Agenda item

The Leicestershire Partnership Trust and the Integrated Care Board submits an update and a presentation on Children and Young People’s Mental Health referrals and the services provided in Leicester.

Lead directors and professionals from the Integrated Care Board and the Leicestershire Partnership Trust presented the update on Children and Young People’s Mental Health referrals and it was noted that:

·       Children and Adolescent Mental Health Services (CAHMS) was only one part of the mental health service offering across Leicester. The aim had been that the appropriate support was available at the appropriate time. The team was really proud of the self-referral route and the triage and navigation service.

·       The latest key performance indicators demonstrated a mixed picture. There were lots of things that effected delivery against the KPIs such as the eating disorder clinic seeing small numbers of patients each month. The overall impression was that the service was performing quite strongly. Where it was not meeting targets, such as the 15-week waiting list, measures had been put in place such as follow up calls and checks.

·       The most significant challenge the team was facing was the significantly increased referrals for Autism and ADHD. They had increasingly become part of the public consciousness, and this had affected services nationally. Leicester was in the middle in terms of referrals and waiting lists. It was emphasised that treatment consisted of controlled drugs.

·       A national report was expected in spring 2026 which would provide further guidance, however the bottom line was that there was not the capacity to meet the current demand.

·       There had been success in reducing inequalities in accessing mental health services. A programme had been run in partnership with Leicester City Football Club which provided mentors for children and young people who would not usually access mental health services. The cohort was largely young black men.

·       Partnership working had also occurred with the police on topical issues such as social media and knife crime.

The Associate Director from the Integrated Care Board clarified that:

·       The triage and navigation service were the entrance point to the service for all children.

·       Emergencies could come from 111 or CAHMS crisis line.

·       There were 787 referrals between 1^st November 2023- 2024. This was a full year which was impacted by collective action.

·       The number of referrals being returned to GP’s had not changed as there was still a lack of information being included on the form. There had been a number of meetings to discuss this and the use of PRISM forms but this had been complicated by collective action.

In response to questions and comments from Members, it was noted that:

·       Members expressed revelation that there had not been a review to consider the returned referrals, and how this was to be improved.

·       Concerns were expressed at GP’s writing letters for referrals as this removed the standardisation of forms and increased the risk of more complications in the referral. The most underserved demographic were black communities which would see huge disparities in how an issue could be represented by different individuals and could allow unintended discriminatory practises into the system.

·       The ICB was working with the Local Medical Committee and had explained the concerns and agreed the minimum level of information required.

·       There was a specialist team who specifically worked with young people who had come through the court system. The data for young offenders was requested by Members.

·       Self-referrals were only possible for certain things, others required individuals to go through the GP. The PRISM form was used for many different types of referrals, but Members enquired which GP’s were refusing to use the forms for Children’s mental health.

·       One of the challenges that the Trust had faced was the differential use of PRISM forms. Any support Member could provide to encourage their use would be appreciated.

·       The ICB had met with the Local Medical Collective 4 times since the collective action had ended as they had desperately tried to achieve better outcomes for young people. 5000 children had a successful referral to the correct service which was not happening prior to the triage team being in place.

·       Families had sought private care to try and get support, due to the waiting lists, but on occasion the diagnosis was not then accepted by GP’s. A list was requested of providers who were being accepted by GP’s.

·       Due to the nature of the medication used to treat ADHD, robust assessments on the process were needed, particularly as the diagnosis would be lifelong.

·       Those who had a neurodivergent condition were more at risk of developing mental health conditions.

·       The health aspect of this issue was only part of the work surrounding it, there was also the SEND agenda, inclusivity in schools and the support provided to the children and families among others.

·       It was suggested this topic could be the subject of a joint PHHI and CYPE scrutiny commission due to the many areas working on it.

·       The children and young people who were on the waiting list were given a robust list of services they were able to access and if required, they could escalate back in if the need increased.

AGREED:

·       The Commission noted the report.

·       Data requested for number of young people being referred through the courts.

·       Data was requested for how many and which GPs are rejecting PRISM forms.

·       Further discussion to be held on a joint scrutiny commission.

·       The list of services received by families on the waiting list to be shared.