Agenda item

This report provides an update to the Health and Wellbeing Board concerning the mobilisation of the Medway Young Persons’ Wellbeing Service which NELFT has provided in Medway since 1 September 2017.

The report provides an update on the implementation of the new service and delivery model and key service transformation objectives / milestones for the next 12 months from 1 April 2018.

Discussion

The report followed a previous report to the Board in September 2017 at which time, the new provider NELFT had just commenced its contract for the delivery of Child and Adolescent Mental Health (CAMHS) services in Medway. These had previously been provided by the Sussex Partnership and in-house team at Medway Council. NELFT operated a similar service in Kent as well as the Kent and Medway All Age Eating Disorder Service. In relation to CAMHS services in Medway, there had been a significant amount of work to reconfigure services as well as work with staff in the service, including a staff consultation.

There was a need to get all staff working with children onto the same clinical record system, including enabling all staff to work remotely. All staff now had a laptop to facilitate this. NELFT was using Open Road for substance misuse services, all other services covered by the contract being were provided by an in-house team.

The new service model had gone live in April 2018 with there being significant service changes planned over the next few months. NELFT was considered to be more than a service provider. It was a strategic partner that was working with Medway NHS Clinical Commissioning Group and other agencies.

A single point of access to the service had been created to answer calls. This included a senior clinician being available to help determine whether a case required immediate treatment, urgent treatment within a week or was routine. There had been a need to use temporary staff initially but there had been little negative feedback as a result. One challenge was making people aware that they could access the service directly without first needing to get a referral from their GP.

Crisis service provision in Medway currently accounted for a third of the total resource utilised in this area for all of Kent and Medway. This showed that demand in Medway tended to be higher than in Kent.

There had not been a permanent appointment to the post of Medway Team Manager to date. An experienced interim was currently in the role with a recruitment process being undertaken for the permanent role. The Team Manager was leading on joint working with other services, such as youth offending and early help and work was taking place with the Kent and Medway NHS and Social Care Partnership Trust (KMPT) to link to adult mental health services in order to ensure a smooth transition from adolescent to adult services. Work was also taking place with Kent Police. It was acknowledged that partnership working needed to be strengthened.

Work was being undertaken with South London and Maudsley (SLAM) NHS Trust to provide more services at Woodland House. The result of a funding bid to support the delivery of these additional services was awaited. Work to improve service delivery pathways was underway. A number of children were admitted to acute hospitals while waiting for a specialist bed to become available. This needed to be addressed as an acute hospital was not an appropriate environment for these children.

NELFT’s digital offer was being reviewed. This included working with young people to look at how services could be delivered in a different way. Work was also taking place with school staff to help them identify more easily what and was not normal teenage behaviour.

In response to a Member question about how the ability to self-refer was promoted, the Board was informed that previous service users had been contacted when NELFT had taken on the contract and the Council’s communications team had provided support. Promotional leaflets had been produced and there had been liaison with schools and GPs. It was acknowledged that further awareness raising activity was required to make all young people aware of the services available.

A Member welcomed the new service, particularly as provision had previously been poor, although he accepted that this was a national problem. The Member considered that the transition from youth to adult services was a particular challenge and asked what support was available for carers. He requested that a list of emotional support providers be circulated to the Board.

It was noted that NELFTs Medway service was now based in the Courtyard in Gillingham. As far as possible, services  would be delivered in schools, homes, and in four local hubs. Measures were being taken to ensure that those who had previously accessed services did not have to start from the beginning of the process if they were to need service again in the future. A Post Discharge group was working on this. The transition from youth to adult services was a challenge, particularly as many who had received youth services were not eligible for adult services. A survey of people who had experienced the transition was being undertaken.

A Member highlighted the importance of engagement with schools and suggested that existing structures should be fully utilised. He considered that the social care pods were best to facilitate access to a range of agencies and suggested that there should be a dedicated health and wellbeing lead in schools. NELFT would utilise existing structures and help ensure that school staff working with young people at exam time knew the signs of mental health difficulties to look out for. The recent Green paper on children’s mental health provision advocated stronger links between schools and mental health services and the Department for Education’s proposals for its implementation were awaited.

The Director of Children and Adult Services highlighted the importance of service delivery through the four Children and Families hubs. Services needed to balance access to early help services, with demand for tier 2 and tier 3 CAMHS services. Appropriate access to early help services could prevent children from having long waits for higher tier services. There needed to be a focus on local learning action zones to ensure that children got the most appropriate support at the earliest opportunity available.

Decision

The Health and Wellbeing Board:

i)             Noted the report and made comments, as set out in the minutes.

ii)            Noted the significant progress made in relation to the mobilisation of the Medway Young Persons’ Wellbeing Service and the plans and milestones for the next 12 months.