Issue - decisions

The Chair of the Health and Social Care Select Committee, Councillor Denys, presented the Committee’s report into the Child and Adolescent Mental Health Services (CAMHS) referral pathway, which was warmly received by the Cabinet. Councillor Denys remarked that the Committee’s report addressed the growing issue of children’s mental health in England, noting a substantial rise in mental disorders in recent years. The report emphasised the importance of early intervention, as half of all mental health problems become apparent before the age of 15. He explained how the report focused on three areas for improvement:

·         Early Support: The report recommended a ‘no wrong door’ policy and better information sharing between practitioners to help families access support earlier.

·         Communication: The report suggested improving communication about timelines and processes to help families manage expectations. It also recommended avoiding over-clinical language that can be confusing or distressing for families.

·         Accountability: The report proposed creating a Parent and Young People’s Board to hold the health service accountable, incorporating the voice of the child into all aspects of the service.

Councillor Denys hoped the recommendations would make a positive difference in addressing children’s mental health issues.

RESOLVED:

That Cabinet welcomes the review by the Health and Social Care Select Committee and acknowledges, appreciates and recognises the work that is already being undertaken across the Borough to improve services in Hillingdon to support children’s mental health.  Furthermore, Cabinet agrees the recommendations made by the Select Committee set out below to be referred to the relevant body:

SELECT COMMITTEE RECOMMENDATIONS:

1.    That Cabinet ask the North West London Integrated Care Board (NWL ICB) to:

a)    provide a comprehensive action plan by 28 March 2024 detailing how and when the Thrive mapping strategy will be completed;

b)   complete and implement the Thrive mapping strategy by the end of January 2025;

c)    provide Hillingdon's Health and Social Care Select Committee with 6-monthly updates on the progress being made on implementing this action plan;

d)   initiate a “No Wrong Door” policy for parents / children and young people who seek support;

e)    ensure that all children and young people's services in Hillingdon are asked to adopt the Thrive philosophy/model to ensure there is "No Wrong Door" for children, young people and their families to access mental health and emotional wellbeing support, and that support is provided based on children and young people’s needs and preferences; and

f)     consider how parents can be offered early support on how to navigate the system including the provision of information about where to get this support to schools and GPs (as they are often the first place parents go to).

2.    That Cabinet ask that the Health and Wellbeing Board ensure that all commissioners of CYP mental health services are asked to include requirements in their service provider contracts that:

a)    parents be given a realistic description of the assessment / treatment process, including estimated timelines and information on where they can direct their feedback if the expectations set are not met; and

b)   all communications sent to parents be reviewed to make sure that the information and tone is sensitive to their situation, not overly medicalised and contains accurate information on other places they can look for support.

3.    That the Cabinet Member for Health and Social Care asks CAMHS to develop a service-user involvement strategy that provides opportunities for scrutiny and coproduction of services and includes the formation of a parents/Young People Board so that they can hold the organisation to account for the communications and service they provide.

Reasons for decision

Cabinet agreed the recommendations from the Committee’s review for sending to the relevant bodies.

The Cabinet Member for Children, Families & Education thanked Councillor Denys and clarified that while the portfolio under discussion technically fell under Councillor Palmer’s purview, it significantly overlapped with her own due to its focus on children and young people. The Cabinet Member stated how the report highlighted the alarming increase in the number referred to mental health services and was pleased that the Select Committee had bravely undertaken a review of the Referral Pathway, despite it not being directly within their domain. The Cabinet Member acknowledged that while the Council was not the provider of mental health services, it could still influence change through collaboration with partners. It was appreciated the Committee’s recommendations included a ‘no wrong door’ policy to ensure children and families in Hillingdon could have better access to mental health services.

The Cabinet Member for Health and Social Care expressed her gratitude to the Committee for their diligent work on the report and acknowledged the report’s excellence and bravery, emphasising the need for clear pathways to expedite mental health support for families and children. It was noted that the Committee voiced concern over the lengthy wait times of 12 to 18 weeks for people to receive help and that the report’s recommendations should assist in providing a clearer understanding for residents of their expectations from the service. The Cabinet Member indicated, as a member of the Health and Well-being Board and the local Integrated Care Board, she would ensure the implementation of these recommendations going forward.

The Leader of the Council thanked the Select Committee for their work, highlighting the value of the Council’s select committees and their role as critical friends to partners and their collective effort in delivering public service outcomes.

Alternative options considered and rejected

Cabinet could have decided to reject some, or all, of the Select Committee’s recommendations or pursued alternative routes by which to progress the objectives of the review.