Chamber and committees

Through the Mental Health Benchmarking Project we have developed a balanced scorecard which measures 20 indicators to ensure information is available to allow NHS boards to measure and compare performances. One of these indicators is specifically around length of stay.

Information and Statistics Division also currently collect and publish length of stay occupancy for mental health inpatients. This can be accessed at:

http://www.isdscotland.org/isd/information-and-statistics.jsp?pContentID=1721&p_applic=CCC&p_service=Content.show.

The Scottish Government has continued to monitor Mental Health Officer (MHO) numbers over the past four years, by means of an annual MHO workforce survey, to assess the Scottish position and assist local services to address workforce planning. This annual survey has found that the numbers of social workers practising as MHOs had steadily increased over the period since 2005 that the new Mental Health (Care and Treatment) (Scotland) Act has been in force, starting from 553 MHOs (495 whole-time equivalents) in 2005 and rising to 691 (625 whole-time equivalents) by 2007, with a small drop to 674 (622 whole-time equivalents) in 2008. The Audit Scotland Report was based on the 2008 MHO Workforce Survey figures.

However, the number of local authorities reporting a shortfall also fell in that latter period, from 23 out of the 32 local authorities in 2007, to 14 of the 32 in 2008. In addition, the survey found in 2008 that there were 105 social workers undertaking training.

Progress is being made by local authorities in redesigning services and, where necessary, increasing their MHO workforce and providing succession planning.

The Scottish Government provides resources to local authorities by means of the Grant Aided Expenditure allocation. In order to meet the additional costs of implementing the 2003 Act when it came into force, including the costs of MHOs, the Scottish Government provided additional resources of £13 million per annum to local authorities; that additional funding has continued to be made to local authorities.

We are putting in place arrangements to collect accurate and complete data based on common definitions that link therapies to particular conditions. The first stage of that work has been completed with the publication of The Matrix - a Guide to delivering evidence-based Psychological Therapies in Scotland. This can be accessed at:

http://www.scotland.gov.uk/Topics/Health/health/mental-health/servicespolicy/matrixfeb2009.

We are about to commence stage two of this work which will focus on referral pathways and information systems. That work should be completed during 2010-11.

We have a specific commitment to increasing the availability of evidenced based psychological therapies for all ages and are working closely with NHS Education for Scotland and NHS boards to deliver on this commitment and meet patients needs better and sooner. We have a specific focus on the delivery of psychological services to older people that includes access issues such as delivering care to the housebound and those in case homes. We have also funded NHS Health Scotland to work with partners, such as Age Concern Scotland and the Mental Health Foundation, to address mental health in later life.

Dementia is a priority for the Scottish Government and we have already put in place and planned a range of practical measures to improve early diagnosis, information, support and care management that is making a real difference not just to those with dementia, but also to their carers and families.

We recently announced our intention to develop a Dementia Strategy over the summer months to review our current work to identify any gaps and further opportunities for change and improvement.

In most cases, those requiring access to mental health services already receive treatment well within 18 weeks. However, for those areas where delays do occur, we are considering new waiting times targets.

We are currently working to establish by April 2010, a referral to treatment waiting time target for specialist child and adolescent mental health services and over the coming months will be giving similar consideration to establishing a waiting time target to access psychological therapies.

We are working closely with NHS Education for Scotland (NES) and NHS boards to develop a range of initiatives to support the development around our commitment to expand and increase access to psychological therapies to meet patient''s needs better and sooner. This includes a tool for NHS boards to use in reviewing available evidence and in considering which psychological interventions might best be used to meet local need and demand. In collaboration with Skills for Health, NES has also produced psychological therapy competence frameworks to ensure that training equips staff to delivery therapy safely and effectively. We have also funded NES to support the training of a range of staff in a number of evidenced based therapeutic approaches.

We will also be giving consideration in the coming months to establishing a waiting time target to access psychological therapies.

NHS boards and local authorities have responsibility to work in partnership and allocate resources on the basis of local needs and priorities, within the context of the Scottish Government''s key strategic objectives and commitments.

Allocation of resources from boards to local authorities are a contribution towards the costs involved in shifting the balance of care from hospital to the community, and are negotiated, agreed and monitored locally. NHS board chief executives remain accountable for ensuring that resources allocated by boards to local authorities are used for the level and type of services agreed with care partners.

Discussions are taking place between the Scottish Government and COSLA to assess the current arrangements for agreeing and managing resource transfers, to ensure consistency across Scotland.

The Scottish Government''s Mental Health NHS Benchmarking Project is working to obtain more comprehensive information around both in-patient and community services; this data will enable boards, local authorities and others to compare and measure services and enhance local planning. The project has representation from the local authorities and through them we have approached the Association of Directors of Social Work (ADSW) who are working to commission core definitions around local authority services. This work has to go to ADSW and local authorities for consultation and approval.

The Joint Committee on Vaccination and Immunisation (JCVI), the UK-wide independent advisory committee which provides advice to the UK health departments on vaccination issues, considered the cost of providing a universal rotavirus vaccine for children prior to making its statement of 20 February 2009. The JCVI continues to reassess the cost effectiveness data in order to inform future decisions.

We are implementing the recommendations from Looked after children and young people: We Can and Must Do Better. We recently wrote to NHS boards to remind them of their responsibility to these children and young people, not just whilst they are in care but also in their transition out of care. This responsibility is to ensure that the physical, mental and emotional health needs of all looked after children and young people for whom they have responsibility is assessed and that appropriate measures are put in place to ensure that any package of care that is put in place following this assessment, is delivered.

To support the child and young people''s mental health improvement agenda, we have recently made available £2 million new money each year to accelerate the development of specialist services. In addition, we recently announced £6.5 million over three years to increase the number of psychologists working in specialist services in the NHS. This is staff that will be able to offer direct services and to support others such as teachers and social workers in the work that they do with young people with mental health problems.