Agenda item

To inform the Health and Wellbeing Board of the refreshed Local Transformation Plan for Children and Young People’s Emotional Health and Wellbeing

The Board considered a report (Agenda Item 4) which provided an early descriptive indication of the changes to the children and young people’s mental health system following the implementation of Local Transformation Plans.

The report of the government's Children and Young People’s Mental Health Taskforce, “Future in Mind – promoting, protecting and improving our children and young people’s mental health and wellbeing”, was launched on 17 March 2015 with the requirement for system wide transformation by 2020.

West Berkshire’s Health and Wellbeing Board approved the local plans in October 2015 which has enabled additional recurrent funding to be released from NHS England to the West of Berkshire Clinical Commissioning Group (CCG).

There was insufficient consistency in national or regional comparator information, to enable reliable benchmarking of local performance however service managers were pleased with the direction of travel indicated by performance data.

Berkshire Adolescent Unit (BHFT) was now a 7 day, 24 hour a day service that was also a registered tier 4 provision in Berkshire. The number of beds had increased from 7 to 9 and so fewer children requiring this level of intervention needed to be placed outside of Berkshire.

The Common Point of Entry (CPE) was now open 8am until 8pm Monday to Friday. The current average waiting time for referrals to CPE was 5 weeks. National indications suggest that the national waiting time for a first CAMHs appointment was approximately 9 weeks.

Initial indications suggested a reduction in waiting times, with more children and young people receiving timely evidence based treatment across all 5 care pathways. The indications from the data also suggested that the number of children waiting for help had also reduced.

The Child and Adolescent Mental Health Service (CAMHS) Urgent Response Pilot ran throughout 16/17 and had been commissioned for 17/18. Short term intensive interventions in the community were provided to young people who had experienced a mental health crisis with the aim of reducing the number of children and young people who had a second or subsequent crisis. The service also provided wrap around support when there were delays in sourcing a Tier 4 in CAMHS patient bed.  Response time to assessment has reduced and length of stay in both A&E and the paediatric wards had reduced with improved facilitation of admission to Tier 4 units when required. Current information suggested a reduction in use of agency Registered Mental Nurses at Royal Berkshire Hospital. There had also been a reduction in the number of minors admitted to the Place of Safety at Prospect Park Hospital.

Information suggested that Berkshire West waiting times for autism assessment i.e. 40 weeks was lower than the national average. However waits remained longer than both the commissioner and provider wanted locally. The current local target was to reduce waiting times for autism assessment to a maximum of 12 weeks by October 2017. The Children’s Delivery Group would be running a conference in May to check that schools were making appropriate referrals.

Sally Murray concluded by informing the Board that a ‘Little Blue Book of Sunshine’ had been produced, targeted at children in years 10 and 11 which included advice and signposted to websites and library books.

Councillor Lynne Doherty expressed the view that the work was a good piece of system transformation and the qualitative data in the appendix to the report provided powerful feedback regarding the success. She enquired whether the increase from 7 to 9 beds in the Berkshire Adolescent Unit was sufficient. Sally Murray advised that these beds were commissioned nationally as a specialist service and so were available to any child in the UK. She reported that there was not strong evidence that inpatient care was effective for treating children with eating disorders so there was a drive around strengthening the support available in the community.

Councillor Doherty asked whether the CPE was open at weekends. Sally Murray advised that it was not but the Urgent Care service was open. At present there did not appear to be the demand for the CPE at weekends but demand would be monitored and if there were changes the service would respond to this.

Councillor Doherty noted that the waiting times for autism diagnoses were unacceptable and requested that a report come back to the Board to review performance. She further asked what communication there had been with parents regarding children’s’ emotional resilience. Sally Murray advised that 8-13 May was Mental Health Awareness Week and there would be a press release. Andrea King advised that under the Emotional Health Academy there were bespoke parent/ carer interventions as they acknowledged that family change was often required to support a child’s recovery.

Councillor Quentin Webb enquired how West Berkshire’s CAMHS waiting times compared with other areas. Andrea King advised that it was not possible to have reliable national benchmarking.

Councillor Mollie Lock enquired whether the Little Blue Book of Sunshine would be made available to other age groups. Sally Murray advised that it was targeted to children in year 10 and above and had been published to coincide with examination season. There were no current plans to target other age groups. Superintendent Jim Weems expressed his support for the material and advised that he would like to promote the booklets through the neighbourhood policing teams.

Dr Anees Pari commended the good work under the transformation plan. He expressed concern that the umber of hospital admissions of children who had harmed themselves was increasing and higher than the South East and England average; he asked how the transformation plan would address this. Andrea King advised that a sub-group of the Local Children’s Safeguarding Board was monitoring this issue with CAMHS and suggested that Dr Pari might wish to join the group. Cathy Winfield suggested that the additional capacity in CAMHS might have caused a spike in admissions as there was now somewhere for children to be admitted to.

Andrew Sharp informed the Board that Healthwatch had been working with students at Newbury College who had mentioned unprompted that self harm was an issue in their peer group. He expressed the view that services needed to be prepared for the potential impact of the media, such as the new Netflix series ’13 Reasons Why’. Andrew Sharp expressed support for the Little Blue Book of Sunshine and asked to promote the material at Healthwatch’s stand in the Market Square, Newbury as part of their Mental Health Awareness  Week campaign.

Tandra Forster mentioned that there had been discussion at the Autism Partnership Board about the lack of services post diagnosis. She advised that the perspective of parents was often that there was a cliff edge between children’s and adult’s special educational needs services. Tandra Forster also enquired what support there was available to parents generally around speaking to their children about their emotional health. Andrea King acknowledged that parents needed to have the literacy to discuss their own emotional health in order to effectively support their children. Councillor Rick Jones acknowledged that there might be a wider community role for supporting children with their emotional health and community conversations might be an effective tool for initiating those discussions.

Councillor Lynne Doherty left the meeting at 9.49am.

Councillor Graham Jones commended the good example of collaborative working demonstrated under the transformation plan for children and young people’s emotional health and wellbeing.

RESOLVED that the Health and Wellbeing Board noted the progress made in line with Department of Health governance requirements.