Agenda item

Purpose: To raise the Board’s awareness of the CAMHs Service.

Sally Murray introduced the report, which aimed to provide an update in the improvement across the comprehensive Child and Adolescent Mental Health Service (CAMHs) System. Sally Murray reported that she would brief the Board on the strategic policy both nationally and locally and then would hand over the Mac Heath to talk about Tier Two services in West Berkshire.

A range of national, regional and local reviews had been undertaken in the last 12 months that related to CAMHs. A very good summary of the policy context could be found in the Commons Select Committee Report, published on 28^th October 2014, which acknowledged the ingrained problems with commissioning and the provision of CAMHs.

Sally Murray reported that tier three CAMHs involved medical intervention and in theory CAMHs Tier One and Tier Two services should prevent this. Schools taking a whole school approach were considered good practice and it was about offering support in the right place at the right time. The aim was to get help to children needing support quickly and to offer a seamless pathway.

In spring 2014 there had been a comprehensive review of CAMHs and a picture of CAMHs locally had been drawn up.

Regarding progress to date, the document ‘Future in Mind’ required areas to have a Transformation plan for 2015/16 to deliver a local offer in line with the national ambition. Additional funding could be applied for through this plan.

Work had begun around where the gaps were and areas of focus going forward included referrals, response rates and bringing the rates down.

Tier Four CAMHs included in house treatments. Historically there had been no Tier Four Service provision in West Berkshire. Since 2014 longer term plans had been agreed between Berkshire CCGs and NHS England to change the Berkshire Adolescent Unit based in Wokingham from a Tier Three (with some tier 4) into a Tier four provision. The unit was open seven days a week, 52 weeks of the year. The aspiration was to expand the unit from a seven bed facility into l a larger patient residential unit as well as catering for day patients.

At crises point a quick response helped to ensure better outcomes. It was also confirmed that the CCG had contributed an extra one million pounds into CAMHs.

Mac Heath reported that he would talk about Tier Two services in Andrea King’s absence. He stated that as commented earlier in the meeting sometimes there might be other professionals besides General Practitioners who could provide a service.

A lot of work was taking place around the range of services available. A multi –agency event had taken place in July to focus on what Tier Two services should be offering. Work was now taking place to co-design an approach to filling gaps and overcoming challenges. A key strand of work was around ensuring different services were educated and confident. The design of prevention services to help further meet the need was also being reviewed.

Sally Murray concluded that a lot effort was going into ensuring focus was being placed on outcomes. The CAMHs outcomes framework ensured a sensible reporting mechanism was in place. The next step was to pull a data set together to help see what was working in the area.

Dr Lise Llewellyn felt that there was a lot to learn from neighbours regarding the use of social media. She also agreed with Mac Heath’s comments about building confidence amongst services.

It was noted that some areas already had online surgeries. Sally Murray reported that there was a system called ‘Sharon’ for eating disorders available in Berkshire.

Dr Bal Bahia thanked Sally Murray and Mac Heath for their report and felt it was helpful to be aware of work taking place in the background.