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 developments through the Local Transformation Plan for CYP Mental Health and Emotional Wellbeing.

Discussion:

The Public Health Principle and the Partnership Commissioning Officer

 introduced the report which provided an update on the contract and developments of the Local Transformation Plan for children and young people (CYP) Mental Health and Emotional Wellbeing.

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

• Waiting Lists – Concern was raised regarding the longstanding issues with wait times in the service with reference made to the target of 18 weeks which was considered as inappropriately long for young people in need of Mental Health Support. Officers stated that all referrals were received through a single point of access where triage occurred following discussion on the case between clinicians. Decisions on relevant pathway was determined following assessment with cases reviewed on an ongoing basis. At triage, the level of need would be determined, with crisis cases assessed and intervention provided immediately or within short timescales, depending on the level of need.

It was noted that those waiting for a neurodevelopment diagnosis could wait for a period of up to 2.5 years but all young people on waiting lists that had a linked condition (e.g. anxiety) would be seen for those conditions.

Mental Health schools team are a national pilot that went live in some Medway schools in Medway in January. These team provide a whole school approach to mental wellbeing. Commissioners are working with school nursing to expand this support to school not involved with the pilot. Bespoke work around self-harm took place which was underpinned by the self-harm strategy.

In response to a further question on the reasons behind the numbers dropping in Neurological Pathways, officers acknowledged that the wait times were unacceptable, and they were exploring all available options with commissioners to reduce wait time as well as different ways to deliver the service. Throughout the process, parents received support to ensure they understood the service and were kept up to date with timelines. Additionally, support and information was provided on how to manage challenging behaviours.

• Recruitment- It was asked what was being done to address the workforce management issue and to attract potential staff. Officers said that it was difficult to recruit clinicians and they looked into various incentives for the hard to recruit posts. They also learned from other authorities’ methods and recruitments drives and tailored incentives to different areas of recruitment. Aside from financial incentives, a good package of training and ongoing support was offered to all practitioners which was locally accessible.

• Voluntary Sector – in response to a question on what extent the expertise of the voluntary sector was used in assisting with cases, officers said that they welcomed the support provided by voluntary organisations. The broader plan was to equip all professionals with the tools to signpost or provide appropriate support. Work was being undertaken with partners on supporting young people earlier to prevent extreme pressure on core services.

• Budget and Funding- It was challenged that the average Clinical Commissioning Group (CCG) spend on mental health services across the country was 14%. Medway was below the national average (11%) despite significant growing demand, with funding having only increased by 1% in a five-year period. Officers said that the NHS long term plan is explicit about increased investment into mental health services and that the rate of increase into children’s mental health was to be higher than any other. This was reflected in a significant amount of additional investment across a range of mental health services from lower-level support through online counselling through to an enhanced crisis support service.

• Patient Experience- it was challenged that one of the criticisms of the service by young people was that their voice was not being heard within the service. It was asked what was being done to ensure that children’s views were considered and were empowered to continue to self-refer during periods they were not at school.  Officers referred to a survey carried out by Medway Youth Council which looked into children’s experience during lockdown and identified that there was increased anxiety pertaining to exams, transitions from primary to secondary school and virtual schooling. Increased hours were commissioned through the online counselling service to provide additional capacity around anxiety and depression. Youth participation workers had been funded within youth services to understand children’s experiences and going forward design and delivery of services to mitigate issues. Resources had also been developed to provide schools with signposting information.

It was commented that the positive work that had been completed to date by the service should be recognised despite the challenges faced.

Decision:

The Committee Noted the report