Mental Health and Wellbeing Support in the Scottish Fire and Rescue Service

10. List of Recommendations

1. The new Mental Health Strategy should continue to be aspirational in that its offer for staff should be broad, but it also must be achievable and robust. The strategy should be subject to SMART assessment, action plans for achieving outcomes should be considered in advance of its publication. Adequate resources should be in place to support the strategy intentions.

2. The SFRS should consider the nomination of a Corporate Mental Health and Wellbeing Champion for the Service. The Champion should be of a sufficiently senior level to be able to direct action and ensure that appropriate oversight and governance is put in place to allow them to scrutinise progress against the next Strategy and any associated action plans.

3. The Board of SFRS should assess if they are fully scrutinising progress of MH outcomes against the aspirations of the MH Strategy. Governance routes up to Board level should be reinvigorated and formalised to ensure scrutiny, oversight and transparent accountability are in place.

4. The SFRS should consider the suitability of the governance arrangements for the Suicide Prevention subgroup. If it is considered that this group cannot achieve the outcomes that are set out within the Mental Health Strategy, then the Service should consider alternative arrangements to replace it. Any new arrangements should ideally be in place before the current subgroup is disbanded.

5. The Service should consider the most appropriate way that it can offer professional support for its Mental Wellbeing Champions. This support should include appropriate processes to track any interventions work of Champions, debriefing and evaluation of interventions and reflective supervision and support.

6. Awareness of the Mental Wellbeing Champion role within the SFRS should be raised. The MWC approach taken to date should be reviewed and robust governance put in place to capture and analyse the work that they do and demonstrate its value. Their ongoing work should be subject to review to ensure outcomes.

7. The SFRS should review the adequacy of mental health training. The most appropriate delivery method should be considered for this training, face to face engagement on critical elements such as the PISP should be considered. Preparation for new roles upon promotion is essential, and mental health should be included within this.

8. The SFRS should consider how best to involve the families in supporting the achievement of positive mental health of their employees and offering social support away from the work environment.

9. The SFRS should consider how it may better utilise the resources that the FFC can offer in the pursuit of positive mental health for all its employees and their families. This should be done on a systematic basis that allows families to be informed of resources that may be available to them, and how they can support their loved ones who serve in the Service.

10. The SFRS should consider if a formal role is appropriate for the Chaplaincy service within their mental health and wellbeing offer to personnel. Options to establish pastoral care across all of the SDAs of the Service should be explored.

11. The SFRS should consider how to best prepare its serving firefighters and support staff for life following their retirement from Service. These considerations should not be limited to financial planning but should also consider the social aspects of the change that retirement brings. They should consider collaboration opportunities within the fire sector to assist with this.

12. The WC role is critical within the Watch based system. They are often the first point of contact for mental health and/or wellbeing issues that may be affecting their Watch personnel. WCs are a trusted role within the Watch system, and they cover the majority of operational firefighters at work. The SFRS should consider how best to utilise the WC role and make them ‘mental health advocates’ to support the needs of operational firefighters on the Watch. Additionally, the Service should consider the training that would be required to ensure any advocates approach is robust. The mental health advocate role for WCs should be mandatory.

13. The Service should consider the most appropriate use of On Call drill night hours to ensure that appropriate access to essential information, including mental health and wellbeing resources, can be achieved.

14. The SFRS should monitor the potential mental health impacts of the hybrid working system. It should consider the impact upon managers who may need to spend additional time in the support of hybrid working team members.

15. The SFRS should consider all aspects of training that may be required for any new or novel operational interventions that may be required to be performed by its staff. These considerations should include aspects of any operational work that may have the potential to cause psychological trauma and negatively impact the mental health and wellbeing of responding firefighters. Mitigations and support should be developed and implemented if harms are identified.

16. The SFRS should consider a range of options to ensure that PISP questionnaires are returned following operational incidents, these should include options for mandatory returns.

17. The SFRS should consider the most effective means of raising awareness of the PISP with a focus on the personal value for those within the operational roles of the Service. Following its consideration, awareness raising of PISP should be planned and delivered across the Service. The awareness raising approaches used should be up to and including face to face engagement with subject matter experts, uniformed personnel and possibly with those who would be prepared to share lived experience of PISP.

18. The SFRS should initiate a review of PISP elements that relate to the OC. The procedure should be fully explained to OC managers and staff via a bespoke communications plan for the OCs. The Service should consider how PISP can be more systematic and less open to personal interpretation in its implementation within the OC personnel group.

19. The inclusion of FDOs within the PISP should be more systematic with set criteria for them to be opted out only as a necessity. The aim should be to include FDOs within the support procedure following operational incidents, and for this to be tracked as appropriate.

20. We note the new monthly contact from the Health and Wellbeing team to their FI colleagues. Given the relatively low levels of PISP returns within the SFRS, and the potential impact upon the mental health of the FI team, the SFRS should consider making the completed return of FI questionnaires mandatory for the role. It also appears that the FI team has had limited contact with professional support regarding the many traumatic incidents that they have attended over recent years. The SFRS should consider this, and how they may assess the potential impact of historical incidents on FI team members’ mental health to date.

Methodology

When undertaking this inspection, we followed established practice utilised in previous Thematic Inspections. This inspection framework provided a structure to our work, which was risk-based, proportionate and focussed on the provision, utilisation and cultural considerations that influence personnel accessing Mental Health and Wellbeing services. We conducted early engagement with the Service and established a single point of contact.

About HMFSI

HMFSI is a body that operates within, but independently of, the Scottish Government. Inspectors have the scrutiny powers specified in section 43B of the Act. These include inquiring into the state and efficiency of the SFRS, its compliance with Best Value, and the way it is carrying out its functions.

HMFSI Inspectors may, in carrying out inspections, assess whether the SFRS is complying with its duty to secure Best Value and continuous improvement. If necessary, Inspectors can be directed by Scottish Ministers to look into anything relating to the SFRS as they consider appropriate.

We also have an established role in providing professional advice and guidance on the emergency response, legislation and education in relation to the Fire and Rescue Service in Scotland.

Our powers give latitude to investigate areas we consider necessary or expedient for the purposes of, or in connection with, the carrying out of our functions:

The SFRS must provide us with such assistance and co-operation as we may require to enable us to carry out our functions. When we publish a report, the SFRS must also have regard to what we have found and take such measures, if any, as it thinks fit.

Where our report identifies that the SFRS is not efficient or effective (or Best Value is not secured), or will, unless remedial measures are taken, cease to be efficient or effective, Scottish Ministers may direct the Scottish Fire and Rescue Service to take such measures as may be required. The SFRS must comply with any direction given.

We work with other inspectorates and agencies across the public sector and co-ordinate our activities to reduce the burden of inspection and avoid unnecessary duplication.

We aim to add value and strengthen public confidence in the SFRS and do this through independent scrutiny and evidence-led reporting about what we find. Where we make recommendations in a report, we will follow them up to assess the level of progress.

We aim to identify and promote good practice that can be applied across Scotland. Our approach is to support the SFRS to deliver services that are high quality, continually improving, effective and responsive to local and national needs. The terms of reference for inspections are consulted upon and agreed with parties that the Chief Inspector deems relevant.

How This Inspection Was Carried out

The purpose of this inspection was to examine the effectiveness of the SFRS’s provision, utilisation of and cultural issues that affect the uptake of mental health and wellbeing services that are in place or are currently being planned for, in line with its Mental Health Strategy 2020-2023.

An inquiry by the Inspectorate can be self-directed or can be subject to direction by Scottish Ministers. This inquiry into the SFRS was self-directed by the Chief Inspector. The following persons contributed to the Inspection and to the report:

Robert Scott QFSM, Chief Inspector

John Joyce QFSM, Assistant Inspector (Lead Inspector)

Gillian Buchanan, SFRS Secondee

David Young, Assistant Inspector