifically to help with low mood and depression. These apps have been nationally procured on a ‘once for Scotland’ basis for all health and social care staff to access;
• developed and promoted a range of new, accessible resources for staff on issues such as sleep, anxiety, problem drinking and Long COVID. These are available as podcasts and short films, and;
• developed a ‘Focus on Wellbeing’ webinar programme to help staff with sleep/insomnia, anxiety/low mood, Seasonal Affective Disorder, and enhancing personal resilience over the winter months.         

The Hub is part of a package of national resources designed to help the wellbeing and mental health of the workforce. This also includes:

• the National Wellbeing Helpline
• Coaching for Wellbeing
• Additional funding for psychological therapies and interventions specifically for health and social care staff
• Workforce Specialist Service, which offers regulated health and social care professionals an alternative pathway for confidential mental health and addictions treatment. 

Anne’s Law Consultation

I remain committed to developing legislation so that those who live in adult care homes have the right to see, and spend time with, the people that are important to them.

We have sought views through a public consultation on the best way to support people who live in adult care homes to maintain connections with family and friends following the commitment made in our Programme for Government to deliver Anne’s Law.

The consultation on Anne’s Law closed on 5 November. We received 283 responses in total. They have come from a range of organisations, such as Scottish Care, Health and Social Care Partnerships, local authorities and care home providers, and from individuals, the vast majority of whom have indicated they are relatives of someone in a care home. Additionally, 81 people, including care home residents attended workshops. 

We also launched a consultation on the Health and Social Care Standards, asking people to share their views on whether the Standards should be strengthened to enable people living in adult care homes to maintain family and friendship connections to support their health and wellbeing.

We have received 155 responses. Respondents are from a similar mix of organisations and individuals. We also held 3 workshops on the Health and Social Care standards, which had a total of 44 people in attendance.

We will consider all of these views carefully, and will publish the responses as soon as possible. In the meantime, we continue to support care homes to increase and normalise their visiting practices.

Delayed Discharge

In addition to the £1.9bn provided to support COVID pressures in health and social care this year, on 5 October the Cabinet Secretary for Health and Social Care announced an additional £300m of funding to address winter pressures.  This includes £62m for enhancing care at home capacity, £40m for interim care, and £20m for enhancing multi-disciplinary teams.  Additional funding of up to £48m will also be made available this financial year to enable employers to provide an uplift to the hourly rate of pay for staff offering Direct Care within Adult Social Care to a minimum £10.02 per hour.

The Cabinet Secretary and I are meeting with Health Boards and Health and Social Care Partnerships to discuss their delayed discharge position, and to agree trajectories and plans for improvement over winter and beyond.

I trust that the additional information above is helpful. If the Committee requires any further clarification, please do not hesitate to contact me.

Yours sincerely,

Kevin Stewart MSP

Minster for Mental Wellbeing and Social Care