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Agenda and minutes

Agenda and minutes

Venue: Meeting Room G.01, Ground Floor, City Hall, 115 Charles Street, Leicester, LE1 1FZ

Contact: Graham Carey, Tel 0116 4546356 or Internal 376356 

Items
No. Item

105.

WELCOME AND APOLOGIES FOR ABSENCE

Minutes:

The Chair welcomed everyone to the meeting.

 

The Chair also referred to the recent announcement by NHS England that they were going to continue to commission Children’s Congenital Heart Disease Services from UHL NHS Trust.  The Chair congratulated everyone that had been involved in the campaign over the previous 2 years.  He felt that the campaign to retain the services at Glenfield had been well managed and conducted in a convivial manner.  He paid tribute to the staff at UHL who had been involved for their professionalism during the campaign under very difficult circumstances.

 

Apologies for absence were received from:-

 

John Adler                                Chief Executive, University Hospitals of                     Leicester NHS Trust

 

Lord Willy Bach                        Leicester, Leicestershire and Rutland, Police and Crime Commissioner

 

Andrew Brodie                         Assistant Chief Fire Officer, Leicestershire Fire and Rescue Service

 

Councillor Vi Dempster          Assistant City Mayor, Adult Social Care and Wellbeing

 

Professor Azhar Farooqi        Co-Chair, Leicester City Clinical, Commissioning    Group

 

Will Legge                                Divisional Director, East Midlands Ambulance           Service

 

Roz Lindridge                           Locality Director Central NHS England, Midlands    and East (Central England)

 

Dr Peter Miller                           Chief Executive, Leicestershire Partnership              Trust

 

Dr Avi Prasad                           Co-Chair, Leicester City Clinical Commissioning

                                                    Group

 

Toby Sanders                           Senior Responsible Officer, Better Care Together Programme

 

Ruth Tennant                           Director of Public Health, Leicester City Council

 

106.

DECLARATIONS OF INTEREST

Members are asked to declare any interests they may have in the business to be discussed at the meeting.

 

Minutes:

Members were asked to declare any interests they might have in the business to be discussed at the meeting.  No such declarations were made.

107.

MINUTES OF THE PREVIOUS MEETING pdf icon PDF 118 KB

The Minutes of the previous meeting of the Board held on 9 October 2917 are attached and the Board is asked to confirm them as a correct record.

Minutes:

RESOLVED:

 

That the Minutes of the previous meeting of the Board held on 9 October 2917 be approved as a correct record.

108.

HOW WILL YOU HEAR ME pdf icon PDF 166 KB

To receive a presentation from Bernadette Kileen, Youth Development Worker on the recent Safeguarding Summit on the Emotional Health and Wellbeing of the City’s pupils.  A short video will also be played.

Minutes:

The Board received a presentation from Bernadette Killeen, Youth Development Worker on the recent Safeguarding Summit on the Emotional Health and Wellbeing of the City’s pupils.  A short video from a series of videos made by the Young Peoples Council called ‘How You Hear Me’ highlighting depression in young people was played at the meeting.

 

It was noted that:-

 

  • How You Hear Me was a participation development tool for professionals which had been developed with the Young Peoples’ Council.
  • It was a collection of 15 short films of young people’s experiences of being heard, or not heard, within different service themes.
  • It had been developed as a resource of around 20 hours of training for staff in organisations to explore their participation practices, explore definitions, develop strategies, and evidence outcomes of participation.
  • It started from a conversation with young people about the inconsistencies of the services they received from different personnel across all service streams.
  • The project started from the premise that if you find new ways to hear, you hear new things.  It challenged professionals, particularly at front line level, to raise the standard of how they evidence and articulate the differences they were making to a child and the family’s life; and, equally, how a child and the family could articulate the difference the professional had made to their life. 
  • The resource had been around for approximately 18 months and had recently won a British Young Council National Innovation Award, and the Young People’s Council were extremely proud of this project

 

The Board were then shown one of the video’s which told the story of a young person experiencing depression as a result of a family member suffering life threating injuries.  It was felt that the video portrayed a powerful story about the young person’s ability to cope and also not cope with the situation he faced.  It demonstrated the resilience of young people to cope with stressful situations, when often their coping strategy becomes depleted and also their ability to articulate that to a system that are working to help them.

 

The Board also received feedback on a recent Safeguarding Summit held on the City which had been commissioned by the Leicester Safeguarding Children’s Board. (LSCB)

 

It was noted that:-

 

  • LSCB had their own Board with young advisors and a number of partners had worked together, including the Young People’s Council, to agree a theme around emotional health and wellbeing in city’s pupils and what was happening to support their health and wellbeing.
  • It had also been linked into the ‘Time to Change’ message with a view to extending the campaign to young people.  There had been partnership working to produce posters, a resources kit and pledge cards.  The posters had used the statistics from the latest health and wellbeing survey in relation to the city.
  • The event had been open to primary and secondary schools in city and 15 schools had attended, with pupils aged from 7-16 years old.
  • The event had not been  ...  view the full minutes text for item 108.

109.

THEMED SESSION ON CHILDREN'S MENTAL HEALTH

The Board will consider the following as part of a Themed Session on Children’s Mental Health:-

109a

INTRODUCTION

Dr Joe Dawson, Head of Service SEN and Disabilities/Principal Psychologist, Leicester City Council to introduce children’s health and wellbeing in the City and outline some of the key challenges.

Minutes:

Dr Joe Dawson, Head of Service SEN and Disabilities/Principal Psychologist, Leicester City Council gave a general introduction on children’s health and wellbeing in the City and outlined some of the key challenges.

 

As general background, Dr Dawson commented that:-

 

  • Approximately 10% of school age children would require some form of professional support for mental health issues, and they were more likely to be boys rather than girls and be aged 11-15 years old than 5 -10 year olds.
  • There were a range of known environmental factors that could impact upon mental health, including housing and social deprivation.  There was a significant association between poor mental health and educational outcomes, which then often led to poor attendance and poor life outcomes. These could then be exacerbated into a cycle of entrapment.
  • Mental health had impacts upon life changes and these could lead to criminality and a whole host of resource heavy behaviours which often resulted in poor life experiences of people.
  • There was a clear understanding by those involved that this needed to be addressed for both the individual concerned and for the effective use of resources.
  • 50% of looked after children were likely to have clinically diagnosed mental health disorders; which is significant and needed to be taken seriously.
  • The risks and protective factors for children young people and their families had long been documented by the Audit Commission and the Mental Health Foundation, and, whilst these factors were well known, the real issues were about the need to put into practice something that recognises those risks and resilience factors and deals with them in the best interest of the children and young people.
  • There was a focus on children and young people but some of the processes within the system could often cloud the vision of what was being done and could stop the system having a clear overview of what it was delivering as a whole.
  • Language could also be a barrier both within the system and accessing it as there was a range of different terms used such as mental illness, mental health, emotional wellbeing and psychological wellbeing etc.  This was both a barrier to people in understanding what professionals were talking about and sometimes it was used by professionals to keep people out of the system and by others to reinforce the perception of needing to involve a specialist and to transfer the responsibility of care to others.  This delineation was often encouraged as a consequence of the referral process.  There was a view that the language used was jargon laden, which could became impenetrable to some trying to access different parts of the system.
  • Different agencies also had different targets and these could be competing with and, sometimes working against, other local authority, health, criminal justice and voluntary sector agencies’ targets.
  • Budget pressures could also impact on services as reducing preventative protective measures were often the first services to be withdrawn as part of budget cuts, but this could result in increased pressures for specialist  ...  view the full minutes text for item 109a

109b

SPECIALIST CHILD AND ADOLESCENT MENTAL HEALTH SERVICES (CAMHS) pdf icon PDF 1 MB

Mark Roberts, Associate Director of Children's Services, Leicestershire Partnership NHS Trust to give a presentation on Specialist Child and Adolescent Mental Health Services (CAMHS).

Minutes:

Mark Roberts, Associate Director of Children's Services, Leicestershire Partnership NHS Trust gave a presentation on Specialist Child and Adolescent Mental Health Services (CAMHS); a copy of which had been circulated with the agenda.

 

It was noted that:-

 

  • The Associate Director had recently taken over responsibility for CAMHS and it had moved as a service from a social to a medical model.
  • The service employed 100 staff serving population of approximately 250,000 children and young people.  There were currently 50 young people in the in-patient care unit at Ashby de la Zouch.
  • Teams within the service included Primary Health, Crisis Home Treatment, Outpatients, Young Peoples, Learning Disability, Eating Disorders, Paediatric Psychology and Inpatients.
  • CAMHS was in a directorate within LPT which was 10 times the size of the CAMHS team and had every element of service that has a direct interest in children’s emotional health and wellbeing beyond the specialist CAMHS service.  This had presented some challenges of co-ordination and the service had responded by developing a place based service co-ordination care navigation system to help improve access to the service.  
  • There had been new investment in Crisis Home Treatment and Eating Disorders Teams and to expand the Inpatients Unit.
  • A Triage Hub had been established to place children in the right place at the right time through the referral process.
  • Work continued to improve resilience and early intervention.
  • Efficiency savings had been outstripped by a 20% increase in referrals.  The numbers currently waiting had increased; partly as result of improving access to the system.  It was felt that the waiting times could be better assessed in six months as the current number of referrals moved through the system.  The details of these waiting times were summarised in the presentation.
  • There was active management of risks for those that were waiting for treatment.  Each individual’s risks were assessed, monitored and reviewed every 3 months through a comprehensive RAG rating.
  • The service had made positive progress since the CQC Inspection and was now moving from ‘Recovery’ status to an ‘Improving Service’.  Resources were being allocated for next year to take this work further forward.
  • The demands on the service and its performance were summarised in the presentation.  It was thought that the increase in demands for the service in June could be attributed to children taking exams.  The service was now achieving 95% performance on the 13 week access wait target and no-one was waiting over 12 months, which was a reduction of over 100 patients who were waiting up 2 years in March 2017.
  • The increase in referrals was somewhat unwelcomed at a time when resources were under pressure and it also increased pressures on staff within the service.  The increase in referrals was, in part, attributed to the increased awareness of service.   The service cost £1m more than the current budget; partly due to the ward and outpatient patient system and the pressure to engage locum specialists, which was acknowledged as an expensive way in meeting needs of children.  It  ...  view the full minutes text for item 109b

109c

UNIVERSAL SUPPORT FOR CHILDREN AND YOUNG PEOPLE pdf icon PDF 846 KB

To receive a presentation from Claire Mills, Public Health Lead Commissioner, Leicester City Council, on “Healthy Together: universal school age offer.”

Minutes:

Claire Mills, Public Health Lead Commissioner, Leicester City Council, Sarah Fenwick, Senior Group Manager, FYPC, Leicestershire Partnership Trust and Catherine Yeomanson, Lead Practice Teacher, School Nursing, Leicestershire Partnership Trust gave a presentation on “Healthy Together: universal school age offer.”  A copy of the presentation had been circulated with the agenda.

 

It was noted that:-

 

·         The local Healthy Child Programme universal offer for 0-19 year olds in the city, commissioned by the Council and provided by the Leicestershire Partnership Trust, represented £33.5 m investment over for 4 years.

·         There were approximately 5,000 new births in city and public health nurses were involved in various aspects of care for 0-19 year olds.

·         The programme provided a universal service that used a range of public health tools to respond swiftly and appropriately to need, in order to promote resilience and maximise the health and wellbeing of children, young people and families in Leicester.  

·         Assessments were made an early stage following a referral to determine the impact on a child and the whole family.  Emotional health was at the centre of the service and those using the service were reviewed at regular intervals.

·         There had been a number of public health campaigns and the service also offered an interactive phone service, a website for teenagers to chat about issues affecting them (including a parents section) and virtual clinics.  There were strong governance and safeguarding arrangements in place to protect users from harm.

·         A new crisis team had provided support for young people without them need to visit their GP or attend A&E.  The service was underpinned by safeguarding arrangements and supported by a good evidence base.

·         The Assessment Framework training for 0-19 staff had been reconfigured to strengthen supporting young vulnerable people and parents.

·         The emotional health pathway had a robust risk assessment embedded into the framework, which every practitioner has to complete.  There was also an assessment of how people were using the screening tools to see if practitioners made a difference and this would hard evidence would be used to see if more specialist resources were required.

 

Members commented that:-

 

  • There was no reference to the criminal justice system in the presentation. 
  • Chief Supt. Lee commented that the triage car working with health colleagues had been a success in dealing with people with mental health issues. There was also a small team of Police Officers looking at longer term issues in working with health colleagues, Police Neighbourhood teams also went into schools and they had some specialist officers that could link into the service.  Chief Supt. Lee undertook to discuss this with the officers after the meeting.
  • It was recognised that the youth offending and probation teams could be better aligned so that they could be better engaged.  This had been recognised in the commissioning of the service and there was now a link with youth offending officers.

 

Following a question from the Chair in relation to parity of esteem in children’s services across mental and physical health, it  ...  view the full minutes text for item 109c

109d

FUTURE IN MIND pdf icon PDF 1 MB

Chris West, Director of Nursing and Quality West Leicestershire and East Leicestershire and Rutland Clinical Commissioning Groups, and Elaine Egan Morris, CAMHS Manager/Future in Mind Transformation Programme Manager, to make a presentation on Transforming Mental Health  and Wellbeing Services for Children and Young People Across Leicester, Leicestershire and Rutland.

Minutes:

Chris West, Director of Nursing and Quality West Leicestershire and East Leicestershire and Rutland Clinical Commissioning Groups, and Elaine Egan Morris, CAMHS Manager/Future in Mind Transformation Programme Manager, gave a presentation on Transforming Mental Health and Wellbeing Services for Children and Young People across Leicester, Leicestershire and Rutland.  A copy of the presentation had been circulated with the agenda.

 

It was noted that:-

 

  • Future In Mind was aimed at transforming children and young people’s mental health services, over five years through ‘Promoting, Protecting and Improving our Children and Young Peoples Emotional Health and Wellbeing’.

 

  • The local aims were to:-
    • Develop in partnership with children and young people. Children and Young People and key stakeholders.
    • Set out a multi-agency approach to improve mental health and wellbeing in Children and Young People.
    • Aim to address gaps in current service provision.

 

  • The planned outcomes were:-
    • Increased prevention and building resilience in Children and Young People and reduce attendance at A&E.
    • Improve timely access to assessment.
    • Increase staff numbers and improve the skill mix.
    • Improve access to evidence based practice.

 

  • Feedback from the initial engagement events with children and young people identified six schemes of work that the plan should deliver.  These were:-
    • Vanguard – Place of Safety Emergency Department
    • Building Resilience
    • Early Help
    • Eating Disorders
    • Access to CAMHS
    • Crisis and Home Treatment

 

  • The next steps were to:-
    • Share with partners the 2017 Transformation Plan which had gone out to consultation and included the key lines of enquiries and also addressed a number of local issues.
    • Publish the final version on the agency website.
    • Review the role and responsibility of key partners and steering group.

 

  • The multi-agency approach now involved health, local authority and voluntary sector staff in delivering services.  This had been developed during the Transformation Plan with additional funds being provided for early intervention services for ADHD.  Relate had been engaged to provide 1:1 sessions as part of the early intervention needs for children.  Schools now had the ability to directly refer children for ADHD assessments.  Additional resources had been provided for ADOS assessments for autistic autism and 1 practice had been able to see over 60 children in a 7 week period and this was contributing significantly to reducing the waiting list for assessments.

  

  • The collaborative working in delivering the new common model was considered a significant success but there was still more to do.  The benefits of having a common model with everyone using the same language and having a single front door of access was also considered important.

 

The Deputy City Mayor for Children, Young People and Schools recognised that the initiative was for Leicester, Leicestershire and Rutland, but sought assurances that children and young people in the City would be able to actively participate in the evaluation and development of the service.  In response, the CAMHS Manager/Future in Mind Transformation Programme Manager stated that young people in the City had been involved in the engagement process. 

 

The Youth Development Worker commented that whilst Young People’s Council and  ...  view the full minutes text for item 109d

109e

DISCUSSION AND NEXT STEPS

The Chair to lead a discussion session on the next steps forward.

Minutes:

The Chair thanked everyone that had made presentations and felt that these had proved that engaging young people in participation work was not simply a ’tick-box’ exercise in the City.  He suggested that Members should reflect on the presentations and ensure that examples of good practice were shared widely and there were good opportunities for all partner organisations to benefit from them.  Although there were many examples of good practice; there were still some ‘blockers’ within the system, some of internal constructs and some from wider determinants. 

 

The Chair felt that the themed session had been extremely valuable and he asked that the Youth Development Worker share the write up from the ‘graffiti wall’ and post–it notes collected as part of the Children and Young People’s Safeguarding Summit on Emotional Wellbeing with the Director of Public Heath so that they considered in the review of the Health and Wellbeing Strategy.      

 

 

110.

QUESTIONS FROM MEMBERS OF THE PUBLIC

The Chair to invite questions from members of the public.

Minutes:

There were no questions from Members of the public.

111.

DATES OF FUTURE MEETINGS

To note that future meetings of the Board will be held on the following dates:-

 

Monday 5th February 2018 – 3.00pm

Monday 9th April 2018 – 2.00pm

 

Meetings of the Board are scheduled to be held in Meeting Room G01 at City Hall unless stated otherwise on the agenda for the meeting. 

Minutes:

It was noted that future meetings of the Board would be held on the following dates:-

 

Monday 5th February 2018 – 3.00pm

 

Monday 9th April 2018 – 2.00pm

 

Meetings of the Board would be held in Meeting Room G01 at City Hall unless stated otherwise on the agenda for the meeting. 

112.

ANY OTHER URGENT BUSINESS

Minutes:

There were no items of Any Other Urgent Business.

113.

CLOSE OF MEETING

Minutes:

The Chair declared the meeting closed at 12.41pm.