Agenda item

Consideration was given to a report presented by Councillor Sansome, Chair of the Review Group, which set out the findings and recommendations of the above Scrutiny Review.

The 7 main aims of the Review had been:-

·                Understand the prevalence and impact of mental health problems and illness amongst children and young people in Rotherham

·                Understand the costs, value for money and quality of current services

·                Clarify how partners work together to support children and young people across all the tiers, especially the role of the RDaSH Duty Team

·                Establish how RDaSH engages with Service users and their families/carers in order to deliver appropriate and effective services

·                Ascertain how identifying and responding to child sexual exploitation is integrated within RDaSH Child and Adolescent Mental Health Services provision

·                Determine how effective support for the mental health and emotional wellbeing of Looked After and Adopted Children is provided

·                Identify any areas for improvement in current Service provision and support

A full scrutiny review was carried out by the Health and Improving Lives Select Commissions with evidence gathering beginning in September, 2014, and concluding in February, 2014.  It had been comprised of round table discussions and written evidence from health partners, RMBC officers, the Youth Cabinet and desktop research. 

Although the principal focus of the review had been RDaSH CAMHS, the Services were not provided in isolation and were part of a complex system of Service commissioning and provision.  The new Emotional Health and Wellbeing Strategy and recent changes to RDaSH CAMHS were positive with a more flexible service across a range of community settings and greater links to Youth Services and school a priority to be progressed further.  The volume of referrals to RDaSH was high and, although waiting times had been reduced for routine assessment, the target was still being exceeded with the Service likely to continue to face high demand.

Improved communication between agencies and with families, clear access criteria, referral and care pathways and renewed attention on health promotion, self-help and early support would help to reduce the number of young people with deteriorating mental health and emotional wellbeing.  Data quality remained an issue and greater attention should be paid to improving and measuring outcomes.  Prevention and early intervention should remain a focus to try and reduce the number of young people needing support at higher levels or continuing into adulthood given the emergence of many lifelong conditions during adolescence.

The review had made 12 recommendations:-

1.    Once the national refresh of prevalence rates of mental disorder is published, RMBC and the Rotherham Clinical Commissioning Group should review the local Analysis of Need: Emotional Wellbeing and Mental Health for Children and Young People and the Mental Health Services commissioned and provided in Rotherham across Tiers 1-3.

2.    Through the CAMHS Strategy and Partnership Group service commissioners and providers should work towards improved and standardised data collection and information sharing on the Service users and patients:

       a.  to help maintain a detailed local profile of C&YP’s mental health over time

       b.  to inform the development of local outcome measures for C&YP individually and with regard to reducing health inequalities in Rotherham.

3.    RDaSH training and awareness raising with partner agencies and schools should include a focus on improving the quality of information provided in referrals to RDaSH CAMHS Duty Team to reduce delays in making an assessment.

4.    CAMHS Strategy and Partnership Group is asked to consider if there is a need to develop a protocol for transition/step up/step down between providers in Tier 3 and providers in Tier 2 to supplement the planned pathways and protocols.

5.    Following the work to build links between RDaSH CAMHS and GPs locality work should now be rolled out by RDaSH into schools, youth centres and other community settings as a priority.

6.    “Investigate the options to provide more robust services at an early stage, both in lower tiers and at an early age, to ensure that patients are prevented from moving into higher (and more expensive) tiers”

       Prevention and early intervention is a clear commitment in plans at strategic level so the CAMHS Strategy and Partnership Group should clarify how this will be delivered through clear resources and outcome focused actions that are closely monitored.

7.    The target waiting time from referral for routine assessments by RDaSH CAMHS should remain at three weeks for 2015-16 and then be reviewed in the light of the impact of the recent positive changes introduced by the service and the delivery of the Emotional Wellbeing and Mental health Strategy for Children and Young People.

8.    RDaSH should review and evaluate the recent changes made to the CAMHS Duty Team to identify successes and any areas for further improvement by September 2015.

9.    CAMHS Strategy and Partnership Group should ensure the new Mental Health and Wellbeing website meets accessibility standards and incorporates a user feedback mechanism and measurement of the number of “web hits” received.

10.  In its leadership role with schools, RMBC should ensure schools link in with partner agencies to discharge their wider duties and responsibilities towards C&YP’s emotional wellbeing and mental health.

11.  RDaSH should continue to work in partnership with Rotherham Youth Cabinet on Service improvements and are asked to submit a progress report on the changes as a result of this work to the Health Select Commission in September, 2015.

12.  RDaSH and Rotherham Clinical Commissioning Group should continue to work together in 2015 on developing a clearer breakdown of costs and on the definitions of treatment to inform future outcome measures.

The Review Group and Scrutiny Officer were thanked for their work on this issue.

It was suggested that:-

-               recommendation 2a include reference to the Joint Strategic Needs Assessment and to be amended to “local data profile”

-               recommendations 3 and 10 follow on consecutively

Resolved:-  (1)  That the findings and recommendations of the report be endorsed.

(2)  That the report, as amended above, be forwarded to the Overview and Scrutiny Management Board for consideration.

(3)  That the Youth Cabinet be thanked for their contributions to the Scrutiny Review.