Agenda item

To receive a presentation providing an update on the work of the Hampshire Child and Adolescent Mental Health Service (CAMHS).

The Committee received a presentation from representatives of Sussex Partnership NHS Foundation Trust on Children and Adolescent Mental Health Services (CAMHS) (Item 6 in the Minute Book).

The Committee were taken through the slides and key issues were highlighted.  It was heard that throughout 2016/17, the CAMHS service had seen a 20-25% increase in the number of referrals.  This year 8000 referrals have been received with the number of contacts offered totalling 79,114.  Members attention was drawn to the main successes which had arisen in the last year, which included an improvement in the vacancy rate which was now 4%, and the implementation of the Single Point of Access.  The Service was also running a yearlong campaign on suicide awareness with a focus on body image and self-esteem.  Members of the Committee were informed of the Fit Fest day events which consisted of workshops and information focussing on issues such as anxiety, body image and self esteem.  Parent and carer events (PACE) events were explained, which were designed to help families better understand the needs and difficulties that young people can face.

The Committee also heard about the challenges affecting the Service, and Members were concerned to hear the length of time that children and young people were waiting to access treatment, 34% of children wait longer than a year to access treatment which is only slightly higher than the national average.  Representatives from the Service highlighted the increasing levels of complexity presented by children with mental health and social needs, and the increasing pressure on the service’s workforce and challenges for clinical space.  The Service’s work with partner agencies was explained and the work with the Willow Team was highlighted.  It was noted that there had been a significant increase in the number of children and young people requiring autism assessments, which had led to challenges, and work was underway to ensure these were conducted in a timely way.  Attention was also drawn to the continuing priorities of the service, and the importance of a multi-agency approach, as well as addressing demand and capacity with resilience and the development of forecasting models going forward. 

In response to questions, Members heard:

·        That there were a number of children waiting an unacceptable length of time for treatment, and work was being undertaken to try and address this by working with commissioners and partner agencies.  Priority would always be given to children with more complex needs and whose needs had deteriorated.

·        A recent Care Quality Commission inspection of the service deemed the service good overall and outstanding in caring.

·        That engagement work with GP’s continued to promote awareness of the CAMHS service at GP forums and through training and support.  It was important to ensure that referral links were also effective.

·        That some children had to be transferred for inpatient treatment out of county as there were only a small number of specialist units available nationally which would be suitable for some individual children’s needs.  It was heard that the aim was to reduce the need to transfer children out of county, and work was currently being undertaken to investigate other models of care including home treatment, as in-patient stay was not always the ideal solution. 

·        That a recent initial pilot scheme which aimed to reduce children having treatment out of the area, as well as minimising the length of in-patient stay, had shown a significant reduction in children receiving treatment out of the area.  It was heard that the service would be continuing with this programme.

·        That there were additional resources available through the Hampshire CAMHS website, which included self-help information and signposting to other resources.  It was noted that sometimes children and young people’s needs could be managed by other services and the website could help signpost to these.

·        That as well as support signposting being available on the Hampshire CAMHS website, there were a number of nationally available web apps which could also be accessed which provided further information.

·        Schools were also available to support emotional wellbeing and mental health, for example Emotional literacy support assistants (ELSAs). 

·        The Service routinely develops care plans and risk management plans for all young people, including those waiting for interventions.

·        That there was a clear protocol in place to aid smooth transition to adult mental health services.

·        That bids had been invited for the recent green paper on child mental health from government.  That until the outcome of the bid was known, there was uncertainty about how much money would be coming into the local area, and other areas of the country were also unclear about the level of financial support they would have. 

·        That a new Autism diagnostic service for school age children came into effect in September 2018, and whilst a few initial problems had been experienced, children who had been waiting for a long time are now being assessed.  It was noted that it was important for all partner agencies to work together and for parents to receive support without being completely dependent on the diagnostic pathway.

·        That the focus of the service was to reduce waiting times for treatment, and for the service to ensure that the child is supported during this time by means of risk assessment and management and care plans which include self-help materials.

·        That there was a complex mix of social factors which could affect mental health in children and young people, and an increasing number of young people were seen to be taking significant overdoses and self harming.  The importance of reducing the stigma of having a mental health diagnosis was also stressed.

·        That issues around recruiting doctors and consultant psychiatrists had been experienced at a local and national level, and ways of attracting consultants to vacant positions was being examined.

Members expressed their concerns about the lack of progress in reducing waiting times for treatment for children and young people, and agreed to a further update to the Committee in 12 months time to include an update on waiting times for access to treatment.  Members were also concerned about how funding received by Clinical Commissioning Groups for children’s mental health services is spent, and agreed for the Chairman to write a letter to the Chairman of the Health and Wellbeing Board to request this information.

RESOLVED:

i)             That the Children and Young People Select Committee note the update on CAMHS and request a further update in 12 months time.  That this update includes progress made to reduce waiting times for access to CAMHS treatment.

ii)            That the Children and Young People Select Committee request that the Chairman write to the Chairman of the Health and Wellbeing Board to seek assurances from the Clinical Commissioning Groups, that money received for CAMHS from government is appropriately passed to the providers for this service, as well as to understand how CAMHS is funded and commissioned in Hampshire.