ITEM 7 Mental Health and Wellbeing Delivery Plan
North Lanarkshire Council · 19 June 2024
Back to Health and Social Care Integration Joint Board — 19 June 2024 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 REPORT Item No: 7 SUBJECT: Mental Health and Wellbeing Delivery Plan To: Integration Joint Board Committee Lead Officer for Report: Ross McGuffie Chief Officer NL HSCP Author(s) of Report Ian Nicol, HSCP North and MHW Strategy Programme Manager DATE: 19 June 2024 1 PURPOSE OF REPORT This paper is coming to the IJB for: For Approval: ☐ For Endorsement: ☐ To Note: ☒ 2 ROUTE TO THE BOARD This paper has been: Prepared By: ☒ Reviewed By: ☐ Endorsed By: ☐ This paper has been prepared by Ian Nicol, Programme Manager, Health and Social Care North Lanarkshire with advice and input from Kate Bell, Senior Manager, Strategic Change, NHS Lanarkshire. 3 RECOMMENDATIONS It is recommended that the IJB: (1) Acknowledges the process and timeline to develop a Lanarkshire Mental Health and Wellbeing Delivery Plan aligned to the National, Scottish Government/COSLA Mental health and Wellbeing Strategy and separate Delivery Plan, both published in 2023; (2) Agrees to receive the final draft Delivery Plan for approval at its next meeting in September 2024;
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2 (3) Agrees that Delivery Plan will subject to the endorsement of South Lanarkshire IJB; NHS Lanarkshire Board; North and South Lanarkshire Councils; and North and South Lanarkshire Community Planning Partnerships. 4 VARIATIONS TO DIRECTIONS? This section outlines if the report requires a direction to be issued to the Local Authority, the Health Board, to both, or that no direction is required 5 BACKGROUND/SUMMARY OF KEY ISSUES 5.1 Getting it Right for Every Person (GIRFEP), a Mental Health and Wellbeing Strategy for Lanarkshire was launched in October 2019 to provide a shared vision and to drive significant shifts in culture (how we see and treat mental health and physical health), focusing on earlier intervention and prevention as well as the redesign and reconfiguration of services and development of new services. 5.2 The scope of the Strategy was not just about the mental health services delivered by the NHS, Integration Boards and Local Authorities but understanding how we, along with our wider community planning partners and society as a whole, contribute to the mental health and wellbeing of the people of Lanarkshire. 5.3 The joint strategic aims, aligned with partner organisations, of Getting It Right for Every Person, a Mental Health and Wellbeing Strategy for Lanarkshire, were to: Improve healthcare and wellbeing; Strengthen effective leadership and governance for mental health services across all sectors; Reduce health inequalities and improve health and healthy life expectancy; Support people to live independently at home through integrated health and social care services; Provide comprehensive, integrated and responsive mental health and social care services and supports in community based settings; and Support all children and young people to live as full and healthy a life as possible and to realise their full potential. 5.4 The aspiration set out in the Strategy was that people in Lanarkshire live in a community where everyone understands that there is no good health without mental wellbeing, where we know how to support and improve our own and others’ mental wellbeing and act on that knowledge, and where our mental Yes ☐ No ☐ N/A ☒
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3 wellbeing contributes to a healthier, wealthier, fairer, smarter, greener and safer Lanarkshire for all. 5.5 The delivery programme comprised of 4 main workstreams: Good Mental Health for All. Improving Access to Mental Health Support and Services. Children and Young People Mental Health & Wellbeing – fully integrated in the North Lanarkshire and South Lanarkshire Children’s Services Plans. Specialist Mental Health Services. The Strategy also had in place a number of cross cutting interdependent workstreams. These included Communication and Engagement, Workforce and Finance. 5.6 The Mental Health and Wellbeing Strategy Board and the majority of project groups were stood down in March 2020 due to the COVID-19 pandemic. Whilst Strategy delivery was restarted in January 2021, there was a further disruption over the summer of 2021 when all non-essential meetings were stood down owing to the pressure on services. 5.7 Over the course of 2022, we were able to look forward, endeavouring to take advantage of the opportunities and experiences of working in different ways. All workstreams reviewed their delivery plans to ensure that they took account of the impact of Covid-19; build on our recovery plans and the new ways of working that have developed over the course of the pandemic, whilst retaining a focus on the vision and objectives set out in the original Lanarkshire Mental Health and Wellbeing Strategy. 5.8 This report outlines the progress made across all Strategy workstreams and sets out our progress in developing a Mental Health and Wellbeing Delivery Plan for Lanarkshire aligned to Scotland’s Mental Health and Wellbeing, the new national Mental Health and Wellbeing Strategy launched in 2023 by COSLA and the Scottish Government. 6 ACHIEVEMENTS Good Mental Health for All 6.1 Challenging the stigma around mental health, promoting good mental health and addressing the barriers (social, environmental, financial or cultural) that make it more difficult for some people to take up opportunities to improve their wellbeing, are a priority across Lanarkshire. 6.2 The Covid 19 Pandemic was stressful for many and threw a spotlight on the relationship between mental and physical health. The impact was not experienced equitably. Those least able to draw on protective factors (good health; financial wellbeing; affordable housing; employment; being able to work from home; support home schooling) were less equipped to deal with the impact. It exacerbated long-standing inequalities in being able to thrive in the face of adversity.
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4 6.3 The longer-term impact of the pandemic is likely to widen these inequalities further unless significant action is taken. This has taken on a new urgency with the emerging cost of living crisis, compounding the threat and further widening the gap. 6.4 Our approach to promoting good mental health and wellbeing and the collective actions/programmes of work undertaken by all community planning partners is distilled in our Good Mental Health for All North and South Lanarkshire Delivery Plans. 6.5 The Good Mental Health for All Delivery Plans cover 6 key areas: Mentally Healthy Infants, Children and Young People; Mentally Healthy Later Life; Mentally Health Environments and Communities; Mentally Healthy Employment; Reducing the Prevalence of Suicide, Self-Harm, Distress and Common Mental Health Problems. 6.6 Key highlights include: Promoting a confident, diverse and skilled workforce through delivering training and building capacity for delivering training in-line with the NHS Education Scotland Framework for Mental Health Improvement and Suicide Prevention Promoting a compassionate response to people presenting in distress by embedding Distress Brief Interventions into mainstream services and supports Delivering a programme of work to tackle mental health stigma and discrimination where it exists and ensure people can talk about their mental health and wellbeing and access the person-centred support they require Driving a programme of work in line with the new national suicide prevention plan, Creating Hope Together Improving access to a range of non-clinical supports to improve mental health and wellbeing via Well Connected and other social prescribing programmes and the Communities Mental Health and Wellbeing Fund Delivering an annual Recovery Event for Lanarkshire enabling people with lived experience to share stories of recovery and explore what recovery means to them Exploring robust Health and Equality Impact Assessments by means of strengthening active consideration of mental health and wellbeing to support a ‘mental health in all policies’ approach. Improving Access to Mental Health Supports and Services (IAMHSS) 6.7 IAMHSS has been concentrating on specific areas to ensure the right support is available at the right time within Primary Care, Emergency Departments, Custody Suites and Prisoner Healthcare and through the development of digital solutions. This workstream has also been responsible for developing and implementing proposals for the use of funding for mental health posts made available through Action 15 of the Scottish Government’s Mental Health Strategy, 2017.
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5 6.8 Primary Care Mental Health & Wellbeing Teams: PCMHW model developed with Mental Health Liaison Nurses now covering 91 GP practices supported by LAMH Mental Health and Wellbeing Workers providing a non-clinical role. Assessment Plus CBT based guided self-help intervention. now providing guided self-help intervention in 3 localities. A Task and Finish Group has now been established to: - review current Primary Care Mental Health (PCMH) service model to learn from our experience to date and ensure we make the most effective and efficient use of resources to provide a central point of referral for self & practitioner referrals of people experiencing mild to moderate mental health problems and divert patients from GP practice; - enhance and develop standard internal referral processes between the PCMH service, Primary Care Occupational Therapy (PCOT) and Community Link Worker (CLW) programmes, CMHTs, Mental Health Flow Navigation Centre & Community Addiction Services. 6.9 Transforming Mental Health in Emergency Departments (ED) Flow Navigation Centre (FNC) fully established in-hours providing an alternative to ED triage for a mental health assessment. Direct links with Psychiatric Liaison Nurse Service for Community Police Triage and Scottish Ambulance Service triage fully established in hours via FNC and Out-of-Hours at Douglas Street. Expanded in November 2021 to include British Transport Police. Out-of-Hours service expanded and fully embedded. Patients triaged and assessed via telephone, virtual platform, or face-to-face. Mental Health Advanced Nurse Practitioners now form part of unscheduled care and liaison services and have developed good links with primary care services to support overall senior decision making. Overall reduction of 68% in police attendance at ED. 6.10 Custody Suites: We set out to develop a range of new ways of working within Custody Suites to deliver a person centred, safe and clinically effective healthcare for people detained in Police custody across the 4 Lanarkshire Custody Suites and develop a new Mental Health and Wellbeing Team staffing model, aligned to the Unscheduled Care Team, the Primary Care Team, and the Community Mental Health Teams who will continue to provide care for the most unwell people who need specialist input. Two Advanced Nurse Practitioners have been recruited through Action 15 funding in place and are providing a valuable mental health assessment resource to support people who present with mental health needs when detained for any period of time. Feedback has been positive.
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6 6.11 Prisoner Mental Health: Mental health Multi-Disciplinary Team staffing model for Shotts Prison developed to ensure the level of care for prisoners reflects the services offered to the rest of the population. Prisoner population of HMP Shotts now has improved access to a wider range of mental health services – in particular psychological therapies and health improvement – through a match-stepped model of care. 6.12 Digital Solutions: Digital solutions explored to help provide services in new ways that make them more accessible and enhance patients’ experience. Near Me well-used with CAMHS, Psychology, and Psychiatry the top 3 users of the system. MORSE transition completed for all previous Midis users. Work remains underway for migration of remaining services. Successful collaboration with Connecting Scotland to provide devices and support to service users. Digital champions identified Child and Adolescent Mental Health Services 6.13 In 2021, the Scottish Government Children and Young Peoples Mental Health and Wellbeing Taskforce published national specifications for Child and Adolescent Mental Health Services (CAMHS) and Neurodevelopmental Services. Both specifications aim to ensure that children and families receive the supports and access to services that meet their needs at the earliest opportunity, based on the GIRFEC approach. For many children and young people, such support is likely to be community based, and should be quickly and easily accessible. These services are required to be available for all children and young people who are aged 0-18 years, and young adults aged 18-24 (and up to age 26 for care experienced people). 6.14 A significant change to the CAMHS model was required to meet the national service specification. Plans were submitted to the Scottish Government outlining how it would be implemented. This specification focusses CAMHS on the needs of children and families affected by the more complex mental health problems, moving early intervention support to the Schools Counselling Model, Schools Nursing and the Community Wellbeing Framework. 6.15 In January 2021, the Specialist Children’s Health Services Unit (SCHSU) was formed bringing a centralised approach to the operational delivery of children’s specialist health services across Lanarkshire. In April 2021, Health and Social Care North Lanarkshire received confirmation from Scottish Government of recurring funding via the Recovery and Renewal Fund (RFF) specific to CAMHS of £3.3 million. 6.16 Major achievements include: Choices and Partnership Approach (CAPA) embedded into CAMHS
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7 Recruiting and retaining staff who can provide the level of expertise required to enable us to deliver the national CAMHS specification fully by March 2026. Putting in place an electronic documentation system that will ensure children and young people who use CAMHS are visible across the system. New South Lanarkshire CAMHS facility within Udston Hospital, supporting CAMHS, the Eating Disorders team and the Neurodevelopmental Service opened to patients on 5th September 2022 and now fully operational. Refurbishment of Airbles Road and Coathill CAMHS outpatient and staff base planned to bring North Lanarkshire estate to same standard. Neurodevelopmental Service (NDS) Steering Group established to oversee development of the service and implement the NDS service specification for children and young people by March 2026. Children and Young People’s Community Mental Health and Wellbeing Support and Services 6.17 Delivering improvements for children and young people’s mental health and wellbeing is embedded in the North and South Lanarkshire Children’s Services Plans and associated workstreams, led by the children’s services partnership boards. Robust progress has been made in offering a range of programmes of work with a focus on prevention/early intervention and promoting positive mental health and resilience. All practice is underpinned by The Promise, GIRFEC and UNCRC approaches. 6.18 Funding from the National Children and Young People’s Mental Health and Wellbeing Programme is being provided for the delivery of community mental health and wellbeing supports and services for children and young people. This is to support the development and provision of bespoke services that are right for each local authority and direct support for children and young people. The Scottish Government is clear that funding is to be used for new or enhanced services. Project officers have been recruited by both local authorities and gap analysis, benchmarking and co-production of services has been undertaken. 6.19 A range of services have been developed at universal and additional levels which complement and value to other service preventative services which address the children’s and young people’s wellbeing, examples include: 6.20 Key achievements include: Living Life to the Full – provided by NLC Community Learning & Development Family support for children impacted by neurodevelopmental difficulties – provided by Carers Together LIAM (Let’s Introduce Anxiety Management) – Educational Psychology Mentoring through sport – Active and Creative Communities Support and services commissioned by through Empowering Clusters, through the community solutions approach, based on local need
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8 Pilot of family wellbeing practitioners based on cluster to divert referrals from CAMHS – Education and Families Intensive Support for care experienced young people who have left care – Education and Families Implementation of a digital mental health and wellbeing platform, Kooth, which has now launched and is available for children and young people aged 10-18 years (up to 26 for care experienced young people). Launch of a public facing Children and Young People’s Mental Health Directory of Services and Resources in Lanarkshire. Following on from a successful collation and distribution of the Directory in an excel sheet format, we have taken on board the feedback we received and the Directory is now available to all on NHS Lanarkshire’s public facing website. Content and layout has been guided by children and young people as well as input for the design. Specialist Mental Health Services 6.21 Key achievements include: Dedicated specialised Community Perinatal Mental Health Team established, incorporating psychiatry, community mental health nurse, clinical psychology, community nursery nurse, midwifery, occupational therapy and social work staffing. Multi-agency, multi-disciplinary Infant Mental Health team established. Maternity and Neonatal Psychological Interventions Service established. Review of Adult Rehabilitation Services completed. New referral form in place with a single point of referral; pathway to community rehab now live; planned date of discharge in place; new Community Rehabilitation Team nursing model embedded in practice; new Rehabilitation & Recovery Service Operational Policy in place. South Lanarkshire Community Mental Health Team (CMHT) funding and staff transferred from the previous hosted arrangements with North Lanarkshire to enable integration of Community Mental Health services within South Lanarkshire HSCP. Scottish Government funding for Dementia Post Diagnostic Support (PDS) Services utilised to create a single dedicated PDS service that focuses on those individuals not requiring secondary care input of an Older Adult CMHT. Adult Autism Assessment Service established as Phase 1 of a wider Adult Neurodevelopmental Pathway.
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9 7 MENTAL HEALTH AND WELLBEING DELIVERY PLAN Scotland’s Mental Health and Wellbeing 7.1 The new national Mental Health and Wellbeing Strategy recognises mental health as a cross-government priority, building on the partnership between the Scottish and Local Governments. 7.2 It recognises that underlying factors, inequalities and types of disadvantage affect certain groups of people who may suffer disproportionate impacts on their mental health. 7.3 We know that mental health does not just mean mental illness; it is a continuum that may include a range of needs, from having the right words to describe how we feel, through to everyday worries and feelings of distress or hopelessness. We must ensure that the right help is always available to those who experience severe and enduring mental health conditions and provide the wider support people may need to maintain good mental health. 7.4 In publishing the Strategy in 2023, the Scottish Government and COSLA acknowledge that all areas of Government will need to work together to achieve our shared vision and to make progress towards our outcomes, which are outlined below. The Strategy sets out a vision of a Scotland, free from stigma and inequality, where everyone fulfils their right to achieve the best mental health and wellbeing possible. 7.5 The Strategy describes a whole system model which very much aligns with the Lanarkshire Mental Health and Wellbeing Strategy 7.6 The Strategy sets out the following outcomes: Improved overall mental wellbeing and reduced inequalities. Improved quality of life for people with mental health conditions, free from stigma and discrimination
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10 Improved knowledge and understanding of mental health and wellbeing and how to access appropriate support Better equipped communities to support people’s mental health and wellbeing and provide opportunities to connect with others More effective cross-policy action to address the wide-ranging factors that impact people’s mental health and wellbeing. Increased availability of timely, effective support, care and treatment that promote and support people’s mental health and wellbeing, meeting individual needs. Better informed policy, support, care and treatment, shaped by people with lived experience and the workforce, with a focus on quality and recovery. Better access to and use of evidence and data in policy and practice. A diverse, skilled, supported and sustainable workforce across all sectors 7.7 It also identifies ten priorities which provide the structure for the first national Delivery Plan for 2023-25: 1. Increased availability of timely, effective support, care and treatment that promote and support people’s mental health and wellbeing, meeting individual needs. 2. Better informed policy, support, care and treatment, shaped by people with lived experience and the workforce, with a focus on quality and recovery. 3. Better access to and use of evidence and data in policy and practice. 4. A diverse, skilled, supported and sustainable workforce across all sectors 5. Work across Scottish and Local Government and with partners to develop a collective approach to understanding and shared responsibility for promoting good mental health and addressing the causes of mental health inequalities, supporting groups who are particularly at risk 6. Improve mental health and wellbeing support in a wide range of settings with reduced waiting times and improved outcomes for people accessing all services, including Child and Adolescent Mental Health Services (CAMHS) and psychological therapies 7. Ensure people receive the quality of care and treatment required for the time required, supporting care as close to home as possible and promoting independence and recovery 8. Work across Scottish and Local Government and with partners to develop a collective approach to understanding and shared responsibility for promoting good mental health and addressing the causes of mental health inequalities, supporting groups who are particularly at risk
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11 9. Improve mental health and wellbeing support in a wide range of settings with reduced waiting times and improved outcomes for people accessing all services, including Child and Adolescent Mental Health Services (CAMHS) and psychological therapies 10. Ensure people receive the quality of care and treatment required for the time required, supporting care as close to home as possible and promoting independence and recovery Lanarkshire Mental Health and Wellbeing Delivery Plan 7.8 Given the close alignment between the 2019-2024 Lanarkshire and 2023 national strategies, the Integration Joint Board agreed at its Liaison Session on 8th November 2023, that, rather than produce a new Lanarkshire Strategy, partners should work together to develop a Lanarkshire Delivery Plan, aligned to the strategic actions set out in the national Delivery Plan, and clearly linking to local strategies and plans including both Health and Social Care Partnership Strategic Commissioning Plans, Our Health Together, Children’s Services Plans, the Plan for North Lanarkshire Community Plans and Local Outcome Improvement Plans. 7.9 Since then, work is continuing to: Assemble a final report on the work carried out over the 2019-2024 Mental Health and Wellbeing Strategy for sharing and publication Establish a programme sustainability plan- to identify any outstanding priorities and actions from 2019-2024 strategy to be carried forward into the new Lanarkshire Delivery Plan Undertake a self-assessment of where we are in Lanarkshire in relation to the strategic actions set out in the National Mental Health and Wellbeing Delivery Plan Consider contributions from stakeholders regarding existing and new priorities and actions (period of engagement and development) Engage with stakeholders both at Lanarkshire-wide and locality level, via the Community Boards in North Lanarkshire and with an equivalent engagement process in South Lanarkshire, to identify any further priorities and actions for the Lanarkshire Delivery Plan Agree future governance and leadership arrangements Prepare the final draft Lanarkshire MHW Delivery Plan for approval by the Integration Joint Board, subject to the endorsement of South Lanarkshire IJB, Community Planning Partnerships, North and South Lanarkshire Councils and the Lanarkshire NHS Board. Stand down current MHW Strategy Board, Executive group and associated workstreams and close 2019-2024 programme of work Establish governance structures and implementation process (embed in operational governance and supported by in-house enablers)
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12 7.10 The timeline to complete this process is set out in Appendix 1, the intention being to present a draft Delivery Plan to the Integration Joint Board in September 2024. 8 CONCLUSIONS 8.1 This section should draw the committee’s attention back to the key reasons and arguments in favour of the recommendations made within the report. 8.2 Conclusions can also inspire fresh concepts to address a problem highlighted within the report or presenting fresh perspectives on a subject. 9 IMPLICATIONS 9.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☒ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☒ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide ☒ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 9.2 ASSOCIATED MEASURE(S) 9.2.1 An outcomes-focused Achievement Framework was developed (Appendix 2) for the Mental Health and Wellbeing Strategy that links the contributions made by projects and workstreams to outputs and the achievement of short and long term outcomes. 9.2.2 We noted in our strategy that as GIRFEP was implemented, people in Lanarkshire would see campaigns to promote ways of improving our mental wellbeing, changes and improvements to the way they access mental health support and services, new ways of working, observe new staff roles, a programme of work to tackle mental health stigma and discrimination, increased interventions to support prevention and early intervention as well as every effort to improve services for people with severe and enduring mental health conditions.
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13 9.2.3 Ultimately, the strategy set out with an ambition to change the culture in Lanarkshire and improve people’s physical wellbeing and mental health. A final report is being developed to report on what outcomes have been achieved over the period of the strategy. 9.2.4 A monitoring and evaluation framework is being developed to accompany the new national Strategy. This will set out how progress towards the outcomes will be measured. It will also take account of existing indicators and standards currently under development. 9.3 FINANCIAL This paper has been reviewed by Finance: Yes No N/A The landscape in relation to additional funding streams, including Mental Health, released throughout the year by Scottish Government, is complex with continued uncertainty around the scale and timing of future funding. The costs and funding available for 2024/25 and future years will be closely monitored and reported. 9.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Choose an item. This is currently no direct risk for the delivery plan. 9.5 ENGAGEMENT & PARTICIPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details on the engagement and participation that was undertaken. Objectives Further details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes Discussion at Lanarkshire Links quarterly meetings Engagement events involving Mental Health and Wellbeing Strategy Board and Comms & Engagement Group Presentation/discussion at Community Boards
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14 ☒ Provide stakeholders with information on how to get involved As above ☒ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs As above ☐ Measure how well we involve community stakeholders in the planning, design and delivery of our services ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery As above ☐ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership Presentation/discussion at Community Boards 9.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: Yes No N/A EQIAs were completed for the development of the 2019-24 Strategy and for most of the workstreams. These will be reviewed and will inform the completion of an EQIA for the Delivery Plan. EQIA added to website: Yes No N/A 8. BACKGROUND PAPERS Getting it Right for Every Person, a Mental Health and Wellbeing Strategy for Lanarkshire, 2019-23 Scotland’s Mental Health and Wellbeing Mental Health and Wellbeing Delivery Plan, 2023-25
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15 9. APPENDICES Appendix 1 – Lanarkshire Mental Health and Wellbeing Delivery Plan - Timeline for Development Appendix 2 – Achievement Framework CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact Maggs Thomson, HSCP North, Head of Health at Maggs.Thomson@lanarkshire.scot.nhs.uk
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16 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed
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17 MENTAL HEALTH AND WELLBEING DELIVERY PLAN APPENDIX 1
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18 LANARKSHIRE MENTAL HEALTH AND WELLBEING STRATEGY ACHIEVEMENT FRAMEWORK APPENDIX 2