Mental Health & Learning Disabilities. 20 September November 2016 KEY DECISIONS AND MATTERS CONSIDERED BY THE COMMITTEE

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1 Reporting Committee: Committee Chair Date of last meeting: Paper prepared on: Mental Health & Learning Disabilities Mel Davies 20 September November 2016 KEY DECISIONS AND MATTERS CONSIDERED BY THE COMMITTEE I am pleased to provide the Board with a summary of the matters discussed and reviewed by the Mental Health & Learning Disabilities Committee when it met on 20 September The confirmed minutes of the meeting held on are appended to this report (Appendix 5a). ADULT MENTAL HEALTH NHS MANAGEMENT ARRANGEMENTS: PROGRESS UPDATE The Committee RECEIVED an update report on the Adult Mental Health NHS Management Arrangements. The Committee was advised that the health board was not ready to transfer the remaining staff, as a whole group, back into Powys on the original timeline, as the out of hours medical staff arrangements were not yet viable and there remained, a number of medical vacancies and therefore risks. To address the out of hours arrangements, the Directorate was in consultation with relevant medical staff. Joy Garfitt, the Assistant Director of Mental Health, would report the outcome of this consultation to the Committee in December On discussing the paper, it was noted that: learning disabilities psychology was included; the Mental Health Directorate was reviewing the current and future psychology arrangements to establish improved processes; Autism Spectrum Disorder (ASD) had moved under the remit of Mental Health and would be managed as a separate specialism; and Reports of the Chairs of the Committees of the Board Page 1 of 19 Board Meeting 23 November 2016 Agenda Item 2.10 Appendix 5

2 the commissioning route was being considered as part of the recruiting options for the various vacancies of specialist staff. The Committee was particularly concerned about the arrangements being put in place to address the long psychology waiting lists. The Committee was advised that a Service Improvement Plan had been requested from Aneurin Bevan University Health Board (ABUHB) and Joy Garfitt was due to meet with ABUHB on 21 September 2016 in relation to this request. The Committee requested that a deep dive of the impact of the long wait for psychology appointments for patients was undertaken, and that colleagues from ABUHB were invited to the Committee meeting in December to present the results of this assurance work to the Committee. The Committee requested that a clinical review of all patients on the waiting list was also undertaken to establish their current clinical requirements and whether there was any harm caused as a result of the long waits. The Committee APPROVED that: Local Primary Care Mental Health Services return to PTHB by 1 November All other services (including Psychology) return to PTHB by the end of the 16/17 financial year in order to ensure a safe and effective transfer of services. It was noted that the health board was now able to access data from Powys County Council in relation to the care coordinators. INTEGRATED PERFORMANCE REPORTS: MENTAL HEALTH (INCLUDING AN EXCEPTION REPORT ON PSYCHOLOGY WAITING TIMES) Particular attention was given to the exception report on the mental health measure. It was noted that both teams in the north and south of the county were small and had sickness absence challenges. The Committee was advised that the health board was advertising for bank staff to help support the teams and current staff were increasing their hours to try to fill some of the gaps. The Committee observed that the recruitment process appeared to be taking a very long time, and queried if agency staff could be used in the interim. The Committee was advised that although agency staff could help to meet the targets, it may raise quality of care issues regarding continuity of care and challenges as to value for money. The Committee discussed if staff within Powys could be redeployed to facilitate the teams that were not meeting waiting times targets. It was confirmed that although this was an option, it was hampered by not having full management responsibility of the staff, which Page 2 of 19 Reports of the Chairs of the Committees of the Board Board Meeting 23 November 2016 Agenda Item 2.10 Appendix 5

3 would not be the case until the transfer was complete on 1 November The Committee noted there were two issues to address: the present situation and how to manage the gap; and succession planning. It was felt by the Committee that there was a need for a more robust plan to address the specific recruitment issues. The Committee expressed frustration at the limited response to the escalation of the long waiting times with ABUHB. It was agreed that a progress report would be brought to the next Committee that included a plan and any financial implications. The Committee was advised that an audit of the quality of care plans was being proposed and it was requested than an update on this was brought to the next Committee meeting. The Committee discussed: the quality of advocacy services in Powys; the figures presented on page 19 of the report, and requested context and assurance that the figures presented were correct; the Section 136 figures and noted that no patients were placed into custody under Section 136; the timescales for inclusion of qualitative data alongside quantitative data. By April 2017, it was expected that the Committee should see a balance of presentation of data; and the inclusion of patient feedback and partnership activities. LEARNING DISABILITIES The Committee discussed the quality of care and quality of life in general for patients with learning disabilities. It was requested that the next steps section of the report was developed for the next Committee meeting, highlighting: how the health board was performing against the commissioning strategy; external reports from independent organisations such as Health Inspectorate Wales etc. and patient experience data. CHILDREN S AND ADOLESCENT MENTAL HEALTH SERVICES (CAMHS) UPDATE REPORT Mary O Grady, Head of Child and Adolescent Mental Health Services (CAMHS), and Sharon Stirrup, Operational Lead for CAMHS, attended the Committee to present the report. Reports of the Chairs of the Committees of the Board Page 3 of 19 Board Meeting 23 November 2016 Agenda Item 2.10 Appendix 5

4 Mary O Grady noted that there was an anomaly between the executive summary and the graphs presented in the appendix. She also noted the Committee s comments made previously in relation to qualitative data and acknowledged the report would include such in future iterations. The Committee was made aware of the significant improvement made by the service in the last eighteen months in regard to waiting times. The Committee requested clarity in relation to the protocol and provision of Section 136 for CAMHS, including the wrap around service between the Coordinated Intervention and Treatment Teams (CiTT) and Prevention teams. It was agreed that an update would be brought to the next meeting with a full report to the following meeting. The Committee discussed the set up of the teams and how they were colocated to support each other across Powys. HEARTS AND MINDS: MENTAL HEALTH PARTNERSHIP DELIVERY PLAN AND ANNUAL REPORT Louisa Kerr, Mental Health Partnership and Project Manager, advised the Committee of the reporting changes issued by Welsh Government. She stated that it was her intention to have the Delivery Plan report completed by the end of December 2016 and to produce a local annual report in due course. It was noted that the key actions in the template were ongoing, and it was intended that they interfaced closely with the Integrated Medium Term Plan. It was requested that, once known, the format and timings of the reports be fed to the Committee Secretariat for inclusion in the Committee Work Programme. Louisa Kerr stated that she would ensure that the local annual report still focussed on service users. TEMPORARY CLOSURE OF THE FAN GORAU INPATIENT UNIT The low number of required in-patient admissions of the patients assessed by the Dementia Home Treatment Service was highlighted. This revealed the positive impact that the temporary model of care had made. In particular, the number of out of hours admissions had reduced to zero, which demonstrated a change in culture within the treatment teams. The Committee was advised there had been two formal concerns received that had been directly attributed to the change of service and were being dealt with via the Putting Things Right process. Reports of the Chairs of the Committees of the Board Page 4 of 19 Board Meeting 23 November 2016 Agenda Item 2.10 Appendix 5

5 The Committee was made aware that patients and families were being asked to complete service user feedback questionnaires and the feedback so far had generally been very positive. It was noted that active recruitment was still an ongoing issue. It was acknowledged that further consideration would need to be given to the future of inpatient services in North Powys should the latest recruitment drive not be successful. The Committee discussed how the staff felt about moving from a ward setting to a community setting. It was noted that the staff themselves were very positive about the temporary changes. It also appeared to have been more beneficial for the majority of patients who had been able to receive treatment at home. For those that had been admitted, there was further to travel, which had caused some issues for the families of those patients. The Committee wished the staff involved in the temporary arrangements to know that their commitment and hard work to manage a temporary solution was valued. COMMITTEE RISK REGISTER The Committee RECEIVED and NOTED the Committee Risk Register. It was noted that despite a review of each of the risks in the register, there had be no change since the last Committee meeting in June The Committee agreed that even if there was no change to report in the Register they still wished to receive it at every Committee meeting. The Committee discussed operational risks and corporate risk and the interface between them. The Committee acknowledged that significant work had been undertaken in relation to the Corporate Risk Register and noted that further work was to be carried out on Directorate risk registers so that they aligned. It was confirmed that any risk over a rating of 15 should be in the Corporate Risk Register and it was intended that progress on the alignment of risk registers would be seen at the next meeting. ESTATES AND ENVIRONMENT OF CARE: MONITORING REPORT The Committee RECEIVED and NOTED the Mental Health Estates and Environment Monitoring Report, which had been produced in conjunction with Wayne Tannahill, Assistant Director of Estates and Property. On discussing the paper the following points were noted: the timeframes for completion of the work on Felindre ward were required; Reports of the Chairs of the Committees of the Board Page 5 of 19 Board Meeting 23 November 2016 Agenda Item 2.10 Appendix 5

6 the temporary closure of the Fan Gorau unit had allowed for compliance works to be carried out using newly released capital funding; scoping work was underway to look at alternative accommodation for the Community Mental Health Teams in Newtown as concern was raised as to the condition of the current accommodation; and the purchasing of furniture should not be an issue raised at Committee level; this should have been addressed at an operational level. The Committee acknowledged that a degree of environmental de-sensitivity had probably taken place, where less than acceptable environments of care had become the norm. The 15 step walkrounds and inspections were helping to identify and rectify unacceptable environments of care. The Committee welcomed the format of the report, noting the RAG rating to be very helpful, as well as collating all the work to be undertaken from many separate reports into a single report. The Committee queried if there was a way to align the work that needed to be done to the legacy Mental Health Charitable Funds. The Committee discussed the links between the long term estates strategy and the vision for mental health services. It was noted that a sub Committee of the Finance, Planning & Performance Committee had been established to oversee Capital and Estates. It was noted that a number of audits had been received and their recommendations would be incorporated into the report by the next meeting of the Committee. DEPRIVATION OF LIBERTY SAFEGUARDS The Committee RECEIVED and NOTED the Deprivation of Liberty Safeguards report. Rhiannon Jones, Director of Nursing, acknowledged the need to include more qualitative data in future reports. Rhiannon Jones stressed that the performance in the report was mirrored nationally, and acknowledged that the health board was not where it needed to be in relation to safeguarding, despite some progress in recent months. The Committee was advised there was a Law Commissions review of Deprivations of Liberty due for release in December 2016 and it was agreed that an update on the relevant safeguarding issues would be brought to the March 2017 Committee meeting. Reports of the Chairs of the Committees of the Board Page 6 of 19 Board Meeting 23 November 2016 Agenda Item 2.10 Appendix 5

7 The Committee sought assurance that there were no risks of an individual being inappropriately deprived of their liberty due to the under resourcing. It was confirmed that the health board would be able to provide more information on the impact of this in the next report. BEATING THE BLUES PROPOSAL FOR BUSINESS AS USUAL SERVICE Harold Proctor, the health board s Dementia Lead, shared with the Committee the outcome of the Mental Health Partnership Board (MHPB) discussions in relation to the Beating the Blues part of the Mastermind project, which had reached the end of its research period. The Committee was advised that the data on uptake of the service required further analysis. The MHPB asked the project lead to work up options to assess whether continuation of the service could be achieved cost neutrally, which would be taken to the Executive Committee for further consideration. It was acknowledged that the concept of e-cognitive behavioural therapy was a proven success. ITEMS TO BE ESCALATED TO THE BOARD NEXT MEETING The next meeting of the Committee is scheduled for 19 January Reports of the Chairs of the Committees of the Board Page 7 of 19 Board Meeting 23 November 2016 Agenda Item 2.10 Appendix 5

8 Appendix 5a POWYS TEACHING HEALTH BOARD MENTAL HEALTH SERVICES ASSURANCE COMMITTEE CONFIRMED MINUTES OF THE MEETING HELD ON TUESDAY 7 JUNE 2016, AT 10.00AM, HAFREN WARD, BRONLLYS Present: Melanie Davies (MD) Mark Baird (MB) Matthew Dorrance (MJD) In Attendance: Carol Shillabeer (CS) Stephen Edwards (SE) Michelle Forkings (MF) Rhiannon Jones (RJ) Joy Garfitt (JG) Catherine Woodward (CW) Pauline Galluccio (PG) Rob George (RG) Hayley Tarrant (HT) Mandy Collins (MC) Sarah Murphy (SM) Observer/Members of the Public: Liz Singer (LS) Powys Teaching Health Board Vice Chair (Committee Chair) Independent Member Independent Member Chief Executive Officer Interim Medical Director Interim Operational Manager Director of Nursing Assistant Director for Mental Health Director of Public Health (in part) Head of Nursing Adult and Children Safeguarding Business Performance and Improvement Manager Head of Learning Disabilities (in part) Interim Board Secretary Corporate Governance Support Officer (Minutes) Independent Assurance Observer MH&LD/16/35 WELCOME AND APOLOGIES FOR ABSENCE The Chair welcomed everyone to the meeting and noted that there was a quorum present. Page 8 of 19

9 Apologies for absence were RECEIVED from Vivienne Harpwood, Powys Teaching Health Board Chair; Roger Eagle, Independent Member & Committee Vice Chair; Alan Lawrie, Director of Primary and Community Care; and Dr Wasi Mohamad, Clinical Director for Mental Health Services. MH&LD/16/36 DECLARATIONS OF INTEREST The Chair invited Members to declare any interests in relation to the items on the Committee agenda. None were declared. MH&LD/16/37 UNCONFIRMED MINUTES OF THE COMMITTEE MEETING HELD ON THURSDAY 3 MARCH 2016 The minutes of the meeting held on the 3 March 2016 were RECEIVED and AGREED as being a true and accurate record. MH&LD/16/38 MATTERS ARISING FROM THE PREVIOUS MEETING The following item was raised: MHSA/16/22 Mental Health Performance Report (including Incidents) It was queried whether the comprehensive list of Powys County Council Care Coordinators had been circulated. The Assistant Director for Mental Health AGREED to follow this up. Action: Director for Primary & Community Care, and Mental Health MH&LD/16/39 COMMITTEE ACTION LOG The following updates were noted: MHSA/16/23 Committee Risk Register It was NOTED that this was on the meeting agenda. MHSA/16/24 CAMHS Report It was NOTED that the post had been recruited to. Page 9 of 19

10 MHSA/16/25 Adult Mental Health Management Arrangements It was NOTED that professional leadership for Mental Health nursing staff sat with the Interim Operational Manager. MHSA/16/27 Mental Health and Capacity Legislation It was NOTED that the contract for advocacy provision in the north and south had been awarded to one provider, Conwy & Denbighshire Advocacy, and provision would start from 1 August It was REQUESTED that a column spelling out timescales for completion be added into the Action Log. Action: Committee Secretariat MH&LD/16/40 MENTAL HEALTH PLANNING & DEVELOPMENT PARTNERSHIP PLAN: EXCEPTION REPORT The Chief Executive presented the report which provided the Committee with an exception report aligned to the Hearts and Minds Delivery Plan, as well as information on the Welsh Government s revised National Together for Mental Health Delivery Plan for On discussing the report, the Committee queried the Mental Health Delayed Transfers of Care (DToC) targets and performance. The Committee was informed that even though the health board was not yet meeting the revised Welsh Government target, the DToC levels were the lowest they had been since 2010 and significant progress towards achieving the target. It was highlighted to the Committee that there was a growing issue of Mental Health bed availability (both adult and older adult) across Wales and England, and there was work underway to understand the reasons for this rise. The Committee NOTED the progress being made and the work being taken forward to meet the requirements of the current Hearts and Minds Delivery Plan. Page 10 of 19

11 MH&LD/16/41 DEMENTIA PLAN The Director of Nursing presented to the Committee the Powys Multi-Agency Dementia Plan that was approved by the Board in May. The Plan was commended for its visually appealing presentation. The Committee queried how the progress would be measured as the Plan did not clearly state the present position of the health board, and what the outcomes were, including milestones. It was acknowledged that the delivery of the Plan was not solely in the hands of the health board, and relied on the participation of stakeholders. The Committee was advised that the pledge leads and key stakeholders were due to meet to set out what success looked like for their respective areas, and further work would need to be undertaken to draw an implementation plan together. It was noted that they would be reporting progress to the Director of Nursing on a quarterly basis, and it was requested the Director of Nursing liaise with the Committee Secretariat with how this would fit with the reporting to the Committee. Action: Director of Nursing The Committee welcomed the Dementia Plan. It was AGREED that in the first instance the Plan should be reported to the Joint Management Team with Powys County Council. Further thought was to be given to wider reporting lines in relation to the risks and representation. Action: Board Secretary The energy and enthusiasm by the team behind the plan was recognised, as was the Plan forming a sound base for part of the longer term health and care strategy. MH&LD/16/42 COMMITTEE RISK REGISTER Page 11 of 19

12 The Committee NOTED and RECEIVED the Committee Risk Register, and as part of discussions the following issues were raised: The issues and risks presented in the north of the county were still significant. The Committee recognised the extent of the work needed to improve the services in the north; The commissioning arrangements with Aneurin Bevan University Health Board (ABUHB) was progressing however arrangements were not yet fully agreed by both parties and discussions were still ongoing. The waiting times for psychology services in the south of the county had been formally escalated to the Director of Planning & Performance so that she could take this forward with her counterpart in ABUHB. The waiting times in the north had been reduced as the health board had been able to use additional funding from Welsh Government. The Committee REQUESTED that a comparison of quarter four of 2015/16 waiting times performance with quarter one of 2016/17 be brought to the next Committee meeting so that the Committee could assess improvement of management arrangements in the north. Action: Director for Primary & Community Care, and Mental Health The governance arrangements around substance misuse services were being strengthened. Progress was being made towards safely moving patient from the Fan Gorau unit to allow temporary closure, and consideration was being given to temporarily establishing an out of hours bed management system. The aspiration was to have the ward closed by 10 June 2016 however, this was dependant on many issues being simultaneously resolved. It was noted that staff had been fully engaged in the current proposals, were supportive and felt supported during the process of enacting the temporary measures. It Page 12 of 19

13 was noted that much of the out of hours psychiatry activity could be prevented by better engagement during working hours, and therefore a review of working arrangements was underway. It was also noted that although outreach provided the best outcomes for patients, it was important to monitor the case loads of community staff under the revised arrangements. It was reiterated that the arrangements being enacted were only temporary. The Committee acknowledged the amount of additional work that the Fan Gorau situation had created, and REQUESTED that an update on progress be provided at the next meeting. Action: Director for Primary & Community Care, and Mental Health MH&LD/16/43 MENTAL HEALTH INTEGRATED PERFORMANCE REPORT The Committee RECEIVED and NOTED the Mental Health Integrated Performance Report and as part of discussions the following issues were raised: The Mastermind project may not hit the ambitious self-set target, however, it was noted that Powys still had amongst the highest levels of referral within the project. The Committee was ADVISED that there was plenty to learn from the application of the project from other rural project participants, and that there would be a Powys as well as European Union (EU) wide evaluation of the project. It was NOTED that the EU funding for the project would not be renewed, so continuation of the project would depend on funding being sourced from within the health board or the additional monies from Welsh Government for Psychological Therapies. The Committee discussed the definition of intervention as well as when intervention was recorded as starting. It was noted that this may Page 13 of 19

14 have an impact on Aneurin Bevan University Health Board s (ABUHB s) psychological performance data. The Committee was advised that the psychological waiting times across Powys were being closely monitored, and concerns would be escalated as and when necessary. The work taken forward to increase the quality and validation of data in ABUHB and Abertawe Bro Morgannwg University Health Board (ABMUHB) was flagged. It was noted that there was a review underway to ensure that cases were no being kept open unnecessarily. It was REQUESTED that a key be added to the table in Part 3 of the report. Action: Director for Primary & Community Care, and Mental Health The work undertaken to reduce the Mental Health Delayed Transfers of Care (DToC) was commended, and it was acknowledged that it would be a challenge to maintain this level. [HT left the meeting] [CW joined the meeting by telephone] The Committee noted and discussed the figures presented in the Section 136 table. It was REQUESTED details of the use of Section 136 be broken down by area and provided in the supporting text. Action: Director for Primary & Community Care, and Mental Health MH&LD/16/44 THE HEALTH OF POWYS VETERANS The Director of Public Health presented a briefing report which considered a range of issues in relation to the health, including the mental health, of Powys veterans. Page 14 of 19

15 The Director of Public Health proposed that the mental health needs of veterans would be better placed under the wider scope of the health board s mental health programme. The Committee queried who the current GP veterans champion was, and whether there was a plan for promoting the identification of veterans in medical records. It was confirmed that the promotion work was part of a wider plan, and that no GP champion had been identified as yet. The Committee discussed whether the priority for treatment under the Covenant arrangements was tracked. It was noted that at present the commissioning arrangements were not set up for such tracking, however, a national approach was being set up. It was AGREED that the Chief Executive would liaise with NHS Wales Information Systems to ascertain the present situation and future plans for tracking veterans under the Covenant arrangements. Action: Chief Executive The Committee REQUESTED clarity in relation to the figures on alcohol misuse presented on page 9 of the report. Action: Director of Public Health It was noted that the veteran s health was much better sighted than a number of years ago. The Committee REQUESTED clarity around it s accountability in relation to the wider health needs of veterans. Action: Board Secretary The Committee discussed where the veteran s health featured in terms of the Quality Outcomes Framework. The Committee noted the report and AGREED that the mental health needs of veterans would come under the wider scope of the health board s mental health programme. In light of this, the Director of Public Health confirmed she would provide an update report at the meeting scheduled for 1 December Action: Director of Public Health Page 15 of 19

16 [CW left the meeting] MH&LD/16/45 REPORT OF POWER OF DISCHARGE COMMITTEE The Committee RECEIVED and NOTED the report of the Powers of Discharge (PoD) Committee. The Committee Chair REQUESTED that the actions from the PoD Committee meetings be included in the report. Action: Director for Primary & Community Care, and Mental Health The Committee noted that members of the PoD Committee had agreed to meet with the new advocacy providers once they had started their contract, to discuss their concerns around the delivery of the service. MH&LD/16/46 ADULT MENTAL HEALTH MANAGEMENT ARRANGEMENTS: PROGRESS UPDATE The Chief Executive presented the report providing a summary of the progress of the Adult Mental Health Services NHS Managements Arrangements Project. The Committee was advised that the project management team met every six weeks or so to ensure the project was progressing, which depended heavily on the recruitment of medical staff. It was noted that consideration was being given to the phasing of the transfer of the Aneurin Bevan University Health Board staff should issues in relation to recruitment not be resolved. It was also confirmed that the models of care had been reviewed and were being finalised, which would determine workload and staffing requirements. The Committee enquired as to whether it was the intention to substantiate all interim posts. It was confirmed that this was the case, across all staff groups. The Committee REQUESTED that this be highlighted in the Mental Health Management Arrangements plan. Page 16 of 19

17 Action: Director for Primary & Community Care, and Mental Health It was noted that the October date set for the transfer of staff may not be appropriate for the whole transfer to take place. The Committee was advised that it was critical that all parties agreed the findings arising from the Assessment for Readiness for Transfer to be conducted in July. Once completed, the health board would be better placed to advise if the transfer would go ahead as planned. MH&LD/16/47 PROGRESS UPDATE FROM ASSISTANT DIRECTOR OF MENTAL HEALTH Estates and Environment of Care: Monitoring Report The Committee was informed there was a monthly meetings were held with the Estates team, where the priorities were determined. It was noted that the list of works was long, which reflected the age of the estate. The Committee noted the approval of the Discretionary Capital Programme by Board in May, and that a number of the bids related to mental health estates. The Committee REQUESTED a full update at the next meeting. Action: Assistant Director for Estates Audit & External Review Reports The Chair advised the Committee that this was included in on the agenda so as to not loose sight of the need for the Committee to be sighted of relevant audit and external reviews, however, it was appreciated that progress had been limited due to staff absence. MH&LD/16/48 DISCUSSION OF WIDER SCOPE OF THE COMMITTEE, INCLUDING REPORTING AND ASSURANCE ARRANGEMENTS The Committee briefly discussed the wider scope of the Committee. It suggested and AGREED that the Executive Lead s report was produced, and highlighted performance by exception, both positive and negative, Page 17 of 19

18 with the full Committee Performance Report included in the Information section of the Agenda. Action: Director for Primary & Community Care, and Mental Health It was suggested that the Committee needed to have a balanced agenda which allowed time for scrutiny and focus on key issues. It was REQUESTED time allocated for Committee meetings was extended to three hours. Action: Committee Secretariat It was REQUESTED that a development session on learning disabilities be arranged, and that this should be open to a wider audience that just the Committee, with a focus on Committee Members. Action: Committee Secretariat The Committee NOTED that Mental Health was now part of the Director of Primary and Community Care s remit. MH&LD/16/49 COMMITTEE WORK PROGRAMME 2016/17 The Committee RECEIVED and NOTED the Committee Work Programme for 2016/17, and it was REQUESTED that two changes as follows: the Executive Lead for the Dementia Plan should be the Director of Nursing; and the Mental Health Workforce Plan: Progress Report be deferred to the October Committee meeting. Action: Committee Secretariat MH&LD/16/50 COMMITTEE TERMS OF REFERENCE The Committee NOTED that the revised Terms of Reference had been approved by the Board on 25 May MH&LD/16/51 ITEMS TO BE BROUGHT TO THE ATTENTION OF THE BOARD AND OTHER COMMITTEES The Committee Members REQUESTED that they be kept abreast of the outcome of the Assessment of Page 18 of 19

19 Readiness for Transfer, and a note of the outcome of the assessment be circulated to Committee Members. Action: Director for Primary & Community Care, and Mental Health It was AGREED that if the assessment highlighted issues that would impact on the time of the transfer, a meeting of the Committee could be convened to discuss the main areas of concern. Action: Committee Secretariat MH&LD/16/52 ANY OTHER BUSINESS No items were raised MH&LD/16/53 NEXT MEETING It was confirmed that the next meeting was scheduled for 1 October Page 19 of 19