Agenda item

This report sets out submissions from the Integrated Care Board (K&MICB) and the Kent and Medway Mental Health NHS Trust (KMMH) on the transfer of Children and Young People’s Mental Health Services (CYPMHS) and All Age Eating Disorders Services (AAEDS) to KMMH.

Discussion:

The Committee received the report which detailed submissions from the NHS Kent and Medway Integrated Care Board (ICB) and the Kent and Medway Mental Health NHS Trust (KMMH) on the transfer of Children and Young People’s Mental Health Services (CYPMHS) and All Age Eating Disorders Services (AAEDS) to KMMH.

The Committee was informed that the Boards for the current provider trust (NELFT) and KMMH had met to review the assurance processes and agreed to proceed with the go live date of 1 April 2026 and confirmation was awaited from NHS England in support of the transfer of service.

KMMH also provided an update on the Care Quality Commission’s (CQC) well-led inspection, which was ongoing within the trust. The CQC had just completed their three day site visit and they would continue with focus groups and interviews with staff over the next two weeks. They had provided feedback and a high level letter was expected in the coming weeks which was anticipated to express good news on the positive changes in the organisation in relation to its values and improvement journey. In addition, prior to the well-led inspection, CQC had notified KMMH that they would be lifting the warning notice for the community teams and had recognised the positive engagement with patients, staff and partners.

The ICB explained that assurance had been sought and provided regarding the contract and the governance process being undertaken, with three main areas of focus for readiness for the launch date of 1 April. It was however recognised that children’s mental health services needed to improve and assurances were being sought on the areas of concern.

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

Migration of IT – it was asked how the transfer of systems would be enacted to ensure a seamless transfer and how confident officers were in the risks identified and mitigations put in place. The Committee was informed that the trust was mindful of the migration taking place over the easter period and there had been independent support throughout the programme to ensure a safe and minimally disruptive migration. The decision had been taken to progress slowly, to ensure there were safeguards in place to be able to respond to issues appropriately whilst maintaining continuity. Members welcomed this approach as it was important to prevent disruption to services received by young people.

First 90 days – it was asked what monitoring would take place to ensure that the system was working as intended and given the scale of changes that would take place simultaneously,  what risks were being taken into considerations. The Committee was informed that there were different layers of assurance and measures in place. NHS England had also built in their own levels of assurance. Due diligence had taken place on identification and mitigation of risks, and it would be key to remain vigilant once live.

Communication and Engagement – the significance of communicating the change in provider to service users was referenced, and it was asked what had been done to ensure that residents were kept informed. The Committee was informed that there had been an extensive communication programme with young people and families, which had included; information and posters at clinics which highlighted clearly that care would not change; service user participation groups had taken place with useful feedback received that helped to shape the communications strategy; health care professionals who were first point of contact had been sharing information with patients and those on neurodiversity waiting lists would receive text messages to inform them of the change.

Stability in service – reference was made to Appendix 2 of the report, which stated that the contract would be transferring with a deficit and it was expected that the service would break even in two years. It was asked what pressures were envisaged and how KMMH would ensure continuity of service, consistency in practice and maintenance of staff levels. The Committee was informed that some of the pressures identified related to the complexity of support needed by some families and the service was exploring ways to use resources as efficiently and effectively as possible. There was a review of capacity and demand due to take place, which would assist with scoping the future transformation plans. The partnership was committed to addressing all areas of concern highlighted. In terms of staffing stability, it was confirmed that TUPE of staff was being rigorously planned for and communication with staff had been extensive and strong. In addition, the service had a number of long standing locum staff which KMMH was actively trying to recruit to as permanent staff to strengthen continuity of care.

Staff understanding of issues for children - reference was made to the importance of staff being fully trained around children with not just autistic spectrum disorder (ASD) and ADHD, but also Feotal Alcohol Spectrum Disorders (FASD) as often those with FASD also experienced Mental Health issues, yet there seemed to be less recognition of FASD and how that presented. The Interim Service Director, KMMH agreed and that this was a priority area of focus. It was suggested that awareness sessions be run for Councillors, staff and partners on this issue.

Accountability - it was asked who would be responsible and accountable for any issues, and in response the Committee was informed that in terms of the legal framework under the NHS, any clinical safety or service delivery issues would fall to the responsibility of KMMH as the provider. Any issues relating to commissioning arrangements or allocation of resources would be the responsibility of the ICB.  Both organisations were accountable to NHS England, who would identify which part of the system was accountable.

Improvement plan – reference was made to the longer term improvements needed across children and young people’s mental health services and the ICB undertook to bring back to scrutiny an integrated children and young people mental health improvement plan for the system within the next financial year.

Decision:

The Committee noted the submission from the ICB, as set out at Appendix 1 to the report and the submission from KMMH, as set out at Appendices 2 and 3 to the report.