Agenda item

To receive a service brief and position statement on CAMHS from the Leicestershire Partnership NHS Trust (LPT).

Professor Adrian Childs, Chief Nurse and Deputy Chief Executive of the Leicestershire Partnership NHS Trust (LPT). Presented a report which gave a service brief and position statement on the Child and Adolescent Mental Health Services (CAMHS).

It was noted that:-

a)         The data in the report related solely to the city and excluded the costs for Leicestershire and Rutland.

b)         The 10 bed CAMHS Impatient Service unit was based temporarily at Coalville Community Hospital was commissioned by NHS England as it provided a regional service for not only Leicester, Leicestershire and Rutland but also Derbyshire, Lincolnshire and Nottinghamshire.

c)         Planning for a permanent site for the service was being delayed until the outcomes of the ‘Future in Mind’ review process was known as this could have an impact upon the number of in-patient beds to be provide.  Planning for a permanent site would also require capital finance approvals.  When the final commissioning requirements were known, there would be consultation on the proposals.

d)         Following previous concerns at the number of children and young waiting for an appointment for over 13 weeks, extra resources had been directed to address the issue.  In November 2015 the waiting list was 250 and this had been reduced to the current level of 43.  The remaining 43 cases had been booked appointments for assessment by the end of June.

e)         Other improvements to the service included:-

·         Providing a single point of access through care navigators to help families, carers and children to work through the health care system to receive help and treatment.

·         There was a Focus on ‘Evolving Minds’ and the service was working with young people to seek their views on how they would like access the service to get information on issues that were of concern to them.  Smart phone applications and the website were being developed to enable direct access for young people.

·         School nurses worked closely with CAMHS so children can contact the School Nurse service through an ‘app’.  The response to any enquiry was provided by a qualified nurse.  This had resulted in providing help issues such as bullying and eating disorders at an earlier stage, as children were more comfortable in communicating with an ‘app’ than talking to an adult.

Following comments from Members, the Chief Nurse and Deputy Chief Executive stated that:-

a)         Whilst it was recognised that the views of the children involved with the service were important, this had to be balanced with the views of their parents and carers which was often at variance with the views expressed by the children.

b)         The service recognises the importance of other services views and input they can bring to add to the service.  School nurses, in particular play an important part in identifying issues by holding discussion groups in schools and seeking the views of how young people would want the service to operate.

c)         The majority of schools are engaged with school nurses who will work closely with the teacher of the children and young people and their families to identify a whole package of measures to address the needs of the child or young person.   The school nurses can access the services available from social workers, communication experts, and specialist with knowledge of learning difficulties, dementia and many more health conditions.

d)         The service also works closely with the Police and engages in joint training.  The service also has links with the Glen Parva Youth Offending Centre, the prison and probation services and many other agencies.  

d)         Treatment plans for children and young people involved with the service have a widespread number of initiatives and activities to improve mental wellbeing and physical activity.  However, the service is not able to be involved with the child or young person to follow up and monitor provision after the discharge from the service.

f)          Whilst a number of suggestions were worthy of merit: the service could only provide what it was commissioned to provide in relation to the health and wellbeing of children and young people referred to the service.

g)         There was still work to be undertaken to enable primary care services to identify and refer cases to the service at an earlier stage than at present.

Members commented that it would be useful to have a Venn type diagram showing the services provided and the interaction with other agencies to depict the direction of travel for the service.

The Chair stated that:-

a)         She felt the delay in providing a permanent site for the service was unacceptable and she would discuss the issue with the Deputy City Mayor.

b)         There were always risks involved in transformational changes and there were concerns for children who had identified issues and could not access the service.  In some instances children with mental health issues were not referred the service when they had not been assessed by staff that were qualified to make that judgement.

c)         She would also discuss with the Chair of the Children, Young People and Schools Scrutiny Commission to arrange for 2 representatives of the Youth Council to take part in a joint scrutiny of the CAMHS service.

AGREED:

That the Chief Nurse and Deputy Chief Executive of LPT be thanked for the briefing and that the Chair have discussions with the Deputy City Mayor and the Chair of the Children, Young People and Schools Scrutiny Commission to discuss the issues identified above.