Fourth national mental health plan: first progress report of implementation activity January - December 2010

2.2 Safety and Quality Partnership Subcommittee (SQPS)

Page last updated: 2011

The Safety and Quality Partnership Subcommittee (SQPS) is a sub-group of the MHSC which is tasked with taking forward the mental health safety and quality agenda. A key role of the SQPS is the provision of expert technical advice and recommendations on the development of national policy and strategic directions for safety and quality in mental health, taking into consideration the National Mental Health Strategy, National Mental Health Plan(s), and mainstream health initiatives.

The SQPS has a watching brief in relation to safety and quality in mental health and may respond, through the provision of advice to the MHSC, on emerging issues of concern and related quality and safety initiatives. The SQPS may also provide advice in relation to monitoring and implementation of the National Standards for Mental Health Services.

The membership of SQPS includes the Chair (appointed by the MHSC) and representatives from key stakeholder groups who are in a position to drive change in the area of safety and quality (State and Territory public mental health sector, Australian Government Department of Health and Ageing, Australian Commission on Safety and Quality in Health Care, Private Mental Health Alliance, Mental Health Council of Australia, Community Mental Health Alliance and New Zealand Ministry of Health as well as consumer and carer representatives from the National Mental Health Consumer and Carer Forum).

Fourth national mental health plan implementation activity

SQPS has responsibility, or shared responsibility, for progressing the work associated with the implementation of Actions 4, 23 and 27 of the Fourth Plan. In the early part of 2010, SQPS revised its work plan for 2010-2011 to ensure alignment with the Fourth Plan objectives, including those actions where SQPS had a keen interest in contributing to, or a watching brief on, activity due to linkages and interactions with the SQPS agenda. In August 2010, SQPS representatives led workshop activities to develop the draft implementation approaches for Actions 4, 23, 27 and 28. Representatives from SQPS also participated as members in other subgroups developing implementation approaches for actions where SQPS had an identified interest.

Action 4 - Adopt a recovery oriented culture within mental health services, underpinned by appropriate values and service models

Recovery is a fundamental action of the Fourth Plan which is complicated due to the multifaceted aspects, interpretation and activities associated with recovery. A major focus of SQPS in 2010 was related to the further development of a recovery oriented framework of service provision, building on the recovery principles of the revised National Standards for Mental Health Services. The National Standards Implementation Steering Committee (NSISC), a subgroup of SQPS, is the overseeing body responsible for finalising the review and guiding the implementation of the National Standards. Top of page

The review of the National Standards involved an extensive consultation process which saw the inclusion of a Recovery Standard and the development of a set of National Principles of Recovery Oriented Mental Health Practice to ensure that mental health services are delivered in a way that supports the recovery of mental health consumers inclusive of:
  • Uniqueness of the individual
  • Real choices
  • Attitudes and rights
  • Dignity and respect
  • Partnership and communication and
  • Evaluating recovery.
To accompany the revised National Standards, the NSISC developed three Implementation Guidelines for the following service sectors:
  • Non government sector
  • Private office based mental health practices and
  • Private hospitals and public mental health services.
The National Standards for Mental Health Services 2010 were endorsed by Health Ministers on 15 September 2010 and officially launched by Her Excellency, Professor Marie Bashir AC, Governor of New South Wales, on 16 September 2010 at The Mental Health Services Conference (TheMHS). The National Standards and the three Implementation Guidelines are available electronically on the MHSC website under the SQPS publications area at the MHSC website under the publications section and can be ordered in hard copy from National Mailing & Marketing website (Tel: (02) 6269 1000). Top of page

More recently, the NSISC developed an overarching National Implementation Strategy for the National Standards with key objectives outlined under the three areas of Implementation, Monitoring and Accreditation.

The NSISC and jurisdictions are now concentrating on the Implementation phase (in line with the National Implementation Strategy) including promotion and awareness raising activities as well as monitoring and reporting issues and the implications for accreditation. As part of the national awareness and promotion activities, a poster and video competition aimed at building awareness in the community was held and competition winners were announced at the Summer TheMHS Forum in February 2011.

In August 2010, MHSC jurisdictional members also contributed to a brief audit process to summarise recovery tools and frameworks currently being utilised or developed across jurisdictions. This information will be expanded to determine baseline activity and utilised by SQPS as it progresses further activity in 2011 in collaboration with the Mental Health Information Strategy Subcommittee and the Mental Health Workforce Advisory Committee. Top of page

Action 23 - Review the Mental Health Statements of Rights and Responsibilities

In acknowledging the strengths of the current Mental Health Statements of Rights and Responsibilities (the Statements), the implementation approach for Action 23 identified that a review project would aim to amend and update the Statements in relation to human rights legislation, modern mental health care concepts and contemporary language rather than undertake a major rewrite of the document.

While SQPS would have oversight/governance of the review project and develop clear guidelines on the expected consultation process and timeframes, the review project activity could potentially be undertaken by an external agency. At its meeting in November 2010, SQPS agreed on the formation of a group to further scope and develop terms of reference and a work plan to progress this review.

Following the scoping activity and MHSC endorsement of the work plan, the intention is to progress the review project activity in the first half of 2011, with the aim of completing the review of the Statements by the end of 2011 prior to seeking Health Ministers' endorsement in 2012. Top of page

Action 27 - Ensure accreditation and reporting systems in health and community sectors incorporate the National Standards for Mental Health Services

In line with the National Implementation Strategy for the National Standards for Mental Health Services 2010, all jurisdictions are now focusing on transitional processes to incorporate the National Standards into accreditation processes, promotional activities and working collaboratively to identify monitoring and reporting issues and options.

Two informal workshops were held (in July and September 2010) with various accreditation bodies to discuss the implementation and accreditation issues relating to the National Standards for the different sectors and agencies.

A larger national forum, held on 1 December 2010, brought together accreditation surveyors and providers to further discuss issues associated with implementing and integrating the National Standards 2010 into the current mental health service accreditation, monitoring and reporting processes.

The key objectives of the December forum were to;

  • Identify the top 5 key challenges/opportunities related to implementing the National Standards into accreditation processes, and to the monitoring and reporting against the National Standards and
  • Identify the key strategies that will facilitate the National Standards being incorporated into accreditation processes, and assist service providers to individually monitor and report against the National Standards to ensure quality improvement. The summation paper from this forum is currently being drafted and will inform the way forward.
As a parallel process, the National Safety and Quality Healthcare Standards being developed by the Australian Commission on Safety and Quality in Health Care (ACSQHC) are also being finalised. Further activity in relation to this process will also be informed by the National Standards. Top of page

Other fourth national mental health plan related SQPS activities

A major focus of SQPS relates to progressing the priority areas from the National Safety Priorities in Mental health: A National Plan for Reducing Harm, the outcomes of which relate to improving services and consumer outcomes. These four priority areas identified are in accordance with the objectives of the Fourth Plan in relation to quality improvement and innovation, and accountability and activity under each priority area is summarised as follows:

Reduce, and where possible, eliminate the use of seclusion and restraint in mental health services

  • Following the successful completion of the National Mental Health Seclusion and Restraint Project, SQPS has had a continued role in maintaining a watching brief on the wider progress of the implementation of seclusion and restraint reduction initiatives across Australia. SQPS members agreed to the hosting of annual forums, with jurisdictional support, on seclusion and restraint. New South Wales hosted a two day forum in Sydney in November 2010 and South Australia is currently in the initial stages of planning the 2011 forum in Adelaide.

Promote the safe transportation of people experiencing mental illness/disorders

  • SQPS has formed a subgroup to undertake a project on the safe transportation of people with mental illness by air, consistent with the National Safe Transport Principles. The project aims to review existing guidelines for air transportation of mental health consumers and to conduct a survey of the current usage of air transportation of mental health consumers across all jurisdictions. The project is in its initial stages and work will progress in 2011. Top of page

Reduce the adverse medication events in mental health services

  • The Reducing Adverse Medication Events in Mental Health Working Party (RAMEMHWP), a subgroup of SQPS, has recently completed a project which involved:
    • The development of Mental Health Medicine Information Leaflets for consumers and carers to accompany the Consumer Medication Information on medications used in mental health care
    • Taking stock of activity in this area from a national perspective and
    • Progressing work on the framework for consumers and carers in the prescribing, dispensing and administering of medications.
  • In recognising the complexity of reducing adverse medication events, the final project report has a number of broad recommendations which includes further work for the Working Party and SQPS and external agencies. Work will continue in 2011 seeking external agency interest in progressing some of the recommendations which are beyond the scope of SQPS.

Reduce suicide for those in contact with mental health services

  • SQPS continues to work with the Australian Government on the requirements of Action 13 of the Fourth Plan to align state, territory and Commonwealth suicide prevention activities through a nationally agreed suicide prevention framework. Top of page

Collaborative work with the Australian commission on safety and quality in health care

Over the last year SQPS has also been keen to build on its relationship with the Australian Commission on Safety and Quality in Health Care (ACSQHC). This recognises the benefits in ensuring that the work of SQPS is aligned with the Commission particularly as the Commission aims to build mental health into its existing work programs. ACSQHC program areas of particular interest to SQPS include:
  • Australian Safety and Quality Framework for Health Care – relates to the proposed development of a National Quality Framework for Mental Health.
  • National Safety and Quality Health Service Standards – relates to the recently revised National Standards for Mental Health Services and accreditation processes.
  • Health Care Rights – relates to the review of the Mental Health Statements of Rights and Responsibilities.
  • Clinical Handover – relates to transition of care across services and settings.
  • Recognising and Responding to Clinical Deterioration as it applies to mental health and psychiatric deterioration – relates to the seclusion and restraint reduction initiatives and the broader area of physical health.
  • Medication Safety – relates to the work and recommendations of the Reducing Adverse Medication Events in Mental Health Working Party.
  • Australian Quality and Safety Framework for Health Care – relates to the proposed development of a Quality Framework for Mental Health which may contribute to the complex area of recovery.
Further discussion on collaborative work with the ACSQHC and a specific strategy to take this forward will occur in 2011.