Agenda item

Report of Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

The Committee received a report in relation to the impact if the Covid 19 pandemic on the mental health of children and young people in Gateshead and the services supporting them.

The impact of Covid 19 on the mental health of children and young people has been widely reported.

Public Health England recognised the need and issued the guidance on supporting children and young people with their mental health and wellbeing.  The guidance offered advice on:

·        Ways to get urgent help for mental health and support

·        How CYP might cope with stress during the pandemic

·        How CYP might manage with physical health issues

·        How CYP who care for others might be supported

·        Strategies to address bullying

·        Support for CYP experiencing grief or bereavement

Referrals into Children and Young People’s Service (CYPS) during the first wave of the pandemic dropped, this was attributed to the loss of the school structure (education being a key referrer for children and young people) and concerns about attendance at GP or other appointments during lockdown.

However, many young people were clearly struggling with the changes to their routines, the fear of the unknown, worries about loved ones, the loss of social contact with peers and increased pressure on families who were under financial pressure and forced to be together for long periods of time.  Sadly there was a marked increase in domestic violence and many young people were exposed to risk which they may not otherwise have faced had they been at school or able to socialise.

As children returned to school and more readily started to access primary care support, the referral rate to all pathways in the CYPS services increased and has continued to do so exponentially.

Initially all young people, including those waiting for services were contacted and risk assessed to monitor their wellbeing.  Face to face contact with appropriate PPE was maintained for those deemed to be at highest risk.

Young people were helped to understand and strengthen their internal resilience, learn helpful coping strategies, relaxation techniques and mindfulness.  Parents were encouraged to promote confidence and support their children by understanding the importance of communication, empathy and the need for their children to feel safe and supported.

There has been a noticeable decrease in overall staff resilience in the service through the pandemic.  The CYPS service has experienced high levels of staff sickness (made of both covid and non-covid related sickness) and recruitment and retention of staff have become a significant challenge.

The average number of referrals accepted over the past six weeks are 25 per week with the rate showing a continued increase.  Under a waiting list initiative the Trust are transferring 25 cases per month to Toby Henderson Trust.  A total of 292 cases have been transferred to Psychiatry UK between April 2022 and July 2022 with the total number being 480 within the 22/23 financial year.

There are lots of children with Autism/ADHD and a lot of children being referred for assessment, work is ongoing to look at how children are supported when waiting for a diagnosis and work is ongoing with schools and families.

Support is being requested from colleagues in the voluntary sector to assist in making an impact on waiting lists.

It was queried as to how we can all work better together.  It was noted that capacity issues have been described but it feels like we aren’t getting the bigger picture in how CAMHS has the ability to deal with the issues.

It was noted that CNTW can’t do this on the own and by working together with education and both primary and secondary care and picking up children at the earliest possible juncture.  There is a question of what we can do at every level and integrating into the community, and if we don’t line up all the dots can we deal with this on our own, the answer is no.

It was noted that the report gives us an insight into the fact that we are dealing with complex problems.  This Committee’s role is to scrutinise services provided so without knowing what the demand is its difficult to scrutinise how well the demand is being met.

It feels that there are some missing bits to the puzzle.  The Health and Wellbeing Board at its December meeting will be having a focus on mental health, we will have a candid discussion about services and how they are meeting needs.

It would be good when the update is provided next year that we can see a baseline and where we are going.

It was queried what had been the impact of Covid on school attendance and what specifically has been put in place to capture the needs of children.  It was noted that unless a child has been referred to the service by a professional or school the service wouldn’t be aware of the numbers.

If a children is not brought to an appointment there would be a safeguarding concern raised, there would be a red flag if they were out of school and known to the service.

The service is linking in with schools and has a designated clinical officer who is new to post.

It was noted that a query had been raised about the current contract and if the need is higher doe the contract meet the need. 

It was noted that it would be helpful to have a couple of case studies to show the pathways, length of time someone is waiting, details of recruitment and retention.

RESOLVED         (i)    That the information presented in the report be noted.         

                            (ii)    That further information be brought to the Committee in April 2023 as requested.