Agenda and minutes

Apologies for absence were received from Councillors Akwasi-Ayisi, Mr Collier, Ms Denny and Mr Taye. 

This report outlines the priorities and outcomes of the Joint Mental Health and Wellbeing Framework. It details the process for development of the Framework, summarises consultation feedback and highlights how the recommendations from Overview and Scrutiny reviews have been incorporated into the Framework. It also proposes a governance structure for delivering the Framework. The Panel are asked to consider the draft Framework prior to its publication.

(To be jointly considered with the Adults and Health Scrutiny Panel)

Tamara Djuretic, Assistant Director of Public Health, introduced the draft Joint Mental Health and Wellbeing Framework. The panel was informed the proposed framework had been developed with a range of stakeholders and experts across the local health and social care economy. It was noted that the framework set out a high level vision for mental health and wellbeing in Haringey.

The Panel was informed that the total spend on mental health in Haringey (including substance misuse) for 2013-14 was over £51 million. This equated to 11% of the total CCG budget and 6% of the Council’s. Tamara Djuretic noted the level of spend going to acute services versus community services was unsustainable moving forward.

The Panel discussed the aims of the framework and Tim Deeprose, Assistant Director, Mental Health Commissioning, Haringey CCG, advised that there were four priorities;

·         Promoting mental health and wellbeing and preventing mental ill health across all ages;

·         Improving the mental health outcomes of children and young people by commissioning and delivering effective, integrated interventions and treatments and by focusing on transition into adulthood;

·         Improving mental health outcomes of adults and older people by focusing on three main areas: meeting the needs of those most at risk; improving care for people in mental health crisis; improving the physical health of those with mental-ill health and vice versa;

·         Commissioning and delivering an integrated enablement model using individuals, families and communities’ assets as an approach to support those living with mental illness to lead fulfilling lives

Mr Deeprose commented that recommendations from previous scrutiny reviews relating to mental health had been incorporated into the overall framework. The priorities had been shaped in line with these scrutiny recommendations.

The Panel was asked to note that consultation feedback had been generally positive, although suggestions for improvement, set out in the report to the panel, had been received. During the discussion, reference was made to the following:

·         The national and local policy context;

·         The role of Haringey’s Mental Health and Wellbeing Framework Expert Reference Group;

·         The mental health needs of Haringey’s residents;

·         Timescales and governance arrangements for delivery of the framework;

·         Lord Bradley’s review (2009) of people with mental health problems or learning disabilities in the criminal justice system;

·         The mental health needs and the effectiveness of provision for young offenders in custody and in the community; Recent mental health inquiries conducted by Select Committees appointed by the House of Commons;

·         The importance of having a whole system approach to integration and enablement, including the need for effective pathways into employment and housing;

·         The impact of population growth and the sources of information that had been used to develop the framework,  including the local Joint Strategic Needs Assessment on mental health in children, young people, adults and older people; Mental Health HaringeyStat; Public Health England’s mental health profiles and the CCG’s and Council’s financial information;

·         The importance of ensuring mental health services were appropriate for Haringey’s diverse communities;

·         The redevelopment of the St Ann’s Hospital site;

·         The services available for looked after  ...  view the full minutes text for item 39.

To consider the report of the Adults and Health Scrutiny Panel regarding the transition process from child to adult mental health services.

(To be jointly considered with the Adults and Health Scrutiny Panel)

The Chair of the Adults and Health Scrutiny Panel introduced the project report of the Adults and Health Scrutiny Panel. It was recognised transition within mental health services at the age of 18 years could be problematic for many reasons. During discussion concerns were raised about the “cliff-edge of lost support”. From a point where young people received regular, focused support for their mental health needs it was noted that by turning 18, young people could find themselves on their own, unprepared for the shift from a child-centred developmental approach to an adult care model.

It was explained that evidence had been gathered from a variety of stakeholders including; Barnet, Enfield and Haringey NHS Mental Health Trust, Haringey CCG, Mind in Haringey, Open Door, Young Minds, First Step, Camden and Islington Mental Health Services and, importantly,  Haringey’s front line staff in Children’s and Adult Mental Health Services.

The Chair highlighted a number of issues, set out in the Panel project report, including:

·         The need for young people to be supported right through from age 0-25

·         The proposed “Heads-Up for Haringey” model

·         The need for information sharing across agencies

·         Concerns about levels of funding for Child and Adolescent Mental Health Services.

The Panel agreed the new Joint and Mental Health Wellbeing Framework (discussed under item 6 on the agenda) was an opportunity to improve mental health services and to improve the mental health and wellbeing outcomes for Haringey residents. The Chair of the Adults and Health Scrutiny Panel commented that taking the Panel’s recommendations forward, as part of the framework, would help ensure there was no “cliff-edge”.

AGREED:

That the recommendations, set out in the Transition from Child Mental Health

Services to Adult Mental Health Services: Adult and Health Scrutiny Panel Project Report, be agreed and that the final report be considered for approval by the Overview and Scrutiny Committee on 26 March 2015.

To approve the minutes of the meeting 22 January 2015 (attached).

AGREED:

That the minutes of the meeting of 22 January 2015 be approved.

To report on the work of the Youth Offending Service with particular regard to the young people in the youth justice system, including outcome and performance measures, service user profile, types of intervention and restorative justice processes.

Gill Gibson, Assistant Director for Children’s (Quality Assurance, Early Help, and Prevention) reported that current performance levels for the Youth Offending Service were the best that had been recorded by the service since records began.  The number of first time entrants for Haringey for the third quarter of 2014 was both better than similar local authorities and the average for London.  37 young people from Haringey had been sentenced to a custodial sentence at quarter 3 of 2014.  This represented the lowest number of Haringey young people entering custody in a 12 month period since this measure had been collated.

The reoffending rate was 40.9 %, which was the lowest that it has been since 2011, representing a reduction of 6.3% in the last 12 months. The size of caseloads had been the most challenging area of performance to address but had recently seen a dramatic decrease.  However, the degree of complexity of cases had increased.  Work to prevent re-offending was undertaken through a range of interventions.  The focus was now on earlier intervention and there had been particular success with restorative justice. 

In answer to a question, Ms Gibson reported that the figures were taken from the most recent Police data and included statistics regarding all of those young people arrested within the borough.  However, it was possible that some young people might live in the borough and offend elsewhere. In respect of restorative justice, the Panel noted that it was a very structured process and required the consent of the victim. She agreed to find out if there was information available regarding the demography of young people who were arrested.  

Councillor Mark Blake reported that successful interventions had been undertaken by several schools within the borough.  Arrest rates had increased and this had been due to the fact that stop and search was not being used as widely as before.  He noted that 86% of gang members were from black and minority ethnic communities but that this had not been reflected in the case load of the Youth Offending Service.

The Panel noted that there had been an application for a free school to be established within the borough for young offenders who had been in prison. The aim was to give them the opportunity to gain qualifications and to support them in their efforts to keep out of trouble.  There was also a lot of diversionary work undertaken within the borough including, for example, the boxing academy. In answer to a question, Ms Gibson reported that there was also specific work aimed at young women and girls.  It was suggested that a briefing paper be provided for a future meeting of the Panel on diversionary activities. 

It was noted that the legal principle of joint enterprise could have serious consequences for young people and there was a lack of awareness amongst them regarding its implications.  How to get important messages like this across to young people was being considered as part of the work to develop the  ...  view the full minutes text for item 42.

To consider the issue of inclusive education in Haringey and the impact of the Special Educational Needs and Disabilities (SEND) Reforms covered in Part 3 of the Children and Families Act 2014.

The Chair thanked officers for the responses that had been provided for the issues that she had raised.  The Panel noted that 56 disabled children and children with special educational needs from the borough were attending university.  There were currently around 1400 children and young people in total with a statement of special educational needs.  A high proportion of these were children and young people with autism.  474 were in some form of further education.  However, 114 young people were currently not in education, employment or training and their progress would need to be tracked carefully as there was a risk that they might be drawn into offending.  Panel Members requested that information be provided on how the performance of young people with special educational needs and disabilities compared with other young people.

The Panel noted that the statementing process was onerous.  There was a higher percentage of statemented children and young people in the east of the borough.  Its incidence was related to deprivation and correlated strongly with socio-economic factors. 

In answer to a question, it was noted that there were a lot of resources available for schools to support them in addressing the needs of pupils with special educational needs.  This included training for Special Educational Needs Coordinators (SENCOs). 

Vicki Monk-Meyer, Head of Integrated Service for children with Special Educational Needs and Disabilities, reported that Blanche Nevile School was a unique Haringey school that addressed the needs of deaf children.  However, the deaf population was changing due to use of cochlear implants which could enable previously deaf people to hear.  Not many adults had as yet benefitted from this as they had not been available for long.  However, their introduction had received a cautious reception from the British Sign Language (BSL) community. 

The Panel requested information regarding the physical accessibility of schools within the borough.  It was noted that there had previously been an access grant available.  Under the provisions of the Disability Discrimination Act, schools were required to make “reasonable adjustments” to their premises in order to make them accessible to people with disabilities.  It was noted that accessibility was also an issue for parents, carers and staff.  All new builds were focussed upon these issues.  The Chair commented that the most important issue was that information was held on the accessibility of individual schools.

AGREED:

That the Panel be provided with further information on;

·         How the performance of children and young people with Special Educational Needs and Disabilities compared with other children and young people; and

·         the accessibility of schools for people with a physical disability.

To report on action to address bullying and hate crime in schools, including reference to exclusions, parents and carers and monitoring data.

Anji Philips, Interim Assistant Director for Schools and Learning, reported that responsibility for dealing with bullying and hate crime now rested with schools.  The Council nevertheless had access to a range of data.  It was not able to identify individual schools where incidents took place but the numbers were nevertheless small. 

The Panel noted that Haringey’s Standing Advisory Council for Religious Education (SACRE) had produced detailed guidance for schools.  In addition, a paper had also been produced for the Local Safeguarding Children’s Board on Ofsted judgements on safeguarding for schools within the borough that focussed on how they dealt with hate crime and bullying.  This gave reassurance that practice was good or outstanding in all but two schools.  Any complaints regarding incidents in schools were considered by school governing bodies.  There were some schools where a lot of issues were raised but Panel Members were of the view that this might be due to them encouraging people to report issues. 

In respect of the Prevent initiative, Ms Philips reported that a lot of referrals had been received.  A substantial amount of training had been carried out as part of the initiative and schools had embraced the agenda.  The Council was looking to bid for additional resources for the initiative. 

The Panel noted that pupils could move to another school to avoid being excluded from their present school.  The local authority did not have any specific responsibilities when pupils were given fixed term exclusions.    Panel Members commented that the figure of 122 for exclusions from primary schools appeared to be high, especially bearing in mind that some schools did not exclude children.

In respect of the Prevent initiative, the Panel felt that it would be useful for Panel Members to receive a briefing on the implications of the Counter Terrorism Act 2015. 

AGREED:

That a briefing be provided for Members of the Panel on the implications of the Counter Terrorism Act.

To note the future workplan for the Panel.

AGREED:

That the report be noted.

The Panel agreed to admit this item as a late item of urgent business.   At the agreement of the Chair, the Panel were addressed by Ms S Chandwani, a local resident. She requested clarification of the budget reductions in services for young people.  It had been reported that the savings were to be £1.6 million but the Council’s budget papers had stated that the savings were £2.1 million. She was of the view that the Young People’s Strategy needed to be communicated to young people in a way that they would understand.  In addition, if young people were to be involved in feeding back on the Strategy, they would need to see some sort of tangible results.  She stated, following the campaign against the budget cuts to services for young people, what happened going forward now needed to be addressed. However, trust with the young people who had been campaigning needed to be re-established.  The young people were putting together their own thoughts on what should be in the strategy, which they wished to present to the Council and they had requested that a group of local residents advocate on their behalf.  She stated that the group of young people came from service users of Bruce Gove Youth Centre.  She felt that it was important young people were engaged with so that they were encouraged to respond constructively to the changes. 

Jon Abbey, the Interim Director of Children’s Services, stated that the voice of young people was hugely important and input from them would be very welcome.  Measures were being taken to communicate the strategy to young people in a way that was more accessible to them. He hoped that the engagement process would include a wide range of organisations representing young people.  The Panel noted that the strategy focussed on young people in general and was not just about what the Council could deliver. 

Panel Members stated that they wished to see a commitment to maintain universal services in the most deprived areas, such as Bruce Grove.  It was also important that links were developed with other relevant services such as child and adolescent mental health services (CAMHS) and the Pupil Referral Unit (PRU). 

Gill Gibson, Assistant Director (Quality Assurance, Early Help and Prevention) reported that the budget reductions were for both the Youth Service and the Youth Offending Services combined and came to £2.1 million in total.  The reduction in funding for youth services was £1.6 million.  The Panel requested that future budget exercises did not combine the two services so that it was clearer where the reductions were to be made. 

Kevin Feviour, the Interim Head of Youth, Community and Participation reported a young persons version of the strategy would be produced and that it would focus on issues that were important to them.  This would be based on feedback obtained from them.  The development of the strategy had begun in the autumn, in line with the development of the Council’s Corporate Plan.  Feedback on the strategy  ...  view the full minutes text for item 46.