Agenda item

Briefing Note of the Executive Director of People

The following representatives have been invited to the meeting for the consideration of this item along with Councillor Ruane, Cabinet Member for Children and People and Councillor Mal Mutton, Chair of the Education and Children’s Services Scrutiny Board (2):

Simon Collings, Specialist Commissioning Team, NHS England

Simon Gilby, Coventry and Warwickshire Partnership Trust

Matt Gilks, Coventry and Rugby CCG

Andrea Green, Coventry and Rugby and Warwickshire North CCGs

Paul Green, Lyng Hall School

The Board considered a briefing note of the Executive Director of People concerning the Child and Adolescent Mental Health (CAMHS) Transformation Agenda. The note provided an overview of CAMHS system performance and any barriers to performance; an update on progress towards achieving the Transformation Plan and how the Plan would address barriers to performance and any service gaps; and an update on commissioning decisions. Councillor Ruane, Cabinet Member for Children and Young People and Councillor Mal Mutton, Chair of the Education and Children’s Services Scrutiny Board (2) attended the meeting for the consideration of this item. Matt Gilks, Andrea Green and Glynis Washington, Coventry and Rugby Clinical Commissioning Group (CCG), Simon Gilby, Asif Atta, Barry Day, Jed Francique, Anita Morgan, Jo Morris, Donna Reeves and Josie Spencer, Coventry and Warwickshire Partnership Trust (CWPT), Simon Collings, NHS England and Paul Green, Head Teacher, Lyng Hall Secondary School were also in attendance.

The note indicated that the CAMHS Transformation Plan related to system-wide change across tiers 1-3.  The initial six months of the five-year plan had focused on addressing some of the fundamental legacy challenges relating to capacity and demand, faced by similar services across the country.  Performance in relation to initial referral to treatment was within the expected range across all services, and while specialist CAMHS (tier 3) follow-up waiting times had been a specific challenge, this had improved.

The Board were informed that there was high demand for autistic spectrum disorder assessments (ASD) compared to other localities and this remained a challenge, even though additional funding had been released. The complexities of need young people were presenting with to targeted tier 2 services such as Reach was also a significant challenge. Recognising that these challenges were not within the gift of a single agency to resolve, the Transformation Board had been strengthened. A Coventry commissioner’s sub-group of the CAMHS Transformation Board had been convened and was meeting on a monthly basis to provide further scrutiny of the progress towards transforming CAMHS across Coventry and to oversee the work programme developed to drive significant transformation change in the next two quarters. A key focus would be on early intervention in schools, revising the ASD pathway and associated partnership arrangements to deliver reduced waiting times and implementing improved support for vulnerable young people including Looked After Children (LAC).

The Board noted that Coventry and Warwickshire Partnership NHS Trust (CWPT) recently received an overall rating of ‘good’ for specialist community mental health services for young people. In July 2016, Coventry and Rugby CCG (CRCCG) Governing Body made a decision for Coventry, to continue to support the delivery of the CAMHS Transformation Plan with a further review in six months’ time. 

Paul Green, Lyng Hall School provided an update of the transformation agenda from a school’s perspective, indicating the main issue had been the significant waiting times but this situation was improving. He expressed strong support for the new focus on early intervention works in schools highlighting that schools were keen to engage in this process.

Paul Collins, NHS England informed of the current position relating to Tier 4 care where children required admission and to the pressures on beds where capacity was very tight across the country. Currently all inpatient beds in the West Midlands area were being used. An update was provided on how improvements were being made to the system to enable children to receive care which allowing them to remain close to their family home. The Board were provided with an understanding of the financial situation. The importance of stability for the child was emphasised.

The Board questioned the representatives and officers present on a number of issues and responses were provided, matters raised included:

·  Concerns about what happened to the patient at the transition stage from childhood to adulthood.

·  Continuing concerns about waiting times for assessment and treatment

·  Why were the percentage figures for autism so high in Coventry and was there a danger of over referral

·  At what age could a child be diagnosed with autism

·  Further information about the proposals for the early intervention work in schools and how could progress be monitored

·  Details about the new Adults ASD service

·  The support provided for Looked After Children

·  What was being done to allow better access to CAMHS for children on child protection plans and children in need

·  Information about the early years support for speech and language development

·  Concerns about children being placed in beds outside of Coventry

·  Concerns that delays in tier 4 provision would have an impact on the tier 3 service.

RESOLVED that:

(1) The performance of the current services and the challenges faced, including all the progress outlined, be noted.

(2) The 2016/17 work programme for transforming services be noted.

(3) An update report on progress be submitted to a future meeting of the Board in six months.

(4) A briefing note be circulated to Members and to the Education and Children’s Services Scrutiny Board (2) providing an update on the proposals for working with patients during the transition period from childhood to adulthood.

(5) An update report on the new Adults ASD service be submitted to a future meeting.

(6) A briefing note be submitted to members providing additional information on the early prevention work in schools, in particular the enhanced primary mental health offer for the 2016/17 academic year, including how progress could be monitored.

(7) The Transformation Board be asked to consider how better access to the CAMHS service could be provided for children on child protection plans and children in need, including looking at the issue of data sharing between partners.