Agenda item

Purpose: To provide an update from the on Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board’s (BOB ICB) response to the recommendations made in the Survey Feedback report by Healthwatch West Berkshire on Child and Adolescent Mental Health Services (CAMHS) (February 2021).

Niki Cartwright presented the report on the BOB ICS Response to the Healthwatch CAMHS Report (Agenda Item 11).

It was stressed that achieving expected outcomes for parents and carers would be the main focus going forward.

Members wanted to understand why there were high numbers of young people who were self-harming in West Berkshire. It was confirmed that the ICB worked closely with Public Health around self-harm and the Suicide Prevention Strategy. It was noted that self-harm was not related to deprivation, but there was  strong link with loneliness and isolation. Also, there was anecdotal evidence of children seeing parents struggling, and children were not able to get the same level of support through schools and clubs during the pandemic. The ICB was looking to see what support could be put in place in schools through Mental Health Support Teams and targeted interventions were being put in place where there were clusters of self-harming incidents / suicide attempts.

The issue of staff shortages was highlighted as a concern and Members wanted to know how this would be addressed. Funding had been secured from the NHS Regional Team to pilot a CAMHS Academy. The ICB was also looking at ways to take people who had just finished their training and fast-track their professional development. It was noted that there had been investment in the Children and Young People’s Neuro-Diversity Service and it had taken 12 months to fully recruit.

Action: Niki Cartwright to provide further details of the scheme after the meeting.

Members highlighted that there were problems with CAMHS waiting times pre-Covid that had been exaggerated by the pandemic. The CAMHS Academy was welcomed as a positive step. It was acknowledged that there were national shortages with specialist staff and Members wanted to know how staffing issues would be addressed locally, given the higher costs of living in the South East of England.

The action to improve communications between CAMHS Teams and parents / guardians was noted. It was highlighted that parents did not understand that they did not have to wait for an assessment in order to access services and it was suggested that communications needed to be improved around this aspect in particular. It was explained that the autism diagnosis did not sit within CAMHS, but under Learning Disability. However, the two services worked closely together. It was accepted that communication with families and parents needed to improve. This would be part of the re-design of CAMHS and would involve co-production. Regarding autistic patients, there would be co-production with local authorities, with the emphasis on being needs-led rather than diagnostic led.

Members noted that the above was not set out in the report and it was suggested that the report should set out all the actions that would be progressed. However, it was also noted that Healthwatch had been supposed to provide a slide on communications as part of the presentation.

Action: Check that co-production work on communications is reflected in the LTP.

It was noted that in some cases parents and guardians did not believe that CAMHS had made any difference. It was suggested that many parents saw CAMHS as a ‘silver bullet’ and there was a lack of awareness of what other help was available. The proposal to align CAMHS with the THRIVE model was welcomed.

It was suggested that there could be a summit for front-line workers on available pathways.

Action: Garry Poulson to discuss a possible summit on pathways for front-line workers.

The fact that the ICB had provided an in-depth response to the issues raised in the Healthwatch report was warmly welcomed. It was accepted that parents’ expectations may not be logical or realistic. Also, it was suggested that children and young people’s mental health was not  just an ICB problem, but needed to be managed holistically. It was suggested that a pilot could be funded through the Better Care Fund to provide additional support workers in primary care. Key issues were ensuring that services were better joined up and better communications with parents. It was stressed that parents were not interested in pathways and NHS structures, they just wanted a seamless service. It was suggested that the issue could be revisited in 12-18 months to understand if the changes were working. Also, it was suggested that any new initiative should be communicated to the public.

It was suggested that activity should be viewed in terms of communities building resilience and all partners had a role to play.

RESOLVED that the report be noted.