To receive a presentation from Catherine Swaile, Vulnerable Children’s Joint Commissioning Manager, following a request from the Panel in November 2015. This presentation will provide an update in relation to Priority 2 of the Mental Health and Wellbeing Framework – “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” – highlighting where recommendations from the Overview and Scrutiny CAHMS transition review (March 2015) fit in.
Minutes:
Catherine Swaile, Commissioning Manager – Vulnerable Children, Haringey Council and Haringey Clinical Commissioning Group, provided an update in relation to Priority 2 of the Mental Health and Wellbeing Framework: “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”.
Ms Swaile commenced her presentation by explaining that in 2015 the Department of Health had published “Future in Mind: Promoting, protecting and improving our children and young people’s mental health and wellbeing”. The Panel noted that this report contained five key themes: Promoting resilience, prevention and early intervention; Improving access to effective support; Care for the most vulnerable; Accountability and transparency and; Developing the workforce.
The Panel was informed that the £280 million Transformation Funding for CAMHS, announced in the Autumn budget, had been top sliced to support a number of pilots and national developments. It was noted that Haringey had received £163,000 as part of these initiatives in 2015/16. Additionally, it was explained that each area had been given a proportion to implement local transformation plans. Ms Swaile advised that Haringey’s allocation for 2015/16 was £515,302 and that in order to access this funding every CCG had to go through a rigorous assurance process.
Ms Swaile explained that the aims and objectives of the Haringey Transformation Plan were:
- To develop and implement a joint commissioning model to develop a whole system approach to child and adolescent mental health and emotional wellbeing.
- To ensure evidence-based, quality assured services that promote participation of children, young people and their families in all aspects of prevention and care.
- To develop an early intervention approach that is embedded across the whole system.
- To transform the model of care to improve access, deliver seamless care, improve outcomes and promote enablement.
- To ensure that all groups of children and young people are able to access appropriate support, and that those where there are higher vulnerabilities have tailored support to their needs.
- To promote the recognition of emotional health and wellbeing across the wider children and young people’s workforce.
In response to questions, Ms Swaile provided information on the following local priority schemes:
- The development of a participation strategy for both Children and Young People and Parents/Carers;
- The development of IT infrastructure;
- Resource mapping and the development of an early intervention pathway;
- CAMHS in GP surgeries - pilot extension – where it was noted clinicians offered brief psychological interventions for patients who would not meet the criteria for Tier 3 CAMHS;
- The development of mental health links in schools and the piloting of a new approach to mental health support for young carers;
- The development of a borough-wide attachment pathway and extending the use of the successful How to BE Tool – Anchor Project;
- The development of an early intervention approach to self-harm and eating disorders support;
- Scoping, and piloting, the extension of CAMHS Access to improve access to CAMHS by providing a non-stigmatised, face to face, community asset based approach to triage;
- Peer support for children and young people and parents, including for eating disorders and self harm;
- The development of an out of hours support model that was safe, supportive and cost efficient;
- The Looked After Children (LAC) Service Pilot;
- Improving transition from CAMHS through the development of a co-produced creative life skills course for 14-21 year olds;
- The recruitment of a CAMHS worker into the Youth Offending Service;
- Post-diagnostic psychological support for ASD and neurodevelopmental assessment;
- The commissioning of resources to contribute to North Central London’s development of a sexual assault pathway and to support transformation implementation;
- Training and resources for the wider children’s workforce in addressing mental health issues; and
- The roll-out and embedding of the Children and Young People’s Improving Access to Psychological Therapies partnership.
The Panel was informed that Haringey services had significantly longer lengths of interventions than Child Outcomes Research Consortium (CORC) comparator services. Moving forwards, it was explained delivery of interventions across services needed to be more focused and outcomes routinely used as part of case supervision, with approaches regularly reviewed to ensure they were meeting the desired outcomes. In addition, it was explained that expectations would be managed by services so that children and young people and their families were clear that their engagement with CAMHS was a focussed time-limited piece of work, in line with recovery and enablement principles. In response to questions, Ms Swaile explained that it would not be appropriate to set a time limit on these interventions as the prescribed length would depend on the modality and complexities of the presentation, however changes to practice would help to reduce the average and median lengths of intervention.
Ms Swaile concluded her presentation by explaining that enablement would be promoted through improving access to step down provision. The Panel was informed that a workshop had been held with providers across child and adult mental health services, and other key stakeholders, to look at transition issues and how previous Overview and Scrutiny recommendations would be taken forward. It was noted that a specific action plan around transition would be completed to include:
- The mapping of different cohorts with a focus on pathways for specific groups including LAC and children and young people with leaning disabilities.
- Delivering a more integrated approach through establishing a joint multi-agency forum to discuss children and young people approaching transition age where the pathway is not clear and creating virtual networks around the young person from April 2016.
- Considering the development of a 0-25 model for CAMHS with adult health commissioners through a more detailed look at the outcomes from the Suffolk and Norfolk, Birmingham and Oregon models.
AGREED:
(a) That the update in relation to Priority 2 of the Mental Health and Wellbeing Framework be noted.
(b) That an update on Haringey’s Transformation Plan, including the work of the Transformation Sub Group and Transition Action Plan, be prioritised as part of the Panel’s future work programme for March 2017.
(c) That an update on the Mental Health and Wellbeing Framework, including Priority 2, be prioritised as part of the Panel’s future work programme for Autumn 2017.