Agenda item

This report updates Hammersmith and Fulham Health and Wellbeing Board on transforming mental health services for young people.  It has been previously presented and considered at the Children and Education Policy and Accountability Committee (June 2016) and the more recent Health, Adult Social Care and Social Inclusion Policy and Accountability Committee (October 2016).

 Councillor Lukey welcomed Angela Caulder, Joint Commissioning Manager, and, Dr Meenal Sohani, Consultant Child Psychiatrist, Hammersmith and Fulham CAMHs, West London Mental Health Trust.  The report integrates the findings of Councillor Alan D’Aths Child and Adolescent Mental Health Taskforce Report 2016 (Appendix 1) and the development of the CAMHS transformation plan.  In 2015, the CCGs in collaboration with local authorities, agreed proposals to improve mental health services for young people, which included establishing a community eating disorder service for under 18s, and, to ‘transform’ local mental health services for young people in line with the recommendations made in ‘Future In Mind’.  Angela Caulder highlighted the following 3 achievements and three next steps:

·         The eating disorders service, established on 1st April 2016, in collaboration with Ealing and Hounslow CCGs, as a hub (Ealing) and spoke (Glenthorne Road, LBHF) model.  This was as self-referral service, with cases being seen within four weeks, and, a one week wait for urgent cases and linked to the CAMHS national specifications for eating disorders.  This was a national incentive with the CAMHs transformation money to develop services for children with eating disorders such as anorexia nervosa;

·         Out of hours’ service, working with 8 CCGs across North West London, involving both Central and North West London Foundation Trust (CNWLFT) and the West London Mental Health Trust (WLMHT).  The service had recently been reviewed and evaluated by both the trusts and LBHF children and young people champions, and received positive feedback.  Both services were now embedded and would be available across all 8 collaborative CCGs in 2017/19;

·         The H&F schools pilot, a successful bid to become one of fifteen national sites.  This linked ten schools together with CAMHS provision from the West London Mental Health Trust, with two hours per week in school (with a specially trained mental health lead in each school) and several young people seen in school, with a further four schools added to the programme, now extended to March 2017.

A related or linked achievement was the co-production work with local children and young people champions (aged between 16-20).  These were young people who had either direct or indirect personal experience of living with mental health problems.  They had been evaluating the services, delivering training with colleagues from WLMHT, in the successful LBHF schools pilot in 2016.   In addition, Ms Caulder reported that a young peoples conference had been held at RBKC Town Hall, attended by children from LBHF with an opportunity to share experiences and meet young social media stars.  Dr Meenal Sohani explained that as part of the national school links pilot project, H&F CCG were successful in their bid to work with WLMHT in developing links with 14 schools in the borough, both primary, secondary and alternative provision.  Linking with the lead in each school, clinicians offered training and consultation to the staff, organising drop in sessions for pupils or guidance for parents.  Feedback to date has been positive and the service well received. 

In terms of next steps, Ms Caulder explained that they were keen to work with LBHF on the development work planned around integrated family support services.  A second objective was to develop a sustainable training work programme for the children and young people work force, to be accessible through an online database offering training on a range of mental health issues, and would be available from April 2017.  A third objective was a further increase in co-production activities, this time including parents and their feedback from children with complex needs. A resources guide using the experience of children was also being developed.  

Dr Sohani added that the redesign of clinical pathways, applying some of the allocated transformation money to reduce waiting times and avoid duplication.  A workshop with key partners was planned on how they could work together to achieve this. Ms Caulder referred to the plans to pilot a tapered transition model and would work closely with WLMHT.

Co-optee Keith Mallinson commented that he welcomed the report and expressed concern about the barriers to services.  It was essential that parents were included in the process and hoped that H&F partnership working would help shape services become more accessible.

Councillor Sharon Holder commended the report but took the view that reported well on specific areas but there was concerned that feedback from the schools or the evaluation from the children and young people champions was not included.  Ms Caulder explained that this had been because the pilot had not yet concluded so there was currently no local or national evaluation available.  It was anticipated that this would be reported more fully around June 2017.  A service users forum was also being set up to enable regular feedback.

Responding to a comment on transitioning from Vanessa Andreae, NW London CCG, Ms Caulder explained that research from Anna Freud showed that the small number of young people transitioning to adult mental health services do not often experience difficulties and that the process is usually well co-ordinated.  Referring to the tapered transition model, it was noted that the pilot would begin small, and start with a pooled budget next year.

Councillor Lukey referred to paragraph 6.20 of the report and enquired about the number of children currently occupying beds in adult facilities.  It was confirmed that there was currently one young person, with complex and challenging needs currently placed in an adult facility, with appropriate safeguarding measures in place.  Ms Caulder acknowledged that there were concerns about transition, social care and EHC (Education, Health and Care) plans to the age of 25 years but noted that there was a disconnect for plans to 18 years.  The pooling of budgets to help address this might be the way forward and Ms Caulder was keen to engage with officers in Adult Social Care to develop this approach.

Dr Mike Robinson, Director of Public Health commented that the four priorities set out in the draft Health and Wellbeing Strategy were all relevant to work currently being undertaken through CAMHs.  He observed that 75% of all long term conditions (LTC) in adults originated in childhood and that early intervention and prevention could mitigate against this. He asked what could the HWB do to help reduce the number of LTC relating to mental health in children and highlighted the need for a differently focused report that could explain which measures successfully addressed this.  Ms Caulder referred to the “Future In Mind” (2016) report recommendations detailing early intervention and prevention.  It was explained that much of the CAMHs transition plan was about building capacity with the aim of picking up referrals early and additionally, delivering very basic and effective interventions for children in frontline services, preventing the development of LTC in adult life. 

RESOLVED

That the report be noted.