Chamber and committees

I can confirm that a working group, chaired by CELCIS, met on 20 May to start a time-limited process aimed at developing an improved pathway to prevent homelessness for people with experience of care. As a result of this meeting, the group is in the process of considering the specific actions required to improve the housing journey of young care experienced people in Scotland. Members will discuss this in further detail at meetings scheduled for 30 July and 28 August.

Policy officials have started preliminary work to understand the experience of people who are homeless as a result of domestic abuse, alongside a wider piece of work on equalities across the Ending Homelessness Together Action Plan. A number of internal meetings have taken place with teams from across the Scottish Government to understand more about the context, raise awareness, and identify the right external stakeholders to take the work forward. In addition, we are currently considering an appropriate platform to develop a domestic abuse prevention pathway by summer 2020.

Early intervention is defined as the commencement of any necessary treatment as soon as possible after diagnosis. The Scottish Government’s Quality Indicator profile includes a measure of the percentage of first presentation psychosis patients that start SIGN or NICE guideline evidence based treatment within 14 calendar days of referral to specialist mental health services.

The improvement work, as articulated in our Vision, will ensure that people presenting for the first time with psychosis anywhere in Scotland will have timely access to effective care and treatment, with early intervention and a focus on recovery.

People with recurring and long term mental illness require good primary and secondary mental health care and treatment. This is the responsibility of local providers including NHS Boards and HSCPs, and the Scottish Government expects that anyone with recurring psychosis will continue to receive the right treatment at the right time.

Our Vision paper lays the groundwork for a nationwide improvement in EI Psychosis services, and all patients experiencing psychosis (including those with recurring psychosis) will further benefit from this improvement work as it moves forward.

Our commitment to improving Early Intervention Psychosis (EIP) services is reflected in Action 26 of the Mental Health Strategy, as well as in the Children and Young People’s Mental Health Taskforce Delivery Plan. The allocation of additional funding reflects that EIP is a policy priority for the Scottish Government, and our Vision to Improve Early Intervention in Psychosis in Scotland provides detail of how these commitments will be taken forward.

The first stage of our two-stage process, as outlined in our Vision, involves an EIP Improvement Network carrying out a national needs assessment, and conducting dedicated improvement work with two NHS Boards. The second phase of the process will be guided by the EIP Improvement Network's recommendations, and will involve the phased implementation of better EIP services and support across Scotland.

More generally, there are powerful arguments for improving EIP services. These are articulated in our Vision paper, including perspectives from people with lived experience. Psychosis can be an acutely serious mental health condition with potentially life-changing consequences. It is therefore vital that we provide the right help for people presenting for the first time with psychosis. There is also a volume of evidence showing that EIP is a highly effective approach, both in terms of clinical outcomes and cost effectiveness.

Healthcare Improvement Scotland (HIS) completed a diagnostic exercise with NHS Greater Glasgow and Clyde’s ESTEEM service (in January 2019) and NHS Highland’s Argyle and Bute Mental Health team (in February 2019). The aim of the exercise was to collect data to inform HIS’s Short Life Working Group on Early Intervention Psychosis (EIP) of the current early intervention service provision in an urban and rural environment.

The diagnostic exercise collected data on the current implementation of available evidence and guidelines, the current levels of demand, referral sources, clinical pathways, workforce, staff competencies (actual and required), and potential future developments that could be supported by a national action plan.

The results have been used to inform our Vision paper, which lays the groundwork for a nationwide improvement in EI Psychosis services in urban, semi-urban and rural settings.

Official published statistics for the Affordable Housing Supply Programme (AHSP) show that for the three year period to 31st March 2019, a total of 16,419 homes for social rent have been delivered. Over the same period, a total of 19,943 homes for social rent have started on site.

The next set of quarterly official statistics on AHSP approvals, site starts and completions to end June 2019 are due to be published in September 2019.

The Scottish Government’s Quality Indicator (QI) profile includes a specific measure (Quality Indicator T5) of the percentage of first presentation psychosis patients starting evidence-based treatment within 2 weeks.

Several of the other QIs are directly relevant in terms of providing better data about the care and treatment of people with recurring and long term mental health conditions, including psychosis. QIs that will provide relevant data include:

• E3 - % people with severe and enduring mental illness and / or learning disability who have had their BMI measured and recorded in the last 12 months. ‎
• E4 - % of people seen for at least 1 month that show improvement in functioning using any clinical outcome measurement over the previous month. ‎
• E5 - % of people seen for at least 1 month that show improvement in symptom severity using any clinical outcome measurement over the previous month. ‎
• Eq5 - % of caseload with an active anticipatory care plan. ‎
• P5 - % of people in mental health services seen for at least 1 month that show improvement in any personal outcome measurement over the previous month.

The QI profile is currently in the process of being rolled out across Scotland. Further information on the QIs can be found here:

https://www.gov.scot/publications/mental-health-quality-indicators-background-secondary-definitions/ .

Official published statistics for the Affordable Housing Supply Programme (AHSP) show that for the three year period to 31st March 2019, there were a total of 30,749 homes recorded as affordable housing starts. The official statistics can be found using the following link: https://www2.gov.scot/Topics/Statistics/Browse/Housing-Regeneration/HSfS/NewBuild/AHSPtables ;

It should be noted that whilst the majority of homes delivered through the AHSP will be new build, the programme also includes rehabilitation projects, off-the-shelf purchases and homes for low-cost home ownership from existing housing stock.

The next set of official statistics in respect of the AHSP are due to be published in September.

The Carers (Scotland) Act 2016 gives every carer a right to an adult carer support plan or young carer statement. This is a personalised plan, focusing on what matters to the individual carer. If the carer has eligible needs in their plan which meet the local eligibility criteria, they must be offered support to meet those needs. Carers also have the right to decide how they receive this support by choosing from the four self-directed support options.

The Scottish Government is fully funding implementation of the Carers Act by providing £17.4 million to local authorities in 2018-19 and an additional £10.5 million in 2019-20, which reflects the projected increase in demand. We expect to see local budgets increasing by this amount compared to the funding for 2018-19.

Under the Act, each local authority and health board must jointly prepare and publish a local carer strategy. This strategy must set out an assessment of the demand for support to relevant carers and the extent to which this demand is currently not being met. The statutory guidance to accompany the Act encourages local authorities to use this assessment to plan for meeting current and future needs, including unmet need.

Carers can access universal, preventative support in the community without having received an adult carer support plan or young carer statement.

In addition to funding for the Carers Act, the Scottish Government is providing £3 million in 2019-20 for the voluntary-sector Short Breaks Fund. The Fund provides four distinct programmes which offer different short breaks opportunities to a range of carers and their families.