To receive an update from the Hampshire and Isle of Wight Partnership of Clinical Commissioning Groups on CAMHS. (to follow)
The Committee received an update on Child and Adolescent Mental Health Services (CAMHS) (Item 8 in the Minute Book) from representatives of Hampshire and Isle of Wight Partnership of CCG’s. This followed a previous update to the Committee on 20 November 2019.
The presentation was introduced and it was heard that there were some significant challenges facing the Hampshire CAMHS Service, which were set out on page 2 of the presentation slides. These included a current waiting list of 1,387 children awaiting assessment, 1,480 awaiting treatment, with 4,174 currently on the treatment caseload. In terms of current activity, it was highlighted that September saw high level of referrals which was attributed to return to school after the Covid lockdown.
Page 3 of the presentation slides detailed an overview of the services commissioned in Hampshire which included specialist CAMHS services, mental health support teams in some Havant and Gosport schools and community counselling services. Pages 4-7 of the presentation slides, highlighted a breakdown of monthly figures over the last year for assessment waiting lists/times and treatment waiting list/times, and it was acknowledged that these figures were too long and not where the service would want to be. The current key challenges were outlined and Members heard that there was rising levels of mental health issues in children and young people, and investment has not kept pace with the rising demand. Issues such as Covid and the ensuing lockdown has affected individuals and families, and as a result of lockdown and school closures, there has been less oversight of risk for partner agencies such as schools.
Members heard details of the core CAMHS capacity investment, and it was heard that a detailed piece of work was undertaken last year which identified problems with levels of investment in the service, and progress has since been made with an increase of £1.3 million in core CAMHS capacity, but the increased demand for services has presented challenges. Page 10 of the presentation slides drew attention to CAMHS crisis investment and it was noted that significant investment has been made in relation to the expansion of the community crisis home treatment team, and also investment has been confirmed for Paediatric/Psychiatric liaison across hospitals in Hampshire, details of which were listed on the presentation slide.
Details around eating disorder services for children and young people in Hampshire were also highlighted, and the challenges presenting for these services as a result of Covid lockdown were explained and it was heard that there had been a significant increase in referrals and inpatient care requirements. In relation to autism and neurodiversity investment, it was confirmed that additional funding had recently been agreed to address autism assessment activity and the development of the wider neurodiversity and neurodevelopment pathway which should help tackle in full the current waiting lists over the next two and a half years.
Page 13 of the presentation slides explained the learning from Covid and details around public behaviour, digital clinical assessments and interventions, CAMHS capacity and crisis pathway capacity were highlighted to the Committee. In relation to Covid, preparations for restoration and recovery were explained and the surge in demand for mental health services as well as likely causes of psychological distress was noted. Digital and self-help resources for children and young people and their families was also highlighted.
Pages 16-19 of the presentation slides gave further information on how the different work streams were progressing with key steps and timescales and key risks to delivery. In conclusion, Members received an overview of investments confirmed for services including CAMHS crisis investment and eating disorders, and these were detailed at page 21 of the presentation slides.
In response to questions, Members heard:
· That in relation to current mental health needs and those post-Covid, the needs of the population would need to be examined to determine where best to invest, and to ensure that investment was based to match the needs of the population.
· That work recently commenced by the CCG’s was based on population modelling, particularly in relation to children and young people, and work with provider colleagues to examine services in enabling a proper strategic investment framework would ensure investments target need going forward.
· That Havant and Gosport areas received ring-fenced Government funding as priority areas for early intervention and prevention in schools via a programme called Mental Health Support Teams in Schools (MHSTs). It was heard that two teams had been recruited in those areas but would not be fully live until January, and would support specific schools in Havant and Gosport rather than all schools. Details of the schools to be supported would be forwarded to the Committee.
· That in terms of investment and staffing numbers, discussions with services on how to address this have been taking place. This has involved conversations with neighbouring CAMHS services in a bid to grow the workforce, and attract people back from other areas who have the relevant skills sets.
· That in terms of confirmed new funding, this would be recurring. Commissioners are not expecting to have much of the newly funded services in place until the final quarter of the year. It was heard that discussions were also taking place with adult psychiatric liaison services to develop an all age response, to be clinically led, and to quickly establish the support needed.
· That if the prevention offer is right, there shouldn’t be a need for long-term high level investment in terms of mental health crisis, and a flexible workforce would be able to respond to different levels of need. It was noted that providers in the community sector were predicting a growth in workforce by about 10-12%, which would help in terms of preventative measures.
· That in terms of waiting times for assessment and treatment, there are active arrangements in place to ensure the safety of those awaiting treatment. The development work of Tier 2 (community non specialist) services in communities was also highlighted.
· That there has been work with Children’s Services in relation to a wider nationally funded preventative mental health intervention for schools called the ‘Link programme’, and supporting emotional wellbeing at school. CCG Commissioners are supporting the roll out of this programme across Hampshire.
· That there has been much research nationally as to why children’s mental health levels are increasing, and there has been a focus nationally on early intervention and preventative factors. Commissioners are applying this learning to the development of local services.
That in response to a comment from Councillor Porter about a further update to the Committee, the Chairman suggested that this was discussed during the work programme item, and Councillor Porter was content with this.
That the Children and Young People Select Committee noted the update provided in the presentation.