Sir Harry Burns says he is standing back looking at the whole system and the public will expect some reassurance in waiting times.

Sir Harry says "huge progress" has been made with waiting times in the past few years.

He says some things are working but there needs to be a holistic approach. 

Image source, bbc

Sir Harry Burns the chair of the Targets and Indicators Review says there should be indicators of progress for improvement not for judgement.

The former chief medical officer says if you give frontline staff the freedom to solve issues there will be huge improvements.

Sir Harry says the review must be approached with targets and indicators that lead in a direction of change, with improved health and wellbeing.

He says people should be in control of their own health and wellbeing. 

Health Committee convener Neil Findlay introduces the next panel of witnesses

• Targets and Indicators Review chair Sir Harry Burns
• Geoff Huggins from the Scottish government
• Paula McLeay from the Convention of Scottish Local Authorities

Image source, bbc

The Scottish government is to launch a consultation with NHS staff on reviewing the approach to targets in the health service.

Health Secretary Shona Robison led a Holyrood debate on "delivering a healthier Scotland".

She said she would consult with NHS staff and stakeholders, along with social care and clinical partners, to review the approach to targets.

The Conservatives, who have called for a review of targets, welcomed the move.

Ms Robison said the NHS's record was one "that everyone working in health and social care can be proud of".

The second Health Committee evidence session this morning will focus on NHS targets.

MSPs will quiz: 

• Targets and Indicators Review chair Sir Harry Burns
• Geoff Huggins from the Scottish government
• Paula McLeay from the Convention of Scottish Local Authorities

Image source, bbc

Conservative MSP Miles Briggs asks about disparity in the success of referrals.

Mr Briggs also asks what priorities the panel have for the next mental health strategy.

In response to the disparity of referrals, Jackie Irvine from Social Work Scotland says there may be a variation in criteria for getting into CAMHS, which should be eradicated.

Ms Irvine calls for emphasis on tier one and tier two in the forthcoming mental health strategy.

She says demand in CAMHS has gone up, particularly in patients on the autistic spectrum or with ADHD.

Image source, Thinkstock

Women aged 16-24 have significantly lower levels of mental wellbeing compared to other age groups, according to annual health figures.

The Scottish Health Survey, external found levels of mental wellbeing for all other age groups were similar, with little difference between men and women.

Women in the 16-24 age group also reported higher levels of self-harm - 23% compared to 18% of men.

Five thousands adults and 1,421 children were surveyed for the report.

The annual figures examined health, alcohol and tobacco intake, diet and physical activity. Those surveyed were also asked about cardiovascular conditions and diabetes, as well as injuries and accidents.

Image source, bbc

Committee convener Neil Findlay says much of this is about poverty and inequality.

The Labour MSP says social work going into homes and providing basic boundaries and help is "desperately needed", but with budget cuts how difficult is this.

Jackie Irvine from Social Work Scotland says there is still a model of home helpers or family assistants, but this is very precarious to keep afloat in the current fiscal climate.

Ms Irvine says there is a real need for family support assistants.

SNP MSP Tom Arthur asks if there is a greater need for data sharing between services.

Ms Irvine says the management of referrals and rejected referrals may need to be prioritised in the forthcoming mental health strategy.

The Social Work Scotland representative says data sharing is by consensus.

She says communication must come to all services in a solution focused way. 

Jackie Irvine from Social Work Scotland says partnership working is crucial.

Ms Irvine says any outcome approach across Scotland is difficult to measure.

She says this is due to the outcome being reliant on a subjective question to the child or parents.

SNP MSP Maree Todd asks how education and psychology fits with CAMHS and how professionals work together to provide care.

Barry Syme from the Glasgow Psychological Service says educational psychologists are now playing a bigger role and intervene at tier one and two where there are gaps to get involved.

Mr Syme says an example of this is doing suicide awareness talks in schools.

He says children with sensory issues need an education and work goes into making the environment appropriate for children with these issues.

Image source, Thinkstock

Childline received more than 900 inquiries from children in Scotland contemplating suicide last year, according to a new report.

The NSPCC, which runs the helpline, said it dealt with record levels of calls on the issue from across the UK.

It received 934 calls and online inquiries from suicidal youngsters in Scotland - an average of 18 a week.

In many cases, counsellors were so concerned about their callers' welfare, they alerted the emergency services.

Childline's annual report reveals that calls from young people reporting suicidal thoughts have more than doubled in five years.

Labour MSP and committee convener Neil Findlay asks what happens after a referral is rejected.

Lorna Wiggin from NHS Tayside says the referrer is contacted and told what other services may be appropriate.

SNP MSP Clare Haughey asks why there is such a variation in the accepted rate of referrals across the country.

Tracey Gillies from NHS Forth Valley says there is a lot of pressure in primary care, with fragmentation and the difficulties in GP recruitment.

Ms Gillies calls for better signposting and some referrals do not contain enough demographic information.

Barry Syme from the Glasgow Psychological Service says the majority of referrals come from GPs but there needs to be work with GPs to check what work they are doing in GIRFEC. 

Mr Syme says this will ensure the child is getting referred to the correct support service. 

Jackie Irvine from Social Work Scotland says it is important that all the pertinent information about the child is contained within the referral.

 An ICP is a tool that allows the comparison of planned care with care actually given. ICPs allow any variances in planned care to be recorded, analysed and acted upon. Here is the ICP CAMH service tiers, external: 

Tier 1

Child and adolescent mental health services at Tier 1 are provided by practitioners working in universal services who are not mental health specialists. This includes:

• GPs
• health visitors
• school nurses
• teachers
• social workers, and
• youth justice workers and voluntary agencies.

Tier 2

Mental health practitioners at Tier 2 level tend to be CAMH specialists working in teams in community and primary care settings (although many will also work as part of Tier 3 services). They can include, for example:

• mental health professionals employed to deliver primary mental health work, and
• psychologists and counsellors working in GP practices, paediatric clinics, schools and youth services.

Image source, ICP

Tier 3

Tier 3 services are usually multidisciplniary teams or services working in a community mental health setting or a child and adolescent psychiatry outpatient service, providing a service for children and young people with more severe, complex and persistent disorders. Team members are likely to include:

• child and adolescent psychiatrists
• social workers
• clinical psychologists
• community psychiatric nurses
• child psychotherapists
• occupational therapists, and
• art, music and drama therapists.

Tier 4

Tier 4 encompasses essential tertiary level services such as intensive community treatment services, day units and inpatient units. 

Green MSP Alison Johnstone says the latest ISD figure show 18.7% of referrals to CAMHS were rejected.

Jackie Irvine from Social Work Scotland says there is a real need to support the development and confidence of staff. 

Ms Irvine says children who have adverse childhood experiences with their family require help and their is a slight increase in growth in functional family therapy, but there is much variation across the country.

Lorna Wiggin from NHS Tayside says it is not just about putting more beds into the system, it is about providing the right support for a child.

Jackie Irvine from Social Work Scotland says the transition from inpatient out into the community must be managed.

Ms Irvine says there must be a transition guidance in place.

Lib Dem MSP Alex Cole-Hamilton says some children are waiting for as much as two years for Children and Adolescent Mental Health Service (CAMHS) treatment.

Mr Cole-Hamilton asks what should be in the next mental health strategy.

Jackie Irvine from Social Work Scotland says looking at CAMHS in isolation will not solve any issues.

Tracey Gillies from NHS Forth Valley says there has been a turn around in waiting times and says low waiting times are attained by making sure children that have been waiting a long time are seen.