Chamber and committees

The Scottish Government sets national direction of policy on mental health and provides funding to agencies – including NHS boards and local authorities – to support implementation of policy.

The management of local actions in implementing national policy, and decisions on local spending priorities are the responsibility of relevant local agencies. It is therefore the responsibility of NHS boards and local authorities to work with their partners and regularly review spending decisions to ensure they deliver fit for purpose services which respond to the needs of their local population. This includes ensuring the needs of female veterans and veterans spouses are assessed and responded to as appropriate.

The Scottish Government will also publish its new Mental Health Strategy later this year. That will set out our 10 year vision for transforming mental health services across Scotland, including improving access to services for all which are person-centred, effective, efficient and safe.

The Public Bodies (Joint Working)(Scotland) Act 2014 placed a duty on Integration Authorities to develop a 'strategic plan' for integrated functions and budgets under their control.

In 2015, the year before integration went live, the Scottish Government published statutory guidance on strategic commissioning setting out that each Partnership's strategic commissioning plan should be based upon a Strategic Needs Assessment of local people's needs, including, as appropriate, the needs of veterans. Strategic commissioning plans have been published by every Partnership, and we are providing support for their on-going development. Some partnerships are undertaking more detailed needs analysis of specific care groups.

The strategic commissioning plan sets out how partnerships will plan and deliver services for their area over the medium term, using the integrated budgets under their control. Stakeholders must be fully engaged in the preparation, publication and review of the strategic commissioning plan, in order to establish a meaningful co-productive approach, to enable Integration Authorities to deliver the national outcomes for health and wellbeing, and achieve the core aims of integration

Health and social care professionals work together to ensure person-centred and effective care and treatment is based on a comprehensive, multi-disciplinary needs assessment with individual care plans put in place to meet that need.

Health and social care professionals are well placed to ensure pre-enlistment factors such as childhood traumatic experiences; socioeconomic adversity; previous psychiatric history; personality, and coping style are taken into account as part of a robust needs assessment process whether the individual is a veteran or not. The aim as always is to provide tailored care which meets the needs of the individual.

All Scottish Government grant funding recipients are required to fully comply with the terms and conditions scheduled in a formal grant offer letter. These include setting out clear objectives and outcomes, a payment schedule (if required) and an end of project evaluation process.

The Scottish Government carries out robust and appropriate due diligence assessments on each recipient prior to issuing any grant. Grantees are required to keep Scottish Ministers fully informed as the project progresses with regular updates on expenditure, and progress towards achievement of objectives and outcomes. Any requests to revise targets or milestones are subject to the written agreement of the Scottish Ministers. Grantees also provide an end of project summary report to Scottish Ministers as evidence of how the project has met the terms of the grant offer.

Grantees must also provide any other information that Scottish Ministers may reasonably require to satisfy themselves that the project is consistent with the formal grant offer letter, and are expected to provide Scottish Ministers with prompt access to any evidence they reasonably require to ensure compliance with these Conditions.

Health and social care professional are well placed to deliver care and support and promote a better understanding of PTSD to help improve the assessment of veterans.

The Scottish Government funds the provision of specialist mental health services for veterans resident in Scotland at £1.2m per year, through arrangements with Combat Stress and NHS Scotland. This includes delivery of an intensive PTSD treatment programme at the Combat Stress facility in Ayr. In delivering effective interventions that meet the needs of veterans, the service ensures Veterans have access to a range of information to allow them to progress effectively along the recovery pathway.

The Veterans First Point Scotland Network which provides a range of drop in and other services across the Country for Veterans, no matter what their need may be also works using peer support to provide access to information and to promote better a understanding of the issues affecting veterans to help them and their families maximise their opportunities.

The Scottish Government is also working with it's partners to increase access to psychological therapies as an evidence based treatment for a range of mental health conditions, including PTSD. With NHS Education for Scotland, we have published the Matrix guide to planning and delivering evidence-based Psychological Therapies within NHS Boards in Scotland. It provides a summary of the information on the current evidence base for various therapeutic approaches, guidance on well functioning psychological therapies services, and advice on important governance issues. This includes the evidence base for the prevention and treatment of PTSD.

I refer the member to the answers to questions S5W-04124 and S5W-04133 on 10 November 2016. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at http://www.parliament.scot/parliamentarybusiness/28877.aspx.

Scottish Government policy on priority treatment for veterans is defined in the Chief Executive Letter (CEL) 8 (2008), which you can find at the following link: http://www.sehd.scot.nhs.uk/mels/CEL2008_08.pdf.

This letter, sent to NHS Board Chief Executives for action, states that all veterans should receive priority treatment for health problems as a result of service to their country unless there is an emergency case or another case that demands clinical priority. The letter also makes it clear that veterans should not be given priority treatment for conditions unrelated to their service in the armed forces. In addition, the CEL notes the extension of the provision of priority treatment to all veterans with health problems as a result of service to their country (and subject to the clinical needs of all patients), even when they are not in receipt of a war pension.

The Public Bodies (Joint Working)(Scotland) Act 2014 placed a duty on Integration Authorities to develop a 'strategic plan' for integrated functions and budgets under their control.

Strategic commissioning plans have been published by every Partnership, and we are providing support for their on-going development. Some partnerships are undertaking more detailed needs analysis of specific care groups.

The strategic commissioning plan sets out how partnerships will plan and deliver services for their area over the medium term, using the integrated budgets under their control. Stakeholders must be fully engaged in the preparation, publication and review of the strategic commissioning plan, in order to establish a meaningful co-productive approach, to enable Integration Authorities to deliver the national outcomes for health and wellbeing, and achieve the core aims of integration.

For local alcohol services, it is for individual Alcohol and Drug Partnerships, featuring appropriate representation from a range of partners including; NHS Boards, local authorities and Third Sector organisations, to ensure that person-centred prevention, support and recovery services are provided to meet the needs of their resident populations (including those of Veterans).

The Scottish Government introduced a target for alcohol (and drug) treatment waiting times in 2011, to ensure clients (including veterans) received faster access to treatment. Through this target we expect that 90% of people to receive access to appropriate alcohol and/ or drug treatment within 3 weeks of referral to support their recovery. The most recent statistics, published on 27 September 2016, indicate that in April-June 2016 for alcohol treatment, 95.6% of 7,068 people waited 3 weeks or less between April-June 2016.

Working with colleagues across the Scottish Government and service providers, the mygov.scot website will bring together information on the advice and support that is available to veterans and their families into one place, including:

• Housing

• Employment

• Health

• Education

• Care

The website will provide easy access to information, advice and support that is required when leaving the armed forces without the need to visit many different websites. This information is in development for publication early next year and will be continually reviewed and improved with input from users.

The Scottish Government’s Alcohol Strategy Changing Scotland’s Relationship with Alcohol: A Framework for Action was published in March 2009 and signalled our whole population approach to tackling alcohol misuse in Scotland recognising that alcohol misuse is not a marginal problem or restricted to one sector of society.

The Framework contains 41 measures which seek to reduce consumption, support families and communities, encourage more positive attitudes and positive choices, and improve treatment and support services. We have taken steps to raise awareness of the risks associated with alcohol so that individuals have the information to allow them to make informed, responsible choices. These include running social marketing campaigns, lowering the drink drive limit, introducing alcohol brief interventions, and introducing updated safer drinking alcohol guidelines which recommend that both men and women drink no more than 14 units a week, spread out over three days or more.

We will introduce the next phase of our Alcohol Framework later this year which will build on the progress so far.