Agenda item

The Committee considered the report on the current position of Chid and Adolescent Mental Health Services (CAMHS), which had been requested at the last meeting.

A number of witnesses attended to present the report and answer the Committee's questions.

Joan Veysey, Deputy COO Hillingdon Clinical Commissioning Group, addressed the meeting and made the following points:

·         There is a strong commitment to look at the concerns raised. There was a national focus in 2014/2015 and since then a five year CAMHS improvement plan has been submitted.

·         There has been improvement in the out of hours services offered to young people, but it was recognised that there is still more work to do around access to services. A commitment was made to move to a fully integrated service model development called the Thrive Model of Delivery (TMD). This model emphasised the need to get support when at risk and focussed on signposting people to the right people and resources for support.

·         The TMD is made of three complementary principles namely needs led, integrated and effective and transparent.

·         Co-production work is required to engage families and schools in order to implement care. The CCG and the LBH has commissioned the Anna Freud National Centre for Families to facilitate co-production workshops.

·         The TMD identified good progress in addressing risks and it is forecasted that the model will be fully implemented by the end of May.

Nicholas Morgan from the Anna Freud National Centre for Children and Families addressed the meeting and made the following points:

·         The Anna Freud (AF) organisation is a national organisation which develops and delivers clinical services and research to families and childrens around models of practice for mental health.

·         The AF organisation aims to work with Hillingdon CCG to support young people and parents to co-produce a shared vision for the development of a revised care pathway. This is being done by initial consultation, keeping users of the service engaged and giving them information on the processes and mechanisms for maintaining a sustainable model.

·         The AF organisation is going to conduct training sessions, seminars and oversee monthly meetings of steering groups to deliver the pathway effectively.

·         Moving forward, the AF organisation hopes to identify what methods work well and what needs to be reviewed.

Dr. Stephen Vaughan-Smith, GP Lead for Mental Health and LD, addressed the meeting and made the following points:

·         The CCG is aware and trying to close the gaps in the care for young people. The organisation has engaged charities such as MIND to look at needs and engage children from 16 - 25.

·         Although it has been suggested in the past to go the GP, if there are mental health concerns, this is not the appropriate course of action. The TMD model will resolve this issue by having a single point of access, methods of co-production, and getting help with professionals.

·         Overall the main objective of the new model of delivery is to ensure children at risk are seen at an early stage, as problems can be solvable by appropriate resources.

Tom Murphy, Head of Early Intervention Services London Borough of Hillingdon. He explained to the Committee that the TMD model shows different approaches and pathways. There is an ongoing dialogue with schools and work is being undertaken with schools by auditing.

The following points were made in discussion:

·         The backlog to receive mental health treatment is a concern nationally not just at a local level.

·         There is an increase in the types of services offered particularly in the areas of self harm and eating disorders.

·         Reasons for non treatment in eight months can be due to service capacity issues. It can also be about preferential treatment. The aim is to have no one on the waiting list. There is an online service being introduced which will reduce backlogs as assessments do not need to be conducted physically.

·         Hillingdon CCG has a target to treat 85% of children within 18 weeks of referral. This is currently not being met. 85% is the minimum to secure funding however CCCH is aspiring to do the best that they can.

·         The TMD is hoped to identify whether a specialist is required on a case by case basis. A single point of access will help facilitate this as it will signpost people to the right services.

·         Schools are committed to improve overall pathways and the new model will provide consistency.

·         There is not a single type of patient and medication is not always appropriate. The model aims to signpost people so young people do not always need to involve their GPs.

·         The risks and obstacles the proposed method of delivery has include the culture in which services are delivered, challenges about technology and pace of delivery as there is a need to work quickly.

·         Prevention in early years is key as it allows children to develop strong resilience.

·         The first consultation is due at the end of April.

RESOLVED -

(1)  The Committee thanked witness for attending and providing an up to date report.

(2)  An update from CAMHS be included in the work programme for 2017/18.