Agenda item

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

The Committee received a presentation by the Children and Young People’s Service Newcastle/Gateshead CNTW, which provided a spotlight on delivery of Children’s Waiting Times.

The Committee received an update on SPA (Single Point of Access) and a ‘one stop shop’ for any children’s referrals requiring a mental health assessment. Following assessment, treatment and intervention will be offered by the most relevant provider if required. Referrals will be reviewed and triaged by community nurse practitioners in the hope that young people are referred to the right place at the right time for onward assessment and treatment or advice and guidance; as per NHS long term plan

Young people aged 0-18 living within the catchment of Newcastle or Gateshead can access SPA and referrals can be made by any professionals working with a young person, self-referrals from the YP or their family/carer. SPA is provided within the children’s mental health services kin CNTW foundation trust.

Conversely the Committee were advised that SPA is not a crisis team and is not a 24/7 provision for children’s mental health – all urgent referrals are dealt with through the Children and Young People’s Service (CYPS) and the Intensive Community Treatment Service (ICTS).  SPA is also not a treatment service but it is for children’s emotional wellbeing and mental health through the Getting Help and Getting More Help services and not for all children’s services.

The Committee also received an update on the Emotional Wellbeing Team, Gateshead which is provided by South Tyneside NHS Foundation Trust and are based within Grassbanks with flexibility to attend other venues if required. The EWBT provide support to children and young people within Gateshead Catchment area via Single Point of Access.

EWBT offers intervention and assessment for a range of issues including:

·        Low mood

·        Anxiety

·        Bereavement and Loss

·        Bullying

·        Eating Distress

·        Relationship Difficulties

Interventions provided by EWBT include individual support (counselling and CBT informed approach). Groupwork further assessment and formulation, parent & carer support and work collaboratively with Education, GP’s, School nurses and health visitors and other specialist services.

The Committee were informed about the work of the Getting More Help Service which was summarised as follows:-

Mental Health Pathway

·        Significant deterioration in emotional wellbeing/mental health

·        Experiencing auditory and/or visual hallucinations

·        Increase in level of self-harming behaviours

·        Concerns regarding risk to self and/or others

·        Concerns regarding exploitation (online, in public) (victim or perpetrator)

·        Increase in level of offending behaviour that appears linked to Mental Health presentation and/or emotional dysregulation

·        Assessment of moderate to severe mental health presentations. YP are offered an appointment with community practitioners and following this community practitioners present their formulation of need within an MDT to support shared decision making

·        Treatment – allocation of care co-ordinator can be treatment in its self or the care

·        Co-ordinator can refer onto therapies via the psychological therapies meeting.

·        This meeting has therapist’s supporting decision making with care co-ordinators to ensure the right therapy is offered. Therapies available are:

·        CBT, DBT (From January), Psychotherapy, family therapy, art therapy

Eating Disorders Team

The Committee were informed that young people must present with eating disorder psychopathology or behaviours, (restriction/exercise/binging/purging) and to what extent each of the behaviours are being observed/impacting wellbeing. Any weight loss/and or stopping of Menstrual cycle.

As per the waiting time standards for eating disorders, all appropriate referrals will be assessed within 28 days

Neurodevelopmental assessment pathway

The Committee were informed that Neurodevelopmental concerns in school age children (eg ADHD/ASD) assessment only pathway – post diagnostic support sits within the Getting Help Services.

Learning Disability pathway

The Committee were advised that the young person must have a diagnosed learning disability and must be experiencing some degree of psychological distress. This also includes children presenting with behaviour that challenges.

The Committee were advised that not all referrals may come directly though SPA and exceptions to this include crisis and urgent referrals, youth offending, liaison and diversion referrals, looked after children (LAC) consultations.

The Committee were presented with a table that demonstrated the number of referrals into SPA from 2019/20 to 2022/23 for Gateshead and Newcastle. Referrals increased by 75% from 2021/22 to 2022/23. In 2022/23 the service received an average of 498 referrals per month. An average of 239 triages were completed each month for young people from Gateshead.

The Committee were presented with a table that demonstrated the Getting More Help Referrals into each of the Getting More Help pathway from 2019/20 until 2022/23 (service as a whole i.e. Newcastle and Gateshead)

There was a slight decrease in referrals during covid in 2020/21 but numbers have continued to rise and in 2022/23 were higher than pre-covid levels. The number of referrals into the mental health pathway have decreased slightly, learning disabilities has remained relatively steady but referrals into the neurodevelopmental pathway have continued to rise year on year. There has been a 112% increase in referrals into the neuro pathway from 2019/20 to 2022/23.

The Committee received an update on waiting times for SPA and were advised that Gateshead Place commissioners have allocated some additional non-recurrent resource for 2023/24 which has been utilised to increase capacity in Kalmer Counselling, Northeast Counselling Service and Children North East with the aim of reducing the number of people being held in SPA.

In response to the increase in referrals and to try and manage the waiting times for young people Place commissioners and CNTW provided significant additional funding in 2022/23.

Place Commissioners increased recurrent investment into the Getting Help partnership by £430k which has resulted in an additional 480 counselling places per year.

CNTW invested £2.3 million non-recurrent funding in 2022/23 which provided an additional 506 counselling places and 780 neurodevelopmental assessments as well as funding some early help hub pilots, neuro hubs, parenting support and therapy bites (app based self help tools).

CNTW has also provided £450k into 2023/24 for some additional counselling capacity and to continue some of the above pilots.

Funding into the Getting More Help pathways has not increased.

The Committee also received an update on some of the challenges faced by CYPS, actions being taken and the expected impact of these actions will be as well as how risks are being mitigated for children waiting.