Agenda item

The contract for the Medway Young People Wellbeing Service was awarded to the North East London NHS Foundation Trust (NELFT) and formally commenced on 1 September 2017. This paper updates Members on the contract and arrangements through the Local Transformation Plan for Children and Young People’s Mental Health and Emotional Wellbeing.

Discussion:

The Head of Service Partnership Commissioning, Resources and Youth Justice introduced the report which updated the Members on the contract for the Medway Young People Wellbeing Service, awarded to the North East London NHS Foundation Trust (NELFT) and arrangements through the Local Transformation Plan for children and young people’s mental health and emotional wellbeing. He highlighted that treatment of 4/5 pathways had improved, with 26% of patients waiting more than 18 weeks compared to 46% six months previously.  He also referred to the transformation needed to support children much earlier and highlighted some of the plans for the next 12 months working with educational leads in these developments.

Two representatives from NELFT were also present to answer questions.  They explained that there were two separate work streams, patients with generic mental health issues and patients with neuro-developmental issues, such as Autistic Spectrum Disorder and ADHD. All referrals were triaged by a clinician.  In relation to generic mental health issues, targets for assessment were; emergency cases to be seen within 4 hours, urgent cases to be seen within 4 weeks and then everyone else to be seen within 18 weeks. This was based on 35% of young people in need of mental health services meeting the threshold, which was a reflection of national funding for mental health services for children and young people. 

For neuro-development issues (this was relevant for children over the age of 11) there was a much longer waiting list, which officers explained was an area of focus and sign posting to services that could support a child while awaiting diagnostic assessment was carried out.  It was recognised how distressing the wait time was for families but it was emphasised that in many other areas, there was no clinician service at all for this age group of children.  The point was also made that the development work with education leads referred to above would also help address the demand on this service.

Members then raised a number of questions and comments, which included:

·           Presentation of information – comment was made that the report was quite technical, included too many acronyms and was difficult to fully understand for Members who were not experts in the field. Officers responded that they would reflect on this issue to ensure Members were presented with the information they needed but in a way which was helpful to Members for effective scrutiny.

·           Engagement with young people – in response to a question about how officers would engage with young people from various backgrounds, officers explained that this was an area of focus via the Local Transformation Plan and the service would be joining up with groups such as the Youth Police Action Group, Medway Youth Council and the Medway Children and Young People Council.

·           SAFE peer mentoring – the scheme, which raises awareness of emotional health and wellbeing in schools by pupils being peer mentors, was referenced in the report to potentially reduce referrals to NELFT as the needs of pupils are addressed earlier.  In response to a question about the evidence behind this hypothesis, officers confirmed that there was national data sets which did demonstrate a positive impact of the scheme and therefore this would be something that would be explored via the Local Transformation Plan to be rolled out to all schools.

·           Trailblazer scheme – in response to a request for further information about the scheme, representatives from NELFT explained that together with the Council they were trying to acquire funding for the scheme to be implemented in Medway, which developed a workforce with Cognitive Behavioural Therapy skills to support children and young people in school settings and would help reduce the demand on current services.

·           Safe havens – in response to a question, it was confirmed that one of the four safe havens proposed for Kent and Medway would be within the Medway boundary and discussions were currently taking place to determine a suitable location.

·           Did not attends – in response to a question about what follow up occurs when patients do not attend their appointments, representatives from NELFT confirmed that follow up was proactive and carried out via text, phone or in writing.  It was recognised that patients were often reliant on their parent/carer bringing them to the appointment and there were often a number of reasons why that may not occur. If the patient was very high risk, for example high risk of self harm, then there would be a home visit or liaison with the Police where necessary.

·           Access to services – in response to accounts given about difficulties of families and schools accessing the service or making referrals, NELFT representatives confirmed there was one telephone number which all calls could be made to, clinics were also open on Saturdays and referrals could be made by anyone, therefore they were concerned about these accounts and suggested further communication on how to access services would be explored.  It was also confirmed that a consultation line for schools to call to share concerns or ask for advice was also open for half a day twice a month.

·           Staff vacancies – in response to questions about staff vacancy rates, NELFT representatives confirmed that vacancy rates were much improved.  The fact that NELFT ran services across Kent and Medway helped in terms of opportunities for staff and keeping staff within the organisation.  Where vacancies did occur, these were back filled with agency staff which was costly to the budget and impacted on continuity of care for patients, therefore incentive programmes were provided where necessary to help with recruitment and retention.

Decision:

The Committee noted the report and requested an update in 12 months.