To receive Report No. 33/2019 from Mark Roberts, Assistant Director, and Paul Williams, Head of Service, Leicestershire Partnership NHS Trust, Families, Young People and Childrens Directorate.

Report No.33/2019 was received from Mark Roberts, Assistant Director and Paul Williams, Head of Service, Leicestershire Partnership NHS Trust, Families, Young People and Children’s Directorate.

The purpose of the report was to detail the current waiting times for children and young people living in Rutland to access Leicestershire Partnership NHS Trusts Child and Adolescent Mental Health Service (CAMHS). It also described the work by the organisation to improve the timeliness of access to services and to manage the risks to children and young people whilst they were waiting. Finally the report provided an update on progress to commission a new CAMHS Inpatient Unit.

During discussion the following points were noted:

·         Members applauded the honesty of the report but found it difficult to understand why the longest a Rutland child was waiting without a scheduled appointment for treatment was 58 weeks. CAMHS officers recognised that it was an unacceptable waiting time but had had to prioritise the children most at risk which had resulted in some children waiting too long. Within the resources that CAMHS had access to, officers felt that they were making the right decisions to safeguard children. Unfortunately, the drive a year ago to reduce waiting and assessment times and for children to enter the service had meant that the cohort that was driven through was now backing up in the system.

·         An analysis of capacity demand had been undertaken which showed that with current resources the service would be able to very slowly reduce waiting times but not at an acceptable rate. In order to reduce waiting times by 75%, additional funding of £900 000 to £1m would be needed. Maintaining this acceptable level would be difficult as the level of unmet need was significant and so how many children would come forward was unknown.

·         CAMHS would be seeking commitment from colleagues to reduce waiting times to this level and this would necessitate finding clinicians, the space to do this and the funding to hold that position. They would also stress the need for a corresponding increase in funding if there was an increase in demand.

·         Most of the children who attended A&E as a consequence, or suspected consequence, of their mental health did so because of self-harm. The behaviours behind self-harm were complex and could not be fixed quickly but the likelihood of going to A & E was greatly reduced because the service was prioritising those at greatest risk.

·         CAMHS officers offered to supply Members with a written response as to why there had been an increase over the last year in the number of Rutland children and young people on a waiting list for treatment, as the figures for the number of referrals did not detail why there was a fluctuation.

·         Funding levels for CAMHS services were on an equal footing, per capita, across all of the areas that were served.

·         Currently, there was not a CAMHS social media presence which could be used to chat or connect directly with young people. NHS apps were available and Public Health had the ‘Chathealth’ service which gave parents and children direct access to a member of the Public Health team who could then pass details on to the Mental Health team. Going forward, the use of social media would need to be considered as part of the CAMHS offer.

·         There had been recent media coverage on the destructive effects of certain websites and whilst CAMHS could not prevent young people from accessing these damaging sites they could put some context around them, for example with eating disorders young people were asked to consider and discuss what motivated them to look at the sites.

·         Officers agreed that it was a fair assessment that there were a number of school children who needed help but who did not meet CAMHS thresholds. Members commented that the school nursing service was unable to help in these instances as it was limited to what it could do by contract.

·         The traffic light system at appendix A needed to be better explained using plain English

·         A recent news story had highlighted that a child who was seen as a relatively low risk had actually been at greater risk of suicide because of the mental health issues of the parents. RCC officers had been working through the CAMHS Improvement Board to develop improved information sharing between services to hopefully prevent this type of incident.

RESOLVED:

The Panel;

1.    NOTED the comprehensive service offer available to local children and young people.

2.    NOTED the challenges faced in providing timely access to some areas of CAMHS Service and requested a further progress report.

3.    NOTED the progress made through the CAMHS Improvement Programme and further actions planned.

4.    NOTED the progress towards the commissioning of a new CAMHS Inpatient Unit.