Agenda item

In accordance with Minute No. 65 of the Overview and Scrutiny Management Board, Paul Theaker, Operational Commissioner, Children and Young People’s Service, and Ruth Fletcher-Brown, Public Health Specialist, reported on the current progress of the Scrutiny Review’s twelve recommendations.

A full Scrutiny Review had been carried out by a sub-group of the Health and Improving Lives Select Commissions between September, 2014 and March, 2015. 

NHS England’s Future in Mind Report was published in May 2015 setting out a clear national ambition to transform the design and delivery of a local offer of services for children and young people with mental health needs.  The Rotherham CAMHS Transformation Plan was developed in response to the Report and encompassed all local emotional wellbeing and mental health transformational developments.  The response to the Scrutiny Review was, therefore, aligned to the local CAMHS Transformation Plan and the response to the Scrutiny Review was monitored through the CAMHS Partnership Group as part of the overall plan.

RDASH had been undertaking a whole CAMHS service reconfiguration and would be complete by June, 2016.  The reconfiguration included the establishment of clear treatment pathways, a Single Point of Access and locality workers linked with locality based Early Help and Social Care Teams as well as schools and GPs.

Consideration was given to the Appendix which contained the response to the recommendations.  Discussion ensued with the following issues raised/highlighted:-

-          Part of the Select Commission’s work going forward into the new municipal year could be a deep dive into recommendation 4 (whole school pilot) to ensure it was meeting its target

-          The new Workers were now in place (recommendation 6).  They would be contacting Schools from Friday, 22^nd April and making the links with partners

-          There had been a deterioration in the wait for an appointment.  As of 8^th April, 153 young people were waiting for an appointment into CAMHS (recommendation 8).  The target was 95% of young people seen within 3 weeks – 28% at the moment.  There was now a weekly meeting in place with the Assistant Director of RDASH and was monitored on a weekly basis.  Part of the feedback was in terms of some of the reconfiguration work and staff not being in post but was something that the CCG and the Council were looking at very closely

-          Why had that target not been met?  Was there a particular period in the year?  Any reason why that particular month slipped behind the target?

Not particularly.  There were periods e.g. end of school term when a number of referrals came through from schools.  The information received was that it was primarily down to the Service reconfiguration not being in place.  They had employed agency workers until September so even though all staff would be in post, there would be the additional agency workers to deal with the backlog

-          Was there a duplication in cost?  What kind of costs were we talking about?  Once the new staff were embedded the Commission would like to see some figures.  The Commission would be concerned if the desired outcomes were not achieved after the extra finance

There was additional cost in terms of agency workers between now and September.  The Service was commissioned by the CCG so the cost was not known but could be requested and further scrutiny would be welcomed.  The whole structure would be filled by June so the number was expected to reduce

-          Officers were requested to check the communication regarding the reconfiguration - was there any feedback to the Commission concerning the number of new posts which were being put into place through the restructure and the timescale against the Service RDASH was committed to provide?  Was the Commission made aware that there may be slippage in Service because of the reconfiguration against the delivery aligned with the cost?

-          How valid were the dates in recommendation 9?  Should there be new dates given the restructure would not be complete until June 2016? 

The restructure of RDASH had had an impact and that had been one of the factors in not meeting certain deadlines.  Advice would be appreciated as to whether the Commission would wish the dates to be revised

-          One of the things that had become apparent from the meeting with the Youth Cabinet was the regularity of involvement.  Would it possible for there to be regular input from the Youth Cabinet concerning the website?  It would help if the young people had greater ownership because they would have on the spot information to feed in whereas if it went into CAHMS there were a lot of people it had to go through before inclusion on the website (recommendation 10)

-          Could you tell me how seriously they have listened to GPs’ concerns?

In terms of the CCG, it was the GP Leads in terms of commissioning.  There was a lead GP around Children’s Mental Health.  A number of the issues that the Council had had with regard to access to CAMHS, young people not meeting thresholds, the bounce back etc. had been echoed by the GPs

-          Were the routine assessments carried out face-to-face in a clinic situation or were they carried out over the telephone?

It was one-to-one with the young person

-          Three pathways – can you just reassure us that the three will meet up together at the end?  I think it is key that it does happen.

Yes

-          This is an area of work of service that had been difficult over a long period of time nationally and I just wondered from your perspective what do you think are going to be the barriers in achieving the progress we would like to achieve and was there anything you think that the Council could or should be doing to try and take things forward more effectively than perhaps done in the past?

From a Public Health point of view a priority would be the Early Intervention and Prevention Work and really investing to save by prioritising some of that work.  The Future in Mind document that came out last year had a really strong focus on Early Intervention and Prevention and was looking at the transformation of CAMHS services across the board.  Quite often, when thinking about the CAMHS Service, you only thought about the provision by RDASH when in actual fact everyone who had contact with children and young people had a role in terms promoting emotional health and mental wellbeing.  When the local transformation plan was signed off Councillor Roche had been very keen that early intervention and prevention was a strong theme and there had been a disappointment within the Council that some of the money was not recurrent funding for prevention.  This was something that would continue to be raised with the CCG

-          Locality work and model – would this include links to School Nurses?

As part of the CAMHS partnership work there was representation from School Nursing.  In terms of linking with the locality workers, School Nurses and other partners, there were a series of meetings currently taking place to look at the issue and how they would link together with schools and other services

-          Was June too early to evaluate the benefits of the locality working model?

Yes it was too early for a full evaluation but the Council was very conscious that it needed to keep on top of the locality work and model in terms of its development and the contacts being made with schools etc. 

-          For workstreams such as the Family Support Service and the community approach how would the Council manage those against prevention and early intervention?

In terms of the whole community approach, that was linked in with the schools to include that.  A group consisting of schools and Officers would go out quarterly to monitor action plans as well as speaking to the community groups or partnerships the schools were working with

Councillor Roche commented that there would shortly be a requirement for local authorities to report their annual spend on Mental Health as a discrete budget heading. 

He also raised concerns regarding Head Teachers’ involvement in the ongoing suicide prevention work. 

Paul and Ruth were thanked for their attendance and presentation.

The report was noted.