Agenda item

Report of the Executive Director of Nursing, NewcastleGateshead CCG

The Committee received a presentation on the redesign of Children, Adolescent, Mental Health Services (CAMHS), by Chris Piercy, Director of Nursing NGCCG. The Committee was reminded that the review of CAMHS has been collaboratively carried out with Gateshead Council, Newcastle City Council and Newcastle Gateshead CCG. The review aims to design an integrated, early response to the emotional and psychological needs of children, young people and families, to improve outcomes and reduce inequalities.

Work on the review started in February 2015, it was noted that the review was challenging due to the number of organisations involved in delivering services. The project has tried to understand how the service is currently meeting needs and how it can move away from a tiered service.  The project has undertaken a ‘Listening’ activity which has involved consultation with young people aged 15-18 years old who are currently engaged with mental health services. It was acknowledged that these young people had an excellent level of knowledge and provided innovative and enlightening ideas. In addition, multi-agency workshops were held which included provider organisations, schools, parents and carers. Focus groups were also held and a targeted listening activity with young people over-represented in mental health services.  Following these consultation events a new model of emotional wellbeing care and support was designed and a number of design workshops were held. It was also confirmed that further targeted engagement with hard to reach groups is ongoing and will conclude in January 2017.

The proposed model is focused on prevention and early intervention, there is a single front door and one point of contact. There will be a shared care approach so less ‘bounce’ between services, although there will be continued commissioning of some services, there is integrated working at the heart of the model. The model is recovery focused and will provide appropriate escalation when necessary.

It was reported that engagement work on the developed model will conclude in January 2017, an event will be held on 16 January with all providers around the specification. Initial service improvement will commence in April 2017, this will be phased implementation and will be monitored on a quarterly basis.

It was questioned whether work has been held with Syrian refugee children and young people. It was acknowledged that this is part of the engagement challenge across the whole system.

It was queried whether this is a redesign of all CAMHS. It was noted that CAMHS is commissioned, is a co-design around provider organisations, Expanding Minds Improving Lives (EMIL) is the project title that young people suggested.  The core CAMHS service is around emotional health and wellbeing and there are strands under this, for example eating disorders.

It was questioned where funding for CAMHS comes from. It was noted that mental health is a priority for NHS England and there is a requirement to keep money for mental health services. It was confirmed that most funding is from the NHS and some is from the local authorities. It was also noted that local authority funding is not ring fenced but the Council values early help and working in partnership to develop commissioning.  Committee was advised that £75,000 was received through project development funding to develop the EMIL project and carry out engagement work and it was confirmed that this was not core funding of the project.

The point was made that this work is aspirational and there were concerns about how realistic this is based on capacity. It was recognised that the current model is not effective because services and providers were not working together, this is now a national priority. It was noted that there is not a lot of funding with which to achieve the desired outcome therefore it is important that the new model enables more integrated and collaborative working.

It was pointed out that currently parents do not get enough time to work with the service. It was confirmed that the model looks to include families earlier on, although there will still be occasions when the child or young person does not want their families to know details of their situation.

It was suggested that schools are now picking up the fall out of mental health services not being able to meet the demands on it, for example buying in counsellors, and it was noted that more early help, i.e. talking therapies, is required. It was confirmed that during the engagement phase of the project, parents and carers were consulted on how they want to be involved and it is expected that the service will be more responsive in the future.

Concerns were raised that previous models have spoken about a single point of access, but in reality this has not been the case. It was acknowledged that the single point of access under the new model will be able to be accessed by all, for example; parents, children and young people and services, and all would be expected to work together.

It was questioned whether the contract would come back to the Committee prior to sign off. It was confirmed that this would be possible, however an event is organised for the new year where the plans would be shared.

It was questioned whether, at the point of assessment, there is a choice for the child or family around where they could receive care. It was confirmed that there is a choice for all patients. It was also queried whether there is criteria set down in order to evaluate the progress within the system. It was noted that work is ongoing in terms of an evaluation tool.

RESOLVED    -           That the comments of the Committee and the information provided be noted.