To receive a presentation on the above titled item by Debbie Hartrick, Associate Director- safeguarding, East Berkshire CCG.

Janette Fullwood, Head of Children, Young People’s and Families- East Berkshire CCG gave a presentation on the above titled item. It was noted that the national strategy, Future in Mind, had been published in 2015 which outlined how local services would invest their resources to improve children and young people’s mental health across the “whole system”. It would also eliminate “tiers” within structures, look at early intervention and promote transformational change. East Berkshire’s first local Transformational Plan was published in October 2016 with nine strategic priorities, this had been refreshed in March 2017 and retained the original priorities. It was highlighted that NHS England required all Local Transformation Plans to be refreshed by the end of October 2019. Board Members were told that additional services including online support and community counselling had been rolled out across the patch. PPEP care training had been delivered to all professionals including GPs and teachers. Eating Disorder and Rapid Response were now in place and that the new Anxiety and Depression support tier 2 support via the Andy Clinic ( Reading University) was now on offer. It was noted that survey and focus groups had been set up to encourage children and young people’s participation. The Board were informed that there had been an increase in Tier 4 admissions but that this had slowed down with the reduction in average length of stay.

Current challenges were outlined as follows;

•       A fragmented service offer – children and young people do not always know about the additional support that has been commissioned

•       Unfamiliarity among professional partners and school staff, who are often unaware of the services that exist in each area and how to access them

•       Rising demand on specialist CAMHS (this continued in the first quarter of 2018, with the total number of referrals up by 14.5% compared to the same quarter in 2017)

•       A lack of dedicated mental health roles for early intervention

•       Weak links between targeted services within LAs and specialist mental health services

•       Under-developed parent/carer participation

•       A data-rich but intelligence-poor system with weak transparency of existing data

•       The absence of a coordinated, system-wide approach to workforce development

•       A high number of inappropriate referrals to specialist CAMHS – approximately 50% of East Berkshire referrals fall into this category

•       Collaborative commissioning needs further development

•       Transformation to date has focused heavily on the provision of additional services, as opposed to a system-wide approach

•       A tiered approach to support, which in practice means that children and young people have to fit the services, rather than the services fitting the changing needs of the child or young person

Key areas of change with the refreshed Local Transformational Plan included, four key priority outcomes and enablers with clear information as to how these outcomes would be achieved. Greater alignment with partners’ priorities through links and partnership working would be included in the refresh. There would be a move from consultation to co-production for delivery of the plan with greater multiagency ownership and delivery of the plan through new governance arrangements. There would also be a systematic and suitable approach towards transformation and this would be broader than the additional funds allocation from NHS England. It was noted that there would be four new outcomes and the first outcome was outlined as “ Communities, Schools, families and young people will work together to build resilience, learning from young people themselves, how best to help them cope with life’s ups and downs.” This outcome would be promoted through good mental health and emotional wellbeing to allow young people to thrive and stay positive through the facilitation and development of peer support. The second new outcome- “Children and Young people will have access to early help to meet any emerging emotional and mental health needs”, this would primarily focus on early intervention and to ensure that systems that care for children and young people would be easily accessible and effective for the service user. Outcome three- “ Better communication- we will provide improved and coordinated information about the mental health and wellbeing support available and we will communicate this is in formation effectively to children, young people and families, communities and professionals; this would be addressed through the dissemination of clear information on the services in the locality relating to mental health and wellbeing. The final outcome was outlined as “ improved coordinated care for children and young people with complex mental health needs and vulnerable children and young people- ensuring the right support at the right time in the right place; and it was noted that this would be achieved by providing immediate, round the clock help to children and young people in crisis.

As part of the ongoing work, there would also be strengthened direct governance arrangements for the delivery of the plan with the formation of the new Local Transformation Plan group. The Board were told that Directors of Children’s Services and Public Health leads had nominated representatives for this group and that the voluntary sector were now an active part of the Local Transformation Plan group. Outcomes would be translated from the plan in a tangible local offer and that this would differ in each local authority area based on current provision and emerging needs. The group were currently meeting monthly to ensure that the plan was implemented at the pace needed, it was outlined that the CCG would remain the lead in coordinating the plan but that the delivery overall was in the remit of multiple stakeholders. The CCG would provide dedicated project leads to manage the workload and to ensure that there was strong project management with a focus on implementation. The priority concerns with the implementation of early intervention support would be supported by ongoing work with the nominated local authority leads and children/young people to co-produced a specification of early intervention support with a view to the model being implemented by May 2019.

At the conclusion of the presentation, Members were happy with the signed off plan and were keen to learn work together in regards to the local offer. It was noted that there was a new Mental Health team who were currently working with a cluster of schools and that this would be something likely to be rolled out across the patch as part of the refreshed Local Transformation Plan.