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Covering Letter

Dear Colleagues

RIGHTS, RELATIONSHIPS AND RECOVERY: DELIVERING THE ACTION PLAN

It is now a year since I took great pleasure in launching Rights, Relationships and Recovery, the National Review of Mental Health Nursing in Scotland. Since then, things have moved on and we have seen the publication of Delivering for Mental Health in December 2006

Mental health nurses have a key role to play in delivering the improvements that lie at the heart of both of these reports. Rights, Relationships and Recovery set out how their role can be supported and developed to achieve this aim. One year on, the enclosed first annual report charts the progress that has been made and seeks to identify where further efforts are needed to deliver the changes that are required. It concludes that we have made a good start but there is still much to be done to strengthen and support mental health nurses to improve outcomes for service users, carers and their families.

I would like to take this opportunity to pay tribute to Robert Samuel who retired in November last year as Mental Health Nursing Advisor. Robert played a key role in developing the mental health nursing review and in setting the course for the rest of us to follow in the years to come. I am delighted that Alex McMahon has agreed to take over from Robert and assume responsibility for mental health nursing within the Scottish Executive. Alex is also the Head of the Mental Health Delivery and Services Unit. He will be known to most of you and I look forward to NHS Board Nurse Directors and local services working closely with Alex and the Implementation Steering Group to deliver on the action plan.

Thanks also go to Eileen Moir who has made a major contribution through her role as Chair of the Implementation Steering Group. The commitment and enthusiasm of Eileen and her colleagues on the group is a major asset in developing this work. Eileen is now the Director of Nursing at NHS Quality Improvement Scotland, having moved from NHS Borders in June but will continue to chair the Implementation Group.

But the biggest thanks must go to those of you on the front line. You have seized the opportunity and taken on the challenges posed by the review. It is clear that considerable efforts are being made across all the areas identified for action. Like all reviews, it will take time to implement all of the commitments but it is important that we continue to work together to keep the momentum going. There are areas of real success but there are others where greater effort is needed, for example, in acute care, leadership, services for older people and in the child and adolescent mental health.

Moving the agenda forward

The first annual report that charts progress against these priorities has now been published and is attached with this letter. It shows that services have responded positively to the action plan. There is considerable activity being carried out and progress is being made across all the priority areas identified in the plan. However, no one area is doing everything well and some are making more progress than others.

It is clear that the pace of change needs to increase in some areas if the objectives are to be delivered by the timescales that have been laid down. That means that local services need to develop a robust local structure to take forward this plan and, indeed, that should be being done through the local implementation groups. They also need to tap into the considerable support and expertise that is available from the National Implementation Group, NHS Education for Scotland, the Scottish Recovery Network and the Scottish Executive, among others.

Success is being achieved in all parts of Scotland. The key is to share it and learn from it to drive forward change and improvement.

The national action plan to improve all mental health services Delivering for Mental Health has been published in the year since the mental health nursing review. Achieving the aims of Rights, Relationships and Recovery will go a long way to helping deliver wider improvements in mental health and in outcomes for those who depend on these services.

Key areas that require attention

• Sharing good practice and practice development

There are many examples of good practice across Scotland that are already delivering on the objectives of Rights, Relationships and Recovery. Sometimes, however, these can be restricted to single service in an NHS Board area. It is important that such success should be spread locally, regionally and nationally.

Local events can be held to examine issues and develop good practice. Members of the National Implementation Group are available to speak at such events. In addition, the Scottish Executive will be supporting a national event and a number of regional events to foster engagement at a local level and share good practice.

NHS Education for Scotland and NHS Quality Improvement Scotland are also working together to maximise capacity to assist in this area of work.

• Benchmarking

It is important to benchmark existing services to help measure the change that is brought about by delivering the objectives. That will help demonstrate that the delivery of plan's objectives produces service improvement and tangible benefits. This will feed into the work programmes around Delivering for Mental Health.

Support for change

Change is challenging but can be done. That is why the Scottish Executive is providing financial support to help local services implement the objectives of the plan. In addition, many other forms of support are available.

One of the most important of these is the direct support available from the National Implementation Group and a list of its members is attached to this report. They can answer questions, point to potential solutions and help services with any difficulties they may be encountering.

NHS Education for Scotland ( NES) is making good progress in developing educational resources that will support the development of mental health nurses. As mentioned earlier, NES is also working with NHS Quality Improvement Scotland to develop Acute Care Forums through regional networks. In addition, connections are being made between the mental health nursing review and the implementation process for Delivering for Mental Health. The Scottish Mental Health Nursing Forum continues to meet and is linked in to the Implementation Steering Group. All this enables good cross fertilisation of ideas and practices and offers scope for development and collaboration.

Further support includes:

• providing funding for NES to take forward work around recovery and education;
• supporting an annual event and a number of regional events to foster engagement at local level;
• continuing to offer participation in local events;
• developing communication tools to keep stakeholders informed of progress of the delivery plan;
• working with the Scottish Mental Health Nursing Forum on developing work around research in mental health, prescribing and older people;
• developing collaboration and support through the national programmes being set up to implement Delivering for Mental Health which include the Collaborative Change Programme; Leadership Programme; Benchmarking; development of availability of psychological therapies; standards for ICPs and other work with partners
• providing resources through NES and Delivering for Mental Health websites .

Working together is the key to success. It is essential that activity at a local level is well co-ordinated and linked in to the national support network to deliver the changes that are needed. That includes ensuring that local implementation groups are working well, with a nominated chair and producing minutes of meetings that can be made available to others. It includes holding events locally, regionally and nationally to build on the success that is already being achieved in some areas and learning the lessons from such developments. It also includes sharing successes and challenges with the national steering group which can help provide solutions and assist local services in moving forward.

A good start has been made and there is a clear commitment to develop and support the role of mental health nurses in improving services for users, carers and their families. Let us build on that to deliver the better outcomes we all want to see.

Paul Martin

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