Evaluation of Phase 2 of Choose Life Patricia Russell & Associates

The research team Patricia Russell Clare Lardner Dawn Griesbach Lucy Johnston Karin Dowell

Aim of the evaluation To evaluate the performance and achievements of Phase 2 of Choose Life, and to make recommendations for going forward from 2010.

Methods Document review Questionnaire surveys to ADATs, CHPs and NHS Boards Interviews with national stakeholders Interviews and groups with Co-ordinators Sounding Board Case studies Expenditure return

Purpose of the Sounding Board To reflect on the main findings and themes emerging from the evaluation To consider the implication of those findings for the future direction and priorities of Choose Life

Changes in the wider context HEAT 5 target Concordat and SOAs Move of NIST to Health Scotland New policy agendas

Focus in Phase 2 improving national and local co- ordination more targeting of high risk groups, but balancing with a public health approach better linkages at national and local level with key services e.g. mental health and substance misuse services a more strategic approach to national and local training mainstreaming and sustainability

National co-ordination The framework – single focus strategy, money. guidance, SG lead, national support Loss of momentum towards end of Phase 2: funding, Move of NIST, Decline of profile - poor links to policies Local view of impact of new location of national support team- fragmentation, loss of SIREN, too much health focus National view – Health Scotland provides expertise, training infrastructure, performance management

Key messages A stronger lead from Scottish Government Retention of a separate identity now but move to becoming embedded in MWB policy. Capitalise on TAMFS Explicit links to the new policy agendas Keep a national support team but clarify the focus of activity – leadership and guidance

Local co-ordination CPPs “high level” and not much involved Co-ordinator role pivotal but a number of models. Key factors: designated CLC F/T or P/T location of CLC seniority of CLC or manager good strategic links and reporting lines good networks and relationships skills and experience of CLC

Targeting high risk groups Limited progress Lack of guidance Two main approaches Training of staff who worked with high risk groups Funding of local projects or posts Need for guidance to support more and better local targeting

Training High numbers trained For the future A training strategy with a focus on training after HEAT5 Tackling lack of trainer capacity in some areas Better targeting of training e.g high risk groups Research on how training is being used and to what effect. Flexibility of training to include other key groups, e.g. pre-registration GPs, police, ambulance workers

Evidence base An achievement Continue with research programme and consider focus for Great concern about loss of SIREN and strong message that it should be revived No national evaluation framework – and limited local evaluation. Address the lack of consistent evaluation

Making better linkages Limited progress both nationally and locally Gaps remain - GPs, primary care, clinical services - although some progress with psychiatrists Locally some evidence of links with health, social work and substance misuse services An area for further work

Capacity building Provision and funding of training, funding for new posts and services, funding for local groups, and advice and consultancy Mixed picture on sustainability Question for the future Is there value in putting resources into projects for the remaining 3 years?

Performance measurement Issues about the 20% target No milestones in phase 2 Development of outcome frameworks Consider the utility and relevance of the target and setting milestones or identifying other outcomes / indicators

Mainstreaming and sustainability Some progress Permanent CLC posts/local infrastructures Retained budgets Suicide prevention in local strategies and plans Suicide prevention a priority of TAMFS – an opportunity

How should Choose Life go forward? Retain the strategy but re- focus Consider utility of target Clarify links to national policy agenda Choose Life needs a stronger SG“push” A national support function is needed Co-ordinator role pivotal locally but with supporting infrastructure Priority should be sustainabilty

Priorities Training – after HEAT 5 A revived SIREN More and better targeting Re-energised effort at links to key services Think about role of project funding Look at new partners e.g employment Improve performance measurement