Agenda and minutes

To consider and approve the minutes of the previous meeting held on 22 October 2020, as a true and correct record of the proceedings.

Resolved:-

That the minutes of the meeting held on 22 October 2020 be approved as a true and correct record of the proceedings.

To receive declarations of interest from Members in respect of items listed on the agenda.

There were no declarations of interest.

To receive questions relating to items of business on the agenda from members of the public or press who are present at the meeting.

The Chair confirmed that no questions had been submitted by members of the public or press.

To consider whether the press and public should be excluded from the meeting during consideration of any part of the agenda.

The Chair confirmed that there was no reason to exclude members of the public or press from observing any of the items on the agenda.

To consider an update report and presentation on the delivery of the Mental Health Trailblazer programme in schools.

Consideration was given to a report and presentation by the Joint Assistant Director of Commissioning, Performance and Inclusion; the Service Manager for CAMHS; and the Clinical Lead for the Mental Health Support Teams. The report and presentation included information in respect of Rotherham’s Child and Adolescent Mental Health Services (CAMHS) pathways. The presentation indicated how the THRIVE model was being implemented by RDASH and the progress in respect of the Mental Health Trailblazer in Schools. It was noted that the Trailblazer, known as ‘With Me in Mind,’ employs a tailored approach for each school and is available to everyone through online resources at www.withmeinmind.co.uk. The Trailblazer was described in the context of the wider CAMHS service and the COVID-19 pandemic. The report depicted the results of two phases of data collection via a survey of young people as part of an annual lifestyle survey. The first data collection efforts took place during the first period of national lockdown and again during October, with the survey closing just before the second national lockdown began.

In discussion, Members noted resilience of young people during the pandemic and the possibility of an element of attrition in the data. It was noted that HELIOS likely came into service at the optimal time just as the pandemic was starting. Members expressed hope that young people would be encouraged to see the positive outcomes and progress that have come from the pandemic. The response noted that the Wellbeing for education return, and the mental wellbieng of staff has been at the forefront of priorities so that staff can be more resilient as well. Some children have a lot of protective factors as far as family environment and economic factors, but some children will not have that, so flexibility has to be built into the programmes to reflect and respond to that. The engagement of young people via digital technology has been really positive, and some young people are more likely to engage with support that way as a gateway, which is something that will continue to be utilised after the pandemic is over.

Members requested clarification around the distribution of values for male and female patients, and the apparent movement of cases from severe to less severe over the course of treatment. The response noted that the numbers are still low for statistical significance, but if, after a year of data collection, the trends persist, it would certainly receive attention.

Members also requested clarification around the percentage of children who reported feeling that their mental health is worse. The response clarified that in October 2020, 48% of respondents said their mental health had not changed and 13% said it had improved.

Further clarification was also requested around the role of schools in collecting the survey information. It was clarified that all responses are anonymous, so there is no way to know which person had responded. Assurance was given that all schools took the survey seriously and identified which age groups responded at which times,  ...  view the full minutes text for item 123.

To consider a report and presentation on delivery of the Healios Pilot and re-designed pathway.

Consideration was next given to a related report on the redesign of the neurodevelopmental pathway. The presentation described the significant challenges that had led to the redesign and the progress that had been achieved. It was noted that formerly, the rate of referral that could be accommodated for assessment by the pathway was 15 children per month. The average referral rate was 50 per month, creating a considerable waiting list. In the six months that led up to school closures in early 2020, the rate had increased to an average of 69 referrals per month. Wait times are dependant on the child’s journey, and the interventions they have received previously, and what has been available to them in their particular circumstances. These are for autism, ADHD or both of these together. These variables make it difficult to calculate an average wait time, but it is known that the wait times are too long. Therefore a bid was completed for the digital pilot of HELIOS and the redesign was undertaken. The bid was for funding to add 180 assessment. Starting wit the families who had been wating longest, the waiting list was progressed. 220 families have requested digital pathways. Anyone waiting has begun to be picked up my HELIOS, working with the CCG and RDASH, who are putting in place a trust wide compact with several different approaches available.

Details regarding the impact on families and the breakdown of funding were also provided as part of the presentation. Initially the clinical team had been quite disconnected from the rest of the process and providers, and the emphasis was on clinical diagnosis. Therefore the new vision was to meet the needs of children who present with neurodiversity there is a network of support in place to put support strategies in place. Families can then decide whether to progress to a formal diagnosis or not.

Whole school approaches are being used in tandem with specialist approaches, provided free to schools at the point of access. Previously this was offered at a cost to school, but because of the funding in place, it can now be offered for free to schools.

A structured and consistent resource pack has also been developed. Some schools will provide a robust and secure response, while other schools may not be able to provide such a strong response. A website was provided that will provide the resources to any staff who are supporting children and who may themselves need support to access education.

The aspiration is that rather than training programmes sitting behind a diagnostic threshold, these trainings are now available without a diagnosis, and families can even self-refer. This removes previous challenges that prevented families from accessing support.

The clinical team was quite isolated from the rest of the team previously, which meant they did not have access to all the contextual information that is needed to feed into the diagnostic process. Part of the investment has enabled a multidisciplinary team to be established including a licensed  ...  view the full minutes text for item 124.

To receive a verbal update in respect of recent activities by partners at Healthwatch.

An informal briefing was provided by Lesley Cooper of Healthwatch Rotherham. The briefing provided an update on activities since October. This included two new staff on board and settled into post, two newsletters had been published on the last Friday of each month.

The report on Discharge from Hospital had been circulated and well received locally. There had been only 12 responses from Rotherham on the national survey, but the case studies included had been quite powerful and received recognition from Healthwatch England and the CQC. One of these had even garnered further media attention and subsequent publishing nationally. A response has been promised from the Hospital and policies are being reviewed following the report.

Other projects have moved forward as well. Current work had been undertaken with HARP (Health Access to Refugees Project). Two third-year medical students had spent four weeks with Healthwatch to look at loneliness and obesity, with reports forthcoming on the website. Work continues on visiting in care homes, but with less response than anticipated. Either the problem in Rotherham is not as big as has been raised nationally, or it is not something that people are eager to talk about, so a strategy for that will be looked at to determine how best to proceed. A future report may focus on the vaccination programme for COVID rather than solely on flu. Now that the newsletter is in circulation on a regular basis, intentions for the new year will also be examined after a breather, perhaps with setting up some coffee mornings and Healthwatch Hours to get public engagement as much as possible on a different topic each week.

The Chair announced that the Governance Advisor had offered to circulate the newsletter to Members.

In discussion, Members noted appreciation for the newsletter and the Hospital Discharge Report. It was further observed that previous anecdotal experience of the discharge process seemed quite chaotic and lengthy, and with COVID, delays are understandable, so it would be very interesting to see the response to this report.

The Chair also thanked Lesley for the update and lauded all the work that had been undertaken.

Resolved:-

1.    That the report be noted.

To consider outcomes from the recent workshop held with Partner Organisations on the subject of Mental Health.

A briefing report was provided by the Governance Advisor regarding outcomes from the 13 November Scrutiny Workshop on Rotherham’s response as a place in terms of mental health service provision. Four presentations from the CCG, RDASH, Public Health, and Adult Social Care comprised the workshop, including information on COVID 19, suicide prevention campaign, challenges that have been encountered, and responsive mitigation plans that are in place. These presentations gave a thorough picture of the response to mental health provision in Rotherham.

Resolved:-

1.    That the briefing be noted.

2.    That arts avenues for suicide prevention be explored.

3.    That suicide prevention and self-harm prevention trainings for mental health professionals be prioritised for delivery in response to the mental health implications of COVID-19.

4.    That all partner organisations proactively publicise available resources to support access to mental health services.  

5.     That basic mental health first aid training for suicide awareness and prevention be included as part of the Member Development Programme.

To consider any item(s) which the Chair is of the opinion should be considered as a matter of urgency.

The Chair confirmed there were no items of urgent business for consideration at the meeting.

The next virtual meeting of the Health Select Commission will be held on 4 February 2021, commencing at 2.00 pm. 

The Chair announced that the next virtual meeting of Health Select Commission is on 4 February 2021 commencing at 2:00 pm.