Agenda item

To receive an update on the priorities and progress of the Starting Well strand of the Health and Wellbeing Strategy and the impact of the Covid-19 pandemic on progress in this area.

The Director of Children’s Services at Hampshire County Council provided an update on the priorities and progress of the Starting Well strand of the Health and Wellbeing Strategy and the impact of the Covid-19 pandemic on progress in this area. Members heard:

While services are holding up well through the response to Covid, new trauma and a range of other factors have been leading to family breakdown.

In reviewing the Starting Well priorities with Covid-related challenges, universal services were not always in place and thus there were fewer collective eyes on children.  Families did not always have the support or help they would have usually had and rather than receiving early assistance, children are now becoming visible  having suffered serious harm.  

With schools and nurseries currently open, the number of referrals will now continue to rise.  The cohort entering the system from April to August was distressing to witness but social workers worked diligently to help them.  Universal services will now be able to identify families needing help early on.

Emotional wellbeing issues at school did not quite play out as anticipated.  Many children have enjoyed the last 6 months and there was less repair of trauma, but more anxiety about returning to school full time – a slightly different and new worry.  

An action plan based the impact of Covid will determine priority areas and picking up on key issues with a joint delivery partnership, including self-harm tool kits, school surveys, websites with resources and training, etc. 

In tackling wider issues, reducing wait times for treatment, acute setting colleagues for paediatric psychiatric liaison services, prevention and early help models and mental health support teams in schools have been prioritized in keeping with the NHS long term plan.  Work continues to bring in young people and family voices to bolster bids for increase in mental health support and provide link programmes between the voluntary sector, mental health, and schools. Partnership with young people for digital offers and how to best connect them to services, digital options, and Child and Adolescent Mental Health Services (CAMHS) solutions in addition to face to face meetings. 

Physical education in schools, maternity smoking cessation, encouraging breastfeeding, strong referral pathways and tools to support people remain priorities alongside existing Covid challenges.  

In terms of codesign and collaboration, working well together requires doing so consistently and timely with a focus on the action plan for an effective joint commissioning board with strategic commissioning priorities, positive feedback,  formalizing work to be completed and refining by partners.  

Work in mental health pathways slowed down during lockdown due to Covid priorities but are now approaching being business as usual and with improvements in those pathways.  The Isle of White is represented in these arrangements as well.  The decision-making body and forum around continuing care is embedded with all partners for effective care commissioning, packages, and managing care support markets collectively together. 

Next steps are now being considered in developing a different approach of how these packages are funded.  The number of children coming into the system are rising but being tracked and addressed with colleagues.  There was more virtual working over lockdown, but there has been a return to face-to-face working in meeting the rise in demand.  Family recovery workers for substance issues and domestic abuse have been working through increasing demand and monitoring continues to provide support, training, and risk assessments for staff.  

Priorities have been agreed with Adults’ health and care for enabled care offers and how children’s services can avail them to provide families with technology enabled packages and building their confidence in using them, especially for shielded and vulnerable children, ensuring social care teams really understand what is on offer and the benefits that can be accessed.

In response to questions, Members heard:

There have been challenges but also positive outcomes and good work at the district and council level and efforts made to do better with more involvement, a coherent approach and joint up working. 

A district level health and wellbeing co-ordinator has been recruited with part-funding from Hampshire County Council and will be coordinating at the district level, which is an opportunity to use resources already available to reflect in a broader spectrum.  There is a Public Health district link also working closely to consider complexities and ensure that priorities are embedded in the districts.

The bid to secure additional cross county mental health services was not successful and the Ninja self-help application received mixed reception with limited advertisement and uptake.  It had been targeted for under 18 but was less appealing to older young adults. It is a piece of work that remains to be done. 

Endorsing the range of work and providing support for CAHMS in light of the shocking figures for self-harm hospital inpatients, comparing them to national numbers, and potential interventions.  The Children’s Commissioner published report in February highlighting disparate levels of funding which affected Hampshire significantly.  This report will be circulated to Members following the meeting.  Acute Trusts colleagues confirmed they would support more funds being allocated to CAMHS, as the best place for treatment is home.

With regards to codesign with service users or other providers, clarity for improving the baseline and engagement would be helpful.  The action plan will identify the best places to work together and how to bring together shared priorities.  There is a 12-month action plan until next March and going forwards, more explicit details will be shared.  

The Fire service offers schemes around self-esteem for children and due to Covid, had lost many of the referrals from school nurses and other colleagues with a decline in numbers participating.  While there have been fewer eyes on children, this component is beginning to be built back in.

Involving partners, patients, and districts will be critical and voluntary sector colleagues requested being included in planning at the earliest possible stages.  

Members congratulated the department and partners on their efforts.

RESOLVED:   

That the Health and Wellbeing Board--

·         Noted the report.