Decision details

Dave Carr, Head of Service, Policy, Information and Commissioning, Lancashire County Council, updated the Board on the evidence of impact of the COVID-19 pandemic had had on children and young people's emotional wellbeing and mental health and that are still continuing to emerge. The report also provided:

·  An overview of the emerging evidence of impact

·  Details of some of the significant elements of Lancashire's local system response

·  Plans for moving forward in the short term

·  Recommendations to ensure a continued support and improved system-wide response.

There were strong indications that the pandemic had had a negative impact on the emotional wellbeing and mental health of many children and young people in Lancashire, who have already required extra help or may do so in the future. Partners have made significant changes in arrangements to better support children and young people but there was much more to do. It was proposed that Partners in Lancashire continued to look forward to delivering the NHS Long Term Plan and wider strategy for children and young people’s emotional wellbeing and mental health, maintaining and enhancing current provision, but in doing so addressed the expected significant longer term impacts of the COVID-19 pandemic.

Among the sources of evidence detailed in the report which was circulated to members of the Board were the findings of a rapid review which had been undertaken nationally by the Anna Freud Foundation, along with further evidence which was provided by the Co-SPACE project which was again was undertaken at a national level by Oxford University which tracked the mental health of school-aged children and young people aged 4-16 years throughout the COVID-19 crisis.  Summaries of both these studies were detailed in the report attached to the agenda.

Evidence shows that more young people have sought support during the lockdown period, and will continue do so as the impact of COVID-19 continues to affect the way that young people live their lives. Equally, for those young people who have found it easier spending more time away from their school environment, the prospect of returning may be challenging.

With regards the Local System Response during COVID-19, many services have continued to operate to provide support for children and young people with many changing their offers to deliver more online and telephony based services and increased the use of technology, as well as continuing face to face contact if required.

There has been a huge amount of resource made available to support children and young people's emotional wellbeing and mental health and this can be found on the Lancashire and South Cumbria Healthy Young Minds Website (https://youngminds.org.uk/training/mental-health-training/) which has been expanded to include COVID-19 specific resources alongside the planned launch of information, advice and resources to support children, young people, parents/carers and professionals identify and manage emotional wellbeing and mental health issues.

As discussed at this Board, Child and Adolescent Mental Health Services (CAMHS) 0-19 service provision (which previously stopped at 16 years of age) has changed in order to address the issue of older adolescents, they are now given a choice as to whether they wish to continue to access CAMHS or move to Adult Services.  This has commenced on a phased basis across the County. Blackpool Teaching Hospitals Trust achieved full implementation in early April 2020, Lancashire and South Cumbria Foundation Trust from end of June 2020 and East Lancashire Hospitals Trust commenced a phased implementation on 1 April 2020 with full implementation by 1 September 2020.

Work around suicide prevention has included real time surveillance data, with an intelligence led approach to communications using social media, and through partner agencies, targeted on high risk locations. Data has also helped identify clusters/groups to target more specific interventions and ensure wider networks get the support they need.

The Board were highlighted on some of the plans moving forward which included:

The Children and Young People’s Emotional Wellbeing and Mental Health Transformation Plan for Lancashire (2015-2020) which was first published in January 2016. That document set out the initial iteration of a five-year plan for Lancashire, to support local implementation of the national ambition and principles as set out in ‘Future in Mind – promoting, protecting and improving our children and young people’s mental health and wellbeing’ (2015).

The Plan’s continued aim is to improve the resilience, emotional wellbeing and mental health of children and young people, especially those who are at increased risk due to their vulnerability, such as those within and on the ‘edge of care’, making it easier for them and their families to access help and support when they need it whilst improving the standard of mental health services across Lancashire and now, South Cumbria.

From April 2020 through to March 2021 is the final year of this Transformation Plan, and there remain some key deliverables including the final stages of evaluation and subsequent implementation of the redesign of NHS funded Child and Adolescent Mental Health Services (CAMHS). Whilst some elements of the redesign have been brought forward as a consequence of the COVID-19 pandemic, completion of the final design, evaluation and further consideration of overall affordability of the proposed model have been delayed.

Discussion ensued around homeless young people who have left care and asked that the Board be reassured that the appropriate public and Voluntary, Community and Faith Sector (VCFS) agencies are supported to pick up on any homeless young people who have left care.  In terms of the pathways there is a system across Lancashire for those young people leaving care and there are a number of services that the county council commissions and also works very closely with district council partners to ensure that the provision is used appropriately and ensure there is a clear interface with social care.  This is something that needs to have continued focus and the Housing Reference group is picking up on some of that discussion at the moment.  Therefore, the Board can take some assurance that support is available, however this is something that needs continued work on.

The Board was requested to monitor the work on children and young people's emotional wellbeing and mental health and note that there is still work do be done.  As these are unprecedented times there really are no measures about the impact on mental health on children going through the Autumn term and some very young children have had no contact with peers, especially if they have no siblings, and that they are going to have be reintroduced to things such as play and for adolescents, being in groups and hanging out with friends is a big part of their development, so it will be about watching very carefully mental health referrals at lower and higher levels during the Autumn Term and making sure that as a Board, it responds appropriately. 

Following discussion the Board noted the impact of COVID-19 on children and young people's emotional wellbeing and mental health and agreed on the principles outlined in the report and that there were still work to do going forward.

Resolved:  That the Health and Wellbeing Board:

i)  Noted the emerging evidence of impact of the COVID-19 pandemic on children and young people's emotional wellbeing and mental health.

ii)  Noted the system wide response to help mitigate the short term impact.

iii)  Agreed that the outcome of the redesign of NHS Funded Services will be reported to the Health and Wellbeing Board at a future date.

iv)  Agreed the continued need for a whole system approach across all partners.

v)  Committed to principles of:

o  Ensuring sufficient resource to meet demand.

o  Implementation of the NHS funded Child and Adolescent Mental Health Service (CAMHS) service redesign.

o  Mental health support for children and young people embedded in schools and colleges, building on the learning from Mental Health Trailblazer Teams.

o  Meeting new national waiting time standards for all children and young people who need specialist mental health services.

o  Investing in early and appropriate interventions, to prevent escalation in to crisis

o  Greater focus on the longer term development of digital services.

o  Co-production with children and young people, including of primary age and those in more vulnerable groups, to help young people to shape services to meet their needs and to play an active role in promoting positive mental health and wellbeing.