Minutes of the Annual General Meeting of the Royal College of Psychiatrists in Scotland, Child & Adolescent Faculty held at the Royal George Hotel, Perth, on 28 November 2014.

Present:

Dr A McFadyen (Chair) Dr M Haridas Dr S Hume (Academic Secretary) Dr C Hart Dr A Afzal Dr C Hennessy Dr Z Ahmed Dr S Hume Dr F Alexander Dr L Johnston Dr T Ali Dr L Kathuria Dr R Berger Dr M Linney Dr A Blower Dr M MacEachen Dr L Boeing Dr R McCabe Dr C Boyd Dr M McNeill Dr C Boyle Dr M Parrish Dr K Brown Dr J Pickett Dr A Cameron Dr M Quilter Dr J Esparon Dr T Schumm Dr C Fell Dr A Sinha Dr J Fuller Dr H Tindle Dr C Gilmour Dr K Towlson Dr J Halliday Dr S Yordanov

1. Apologies Apologies were received from Dr Elaine Lockhart, Dr Jane Hosie and Ms Penny Curtis. No other specific apologies were received.

2. Minutes The Minutes of the AGM held on Friday 22 November 2013 were accepted and approved as a true and accurate record.

3. Faculty Elections Dr McFadyen reported that Dr Jackie Pickett, Dr Alasdair Hosking and Dr Kevin Brown had all stepped down from their roles as elected members of the Child and Adolescent Executive Committee. Dr McFadyen thanked them all for their contributions to the Faculty in Scotland and noted that there were now 3 vacancies for Child and Adolescent Faculty Executive Members in Scotland. The terms of office are 2 years followed by an additional optional 2 years.

The following nominations were received:-

AGM Minutes CA Faculty Scotland 28 November 2014 FINAL 1 Dr Ereni Skouta (Executive) Dr Dianne Forsyth (Executive) Dr Kate Towlson (Executive)

Dr McFadyen said it was also crucial to have an academic representative on the Committee and Justin Williams had agreed to do this. Dr Helen Minnis had also suggested a trainee Adele Whorlow

4. Chair’s Report

Dr Anne McFadyen congratulated Helen Minnis on her appointment as Professor of Child and Adolescent Psychiatry at the University of Glasgow.

Dr McFadyen then delivered the Chair’s report and a summary of the key areas discussed is outlined below:

Recruitment The Executives’ ongoing discussions regarding recruitment have involved colleagues at UK Faculty level, academic psychiatrists, CAPFEC and others. The Executive aims to produce a recruitment strategy specifically addressing issues in Child and Adolescent Psychiatry. They also plan to amend the constitution to permit the co-opting of an academic representative which will allow more direct consideration of the issue of time devoted to medical student training and more formalised opportunities and experience at other points on doctors’ career paths. Dr McFadyen asked the members for their ideas on how to promote recruitment into psychiatry and suggested speed dating for medical students and outreach within the school setting as examples.

Dr Susie Hume and Dr Gilmour spoke about a programme for schools that allows children to be placed in hospital departments (‘doctors at work’ programme). Dr McFadyen highlighted that there is a confidentiality issue with this. Dr Boyle said she also believed it might affect the therapeutic engagement with the patient as many young patients may find it very awkward to be faced with someone who is of the same age as them.

Dr Fell noted that psychology is often very popular with pupils in school and so there might well be people who are not thinking of medicine but who are interested in psychology. Dr Berger agreed saying he was a psychology graduate who had moved into Child and Adolescent psychiatry and so this was a good point.

The Group moved on to talk about the use of the media to promote the profession. It was highlighted that a lot of people are often interested in Forensic Psychiatry for this reason and it was perhaps an area that could be explored.

Dr McCabe reported that he had hosted a FY1 taster week for those doctors who were interested in changing their career path and the feedback from this had been very positive.

AGM Minutes CA Faculty Scotland 28 November 2014 FINAL 2 Dr Hennessy spoke about doing more with medical students and highlighted the 5 week clinical programme offered by Glasgow University which could be repeated more often. He added that undergraduate medical students do not get time in CAMHS and so suggested offering more extracurricular sessions.

Dr Jane Fuller pointed out that there needs to be time for teaching as with the reduction of SPA time in new consultant contract it is more difficult to have allocated time to teach. She noted that the College needs to stand up for protected time with regards to these activities so that medical students can be given a good experience.

Dr Caroline Fell talked about the special study component for 3rd year Glasgow University Medical Students called ‘psychiatry in schools’. This is run by CAMHS but students also get an experience of General Adult with an emphasis on developmental psychiatry. It is a 5 week project open to 4 students and at the end they have to deliver a presentation to a school on mental illness.

It was also suggested that patients could be brought in for an hour to talk specifically to medical students about themselves and their experiences.

Dr McFadyen thanked the Group for their ideas and said she would take these suggestions to the next Executive Committee meeting in February where more time could be spent consolidating them and preparing a paper.

Training There had been a very poor response to Dr Justin Williams’ email regarding consultants facilitating teaching sessions. Dr McFadyen pointed out that many people said they had not received the email and wondered if there was an issue about communications from the College being treated as SPAM. Dr Williams would like to hear from consultants about what they would like to teach about. Dr Blower said it would be good to know where there are gaps and if is there a particular area that requires support for teaching then people might well be interested. Dr Towlson asked if she could see the email again and Dr McFadyen confirmed Dr William’s email address for anyone wishing to contact him directly ([email protected]).

Value Based CAMHS Commission Dr McFadyen reported that this is the inspiration of past president of the Royal College of Psychiatrists, Professor Sue Bailey. The Commission has been established by The Royal College of Psychiatrists, with Young Minds and the Children and Young People's Mental Health Coalition. The purpose of the Commission is to establish a core set of values to underpin Child and Adolescent Mental Health Services (from Tiers 1-4+) and the commissioning and provider resources that would be needed to deliver Values based CAMHS.

The aims of the Commission are to work with a wide-range of stakeholders to agree a core set of principles, to develop and adapt

AGM Minutes CA Faculty Scotland 28 November 2014 FINAL 3 commissioning tools, to identify a range of technical and non-technical resources in order to deliver Values based CAMHS, to identify the innovation and transformation programmes which could drive the development of Valued based CAMHS and the investment needed to ensure its success.

Dr Anne McFadyen reported that she had recently attended a scoping meeting about the proposed Values Based CAMHS Commission and she has written about the Scottish Experience in the recent Child and Adolescent Faculty and Executive Newsletter. This newsletter can be accessed on the web pages at: http://rcpsych.ac.uk/workinpsychiatry/faculties/childandadolescent.aspx

Dr McFadyen said she was keep to be part of this but not undo the work of the Scottish Needs Assessment Programme (SNAP). She urged members to engage with the College network adding that she and Dr Elaine Lockhart are attending these meetings and would be interested to hear feedback from the Scottish membership on this issue.

Dr Leonie Boeing asked if the College in London were curious about the Scottish Needs Assessment Programme. Dr McFadyen confirmed that they were interested in what Scotland had learned from the process and what could be done better.

CR192. Managing Self-Harm in Young People Dr Anne McFadyen referred members to the new College paper on children who self-harm and highlighted that the English context is slightly different as children are not allowed in adult wards. A copy of the publication can be found on the College web pages at: http://www.rcpsych.ac.uk/usefulresources/publications/collegereports/cr/ cr192.aspx

RCPsych in Scotland Early Years Group Dr Anne McFadyen reported that this cross Faculty Early Years Group had been set up by the RCPsych in Scotland and is chaired by Dr Roch Cantwell. Dr McFadyen confirmed that she will be meeting with Dr Roch Cantwell in the next few weeks to discuss this further.

Dr Cleo Hart noted that the Royal College of Paediatrics and Child Health in Scotland are also carrying out some work in this area and suggested contacting them with regards to this.

‘ Children who Die’ Dr McFadyen had recently attended a RCPCH meeting at the Scottish Parliament about ‘Children who Die’ and it had been an opportunity to raise the issue of parity of esteem with Dr Kate McKay, SG Adviser on Child Health. The concern that a small but significant number of young people commit suicide and also die in the context of violent or risk-taking behaviour needs to be addressed in relation to the delivery of CAMH Services and the early identification and management of risk.

AGM Minutes CA Faculty Scotland 28 November 2014 FINAL 4 Scottish Government CAMHS Implementation Dr McFadyen reported that the Scottish Government CAMHS Implementation Group had not met in over a year and this has meant there is no place to talk to officials at the Mental Health Division about the CAMHS targets. Over a year ago Working Groups were set up to focus on CAMHS LD Services, Tier 4 services (linked to the commitment to reduce the number of adolescents in adult psychiatry beds) and the mental health of LAAC Children and young people. There had been a Tier 4 meeting in June this year led by Penny Curtis and there was some discussion about trying to think about ways in which to make services work more efficiently. There is agreement that there are not enough specialist beds and opportunities to discuss this directly with Scottish Government officials will be sought. Dr McFadyen suggested that if members meet Penny Curtis or Lauren Murdoch at an implementation visit that they might bring up the issue of HEAT targets.

Cross Party Group on Mental Health The next meeting of this group on 4 December 2014 will include a focus on CAMHS Waiting Time targets. Questions have been asked in the Parliament on a number of occasions and we will contribute to this discussion. Dr McFadyen highlighted that the HEAT target has to be considered in the context of increasing referral rates, a shortage of inpatient provision (including for those requiring secure facilities or specialist Learning Disability provision). Dr McFadyen encouraged members to get in touch if they would like to contribute their ideas.

Dr Cleo Hart noted that while she understands that HEAT targets are valuable she believed that they do not always take into account the pressures in different health board areas. This can then lead to a negative impact on departments with regards to lost CPD and meeting time for example.

Forensic services including Inpatient provision Dr McFadyen reported that a Working Group set up on behalf of Directors of Planning and chaired by Catriona Renfrew met throughout last year. It was recently reconvened and has recognised that there is a need for a small specialist IPU. Dr McFadyen noted that she was pleased to see a positive outcome on this.

There followed some discussion about the case of a 16 year old patient with ID and Forensic issues who is on a cross border transfer. Dr McFadyen asked members to keep her informed about issues like these so that she is able to pass on the evidence.

Affiliations Dr McFadyen highlighted that the RCPsych in Scotland have been approached by two coalitions of charities/children’s services recently. She added that there had been a lengthy discussion about how to collaborate but also not privilege some organisations over others. Dr McFadyen suggested that the Members’ view on this would be welcome.

AGM Minutes CA Faculty Scotland 28 November 2014 FINAL 5 5. Academic Secretary’s Report

Dr Susie Hume reported that the feedback from this meeting had been very positive and the attendance was also good and very encouraging. She noted that the delegate fee was slightly higher this year due to an additional 10% which had been added to delegate fees in Scotland. This had been proposed and approved by the Scottish Executive Committee to ensure that the finances of Scotland remained stable following the addition of members’ meeting facilities at the Edinburgh office. This charge was in addition to the 15% College development fee which is the levy which is built into the financial planning for all College conferences, courses and meetings. Dr Hume added that the College is currently discussing plans to discontinue the 15% development fee but this had not yet been formally agreed at present.

Dr Hume said that discussions were currently underway about repeating the one day CAMHS conference on physical health next year but this is still in the early stages and a programme and further details will be announced in due course.

Dr Hume noted that it had been a pleasure to work with Psychotherapy colleagues on this meeting and extended personal thanks to the staff at the RCPsych in Scotland and higher trainees Colm Hennessey and Lauren Wilson for all their hard work.

Dr McFadyen thanked Dr Hume for her role and efforts in putting together such a successful conference.

6. CAMHS Update

Penny Curtis had given her apologies for the meeting but Dr McFadyen confirmed that she and Dr Elaine Lockhart would be meeting with Penny Curtis and Lauren Murdoch in the New Year. There will be a further investment of £15m in Mental Health with a slant to early intervention and prevention for not just CAMHS but all of Mental Health. Dr McFadyen asked members to think about what advice can be given to the Scottish Government on how to spend this money.

7. AOCB

Dr McFadyen encouraged members to use the new meetings rooms at the RCPsych in Scotland office in Edinburgh. Members are very welcome to book rooms for their meetings for free, or call in and have a comfy seat and a coffee! The Boardroom holds 18 people, a small meeting room seats up to 8 and there is an additional lounge/working area for members to use.

8. Date and time of next AGM

AGM Minutes CA Faculty Scotland 28 November 2014 FINAL 6 The next AGM will be arranged to coincide with the Faculty Academic Meeting in 2015. The date and venue are still to be confirmed but an initial date of 27th November 2015 was suggested. Dr McFadyen suggested that Members could note on the feedback forms if they had a preferred date.

AGM Minutes CA Faculty Scotland 28 November 2014 FINAL 7