Performance management

In order to continually monitor and evaluate mental health improvement work, the Mental Health Leadership team in NHS Ayrshire and Arran has chosen 15 national mental health indicators for use on the Covalent performance management system.

In order to implement its local population mental health strategy, NHS Ayrshire and Arran and its partners have developed local action plans relating to the three local authority areas in Ayrshire. These plans also incorporate strands of the ‘Towards A Mentally Flourishing Scotland’ (TAMFS) strategy.

An important strand of activity is monitoring and evaluation. To approach this, the Mental Health Leadership team is using a two-pronged approach. The first is the bi/tri-annual application of the Warwick-Edinburgh Mental Wellbeing Scale (WEMWEBS) via three local authority ‘people's panels’(or equivalent). The second is the Covalent system, a computer-based performance management system which allows monitoring of a range of data. This package has been purchased by NHS Ayrshire & Arran and is slowly being introduced right across the system e.g for HEAT targets

The mental health leadership team has picked 15 of the 54 national mental health indicators to enter into the system. Anne Clarke, Senior Manager, Public Health Department, NHS Ayrshire and Arran, explains: “We selected these indicators by collectively assessing which were most relevant and, most importantly, which data could be accessed routinely and locally. This means that when our local authority partners report on these indicators, such as educational attainment or unemployment statistics, they can be recorded onto Covalent. Two of the three local authorities within Ayrshire also use Covalent and, once the data is recorded on their local systems, the NHS can access the data immediately (with appropriate permissions) to populate the NHS system.

Impact and results

Information was loaded onto Covalent, and a quarterly progress report is produced.

‘When we come to report, we can show an action as being achieved,’ says Anne, ‘or show a percentage of movement achieved towards a goal, which will be registered as red, amber or green in terms of progress.

‘When indicators are reported, we will be able to see the direction of travel in terms of local data. The outcomes planning work for mental health improvement, along with mental health improvement logic modelling and use of indicators, allows us to be confident about the contribution our work is making, but we recognise that it is an imperfect science.

‘We are convinced of the benefits of showing movement around the indicators which support mental wellbeing,’ Anne states.

‘With the current economic climate, we are not anticipating that local data around employment, income or general health will improve, and when the respective WEMWEB scores come back we can show objective, measurable shifts on the scores and relate that to factors affecting mental wellbeing. The evidence can help partners fully identify their role in contributing to this agenda.’ Use of the Covalent system encourages staff to think in an outcomes-focused way, as they use logic models evaluation planning tools in the writing of strategies. The aim is to turn all action plans into outcomes-focused action plans by the end of 2012.

Wider implications for learning and workforce development

This approach contributes towards creating an evidence base for the effectiveness of learning and workforce development activities in contributing to mental health improvement. It does this through creating a clear link between learning activities and outcomes and then effectively measuring the achievement of these outcomes. This can contribute to disseminating effective practice across Scotland and ensure the contribution of learning and development activities as part of a wider mental health improvement strategy are recognised.


Anne Clarke, Senior Manager, Public Health Department, NHS Ayrshire and Arran
01292 885915