To receive an update report in respect of Child and Adolescent Mental Health Services (CAMHS).
Consideration was given to an update report on Rotherham Child and Adolescent Mental Health (CAMHS) – Annual Update to Health Select Commission which provided a further update regarding the Local Area SEND inspection in association with children and young people’s mental health, the impact of the Covid-19 pandemic on children and young people’s mental health, and on progress in relation to implementing the re-designed neuro-developmental pathway and phase 3 of the SEND sufficiency strategy.
In discussion, clarification was requested around digital services Kooth and Healios. The response from partners indicated the differences in Kooth as an anonymous online platform for low-level signposting and advice versus Healios which is an assessment-focused pathway to assistance for young people with ADHD and Autism. There are robust criteria whereby not all children can be referred through Healios, but if cases are complex or involve safeguarding issues, these cases stay within CAMHS.
Members expressed interest in the investments that had been made recently in the service to attempt to manage caseloads and waiting lists. The response from officers, the Cabinet Member, and partners identified the plans that had been in place before the pandemic to whittle down the waitlist whilst keeping up with current demand for assessments. The pandemic had resulted in an increase in demand, so the waitlist had not been growing but had not diminished in the timeframe planned. More resource had been worked into the system, but as for specific numbers, these could not be shared in the meeting. A new referral pathway had been designed based on the current numbers and rates whereby the waiting list could again be eradicated, in part by reducing the number of inappropriate referrals. The Cabinet Member noted the use of Containment Outbreak Management Funds in the service of CAMHS, although the cases of Tier 4 mental health issues are funded centrally by what has been formerly known as Public Health England rather than from place funds.
Members requested clarification as to whether these pathways were the primary pathways for CSE survivors. The response from partners identified that for CSE survivors, specific, diverse consultation methods and advice models were in use, and trainings and advice were provided in respect of CSE. The Cabinet Member also noted in respect of reviewing the effectiveness of the pathway redesign, that the Rotherham Parent Carer Forum is consulted on a regular basis and was involved the recent SEND inspection. The Cabinet Member stressed the importance of multiple partnership working for maximum effectiveness.
Members also sought assurances that the service had been able to recruit and retain the sufficient staff with the right skills to meet the need. Partners provided details around recent successful recruitment campaigns and workforce strategy which sought to retain trainees, psychologists, and social workers. When occasionally there were pressures and shortages, these were often in respect of the neurodevelopmental pathway, and periods of challenges in recruiting did sometimes occur.
Clarification was requested around average waiting times for assessments versus the target wait time. The response from partners noted that the previous wait time for assessment was 3.5 years. Under the redesigned referral pathway, the average wait time was 18 weeks. It was noted that for some children the diagnosis is important, but for many the importance is in the child’s receiving the support they need to achieve their potential.
Members requested clarification around the referrals through schools and education. The response in schools had not been consistent. Some schools have robust support while others do not, and this varies based on the individual resource capacity of that school. Officers noted that not all parents and carers are aware of the support that is available. Work had been undertaken with parents, carers and in schools and with members of the voluntary sector to ensure that the available support provision was appropriate. The Cabinet Member noted that the challenge seems to have been in accessing the local support offer rather than in the content of the local support offer.
Members requested further information around the crisis provision from an operational standpoint. The response from partners provided details around timing and staffing provision for crisis response and supplied narrative around crisis pathway workflows and the handling of queries in real time.
Members requested additional information around timelines for next steps identified in the report. The response from officers and the Cabinet Member offered to elaborate on each of these in a subsequent update and would share the upcoming NHS England action plan.
Members requested further details around attendance at appointments. The response from partners identified the Did Not Attend rate at a very low 4%, partly due to the implementation of text messaging reminders.
Further assurances were requested around the response to increasing cases of eating disorders. Partners noted the dramatic increase in eating disorders in the last two years. The support had been working, and the position had greatly improved in respect of eating disorder patients, with no cases currently in the hospital. It had been observed that the cases had high acuity and were more severe than were being seen before the pandemic.
The Cabinet Member further emphasised the need to understand the growing prevalence of mental health issues among children and young people in order to prevent this. Behind each case is a child and a family who are seeking help. With exam pressures, social media, and worries about climate change affecting more young people’s mental health, the importance of trailblazing mental health support in schools is growing. If children can be supported early on when they are starting to experience a mental health problem and are not labelled, this can go a long way to help prevent a serious issue in the longer term.
1. That the report be noted.
2. That the next update be presented in 12 months’ time to include projected timelines for all next steps.
3. That a briefing describing timelines for the next steps identified in section 2.2.6 of the report be provided to Members and that the “You Said, We Did” document also be circulated to Members when available.