Decision details

Children's Services Update

Decision status: Recommendations approved

Is Key decision?: No

Decisions:

Children and Young People's Emotional Wellbeing and Mental Health Transformation Programme

 

Dave Carr, Head of Service, Policy, Information and Commissioning and Gillian Simpson, NHS Midlands and Lancashire Commissioning Support Unit were welcomed to the meeting for another update on the Children and Young People's Emotional Wellbeing and Mental Health Transformation Programme.

 

This was the third year of delivery against the pan Lancashire Children and Young People's Emotional Wellbeing and Mental Health Transformation Programme which had resulted in the delivery of a number of key objectives which enabled children and young people to benefit from enhanced services and greater access to support.  There had been significant engagement to inform the redesign of NHS funded Child and Adolescent Mental Health Services (CAMHS) and a core design developed for the future delivery of CAMHS services across the Lancashire and South Cumbria footprint.  During the coming weeks, dialogue was expected to progress with NHS Providers and Clinical Commissioning Groups (CCGs) to agree a timeline for the further development of costed proposals, subsequent evaluation and implementation.

 

This report provided an update relating to the Lancashire Children and Young People's Emotional Wellbeing and Mental Health Transformation Programme including an overview of achievements during the past year and progress in the redesign of community Child and Adolescent Mental Health Services (CAMHS).

 

The last update to the Lancashire Health and Wellbeing Board, in January 2018, highlighted good progress in delivery against the 26 objectives in the pan Lancashire Transformation Programme.  The work had continued during 2018. 

 

Key achievements included:

 

·  Consulting with schools to inform the development of a Resilience Framework which would provide a common understanding of what was meant by resilience, the activities which could build resilience and provide opportunities to share good practice.

·  Continued funding for the Lancashire Sports Trust to support young people in building resilience.

·  Defining a "complementary offer" of non-clinical support to children, young people and their families.

·  Increasing access to Youth Mental Health First Aid (YMHFA) Training, delivered through the new network of Primary Mental Health Workers across Lancashire and complementing YMHFA training commissioned by the County Council.

·  Engagement with children, young people and stakeholders and the first stages of development of a new "Digital" offer for professionals, children, young people and their families.

·  Progressing the redesign of NHS funded CAMHS services. NHS CAMHS provider organisations had worked collaboratively with voluntary community and faith sector providers and with Clinical Commissioning Groups to co-produce a core model for CAMHS services across Lancashire and South Cumbria through a process of engagement and co-production with children, young people, families and wider stakeholders. Work was now progressing to establish the potential impact on funding and to agree timescales for the production of a final costed proposal, evaluation and potential implementation.

·  Securing interim community services to support “children with behaviours that challenge”, pending the CAMHS redesign.

·  Opening the Specialist In-patient Mother and Baby Unit in October 2018.

 

There were a number of challenges which create pressure in the system and acted as a catalyst for the transformation programme to propose to the need to increase the scale and pace of change. 

 

These were:

 

National Access Target

 

At least 35% of children and young people with a diagnosable mental health condition to receive treatment from an NHS-funded community mental health service, or for those already hitting 35%, an additional 7% was required.  This meant we still had 65% not in an NHS funded service.

 

Lancashire County Council re-invested £1.1m in early help.  Whilst this was positive in terms of supporting children and young people with the aim of providing support earlier and hopefully preventing CYP needing to access CAMHS, it did leave a £1.1m gap in CAMHS funding.  CCGs used Transformation funding to fill that gap but this was not sustainable and an ongoing solution was needed.

 

Variations

 

There were significant variations in investment, in age range and in the services offered for Children and Young People with Emotional, Wellbeing and Mental Health across the Sustainable and Transformation Plan footprint. 

 

Since the publication of the original Lancashire Transformation Plan in 2016, the programme had been clearly committed to redesigning, developing and commissioning services in line with the THRIVE model.  THRIVE offered an opportunity to fundamentally change the way that services were conceptualised and delivered, moving away from the tiered approach to one that was integrated, person centred, goal focussed and evidence informed.  THRIVE had been shown to reduce waiting times and improve experience of care.  It was the nationally recognised model of choice and had been widely researched and evidence based and is central to the redesign.

 

The local performance for 2018/19 full year for the access target for Children and Young People Mental Health Services was broken down by each Clinical Commissioning Group area.  All areas included within the Lancashire transformation plan area had achieved the target.

 

An issue was raised with regards performance on waiting times for CAMHS for each of the Clinical Commissioning Groups and requested a more in depth analysis on this.  Gillian Simpson agreed to feed this information back at a future meeting when the Transformation Programme was due to return for an update.

 

As needs are higher than resources available, variation needs to be analysed and also access across the County too, as one are may need less resources than another area and the balancing of needs of the service needs looking into.  The Board agreed that this should be raised through the Integrated Care System and feedback at a future meeting.  It was also noted that for the following reports it would be useful to have sight of the impact of the other projects in the programme and what the outcomes are.  An additional recommendation was also made.

 

Resolved:  That the Health and Wellbeing:

 

i)  Noted the report and accompanying presentation.

ii)  Request that Clinical Commissioning Groups through the Integrated Care System look further at the issues around how we collectively fund and deliver mental health provision for children and young people in a more equitable way and bring other elements with the next update.

 

Lancashire Special Educational Needs and Disabilities (SEND) Partnership – Update on the Implementation of the Written Statement of Action

 

Sian Rees, Improvement Partner SEND, Lancashire County Council updated the Board on the Lancashire local area SEND services which were inspected by Ofsted and the Care Quality Commission (CQC) in November 2017 to judge how effectively the special educational needs and disability (SEND) reforms had been implemented, as set out in the Children and Families Act 2014.  The inspection identified two fundamental failings and twelve areas of significant concern.

 

The partners in Lancashire were required to produce a written statement of action, setting out the immediate priorities for action; the progress on implementing these actions are monitored by the Department for Education (DfE) and NHS England (NHSE).

 

Since the last Health and Wellbeing Board update in September 2018, work had continued to progress the actions set out in the written statement of action and these are detailed in paragraphs 2.1 and 2.2 in the report.  Since the agenda circulation, the draft strategy and provision have been revised and will be presented to the SEND Partnership Board on 26 November 2018.  Once they have agreed the amendments, Sian will circulate to the Health and Wellbeing Board.

 

This is the third update to the Health and Wellbeing Board.

 

John Readman informed the Board that the Clinical Commissioning Groups involvement had been really strong and that Mark Youlton who represented them had brought strength to the SEND Partnership Board and the Integrated Care System (ICS) were discussing Mark's replacement when he leaves shortly.  Edwina Grant will also be replacing John Readman, Interim Director of Children's Services when she commences at Lancashire County Council in December 2018 as the new Executive Director on the Health and Wellbeing Board as well as the SEND Partnership Board.

 

The Chair expressed its thanks to John and Mark as well as the SEND Team for their work on this.

 

Resolved:  That the Health and Wellbeing Board

 

i)  Noted the progress of delivery on the written statement of action;

ii)  Received an update on progress at the January Board meeting

iii)  Noted the likely changes to the external monitoring process in 2019 as described in paragraph 4.

 

Report author: Helen Makinson

Date of decision: 20/11/2018

Decided at meeting: 20/11/2018 - Lancashire Health and Wellbeing Board

Accompanying Documents: