Agenda item

To receive and consider the CAMHS Review report.

The Child and Adolescent Mental Health Services (CAMHS) Review report was presented by Andy Fitton, Assistant Director of Joint Commissioning

NHS Berkshire West CCG and Kim Wilkins, Senior Specialist Strategy and Commissioning.

Members of the Health Overview and Scrutiny Committee were in attendance to participate in the discussions of this item.

Andy Fitton stated that the report contained the refreshed Future in Mind Local Transformation Plan (LTP).  This report provided an overview of the achievements of the partnership with providers, the CCG and the local authority, and it also outlined of what still needed to be achieved and what the priorities were.

Andy Fitton highlighted the following points:

·           The establishment of the first local Mental Health Support Team, providing early intervention and support service which was co-located in the community around the schools.  A third of Wokingham Borough was currently covered by this new scheme, it was hoped that in time NHS England would fund more teams for Wokingham;

·           There had been an increase in access to services, both for early intervention stage and for more specialist CAMHS.  Referral rates continued to increase year on year;

·           The training offer was much improved, both for schools and for Children’s Services staff, it was important to be able to identify the need for intervention as early as possible;

·           Seven priorities had been identified across the partnership.  Particular attention was being given to meeting the emotional and mental health needs of Children In Care (CIC);

·           Response to crisis was an area that was continuing to be developed;

·           The development of response to eating disorders was continuing to be developed;

·           During the Covid pandemic there had been a decrease in the number of referrals and an increase in the number of acute cases;

·           Providers had been very quick to offer online solutions during the pandemic.

During the discussion of the item the following comments were made:

·           Councillor Grandison was concerned about the waiting time for the treatment of anxiety and depression (page 19).  He also wanted to know if there was any feedback on the usefulness of Kooth;

·           Andy Fitton stated that the Kooth service had only been running for the last three months, he had not yet received any feedback but would report back when this information was available;

·           Andy Fitton believed that the high waiting time for the treatment of anxiety and depression was likely to be because the demand for the service outstripped the capacity of the service.  He offered to bring more information on this data to the Committee;

·           In relation to the replacement of Willow House, Councillor Mickleburgh asked if the new provision was going to offer the same services and how many young people were placed out of area.  He was also interested to know of data about eating disorders and self-harm and whether the new initiatives were having an impact on those conditions;

·           Andy Fitton stated that Willow House was commissioned by NHS England and he suggested that the Committee ask them to comment on it;

·           Andy Fitton stated that the self-harm data came through Public Health, he was not able to comment further. The numbers for eating disorders had been going up every year, but there was a quick response to young people with eating disorders;

·           Councillor Mickleburgh asked how young people could access urgent care at the moment.  He also asked about the waiting times for ADHD assessments and weather this assessments had been suspended;

·           Andy Fitton stated that he was not aware that ADHD assessments had been suspended.  He confirmed that wait times for ADHD were going up, and offered to confirm the average waiting time.  However, reducing waiting times was related to capacity, and it was a challenge to recruit staff with the necessary specialism; it was also important to support people during the waiting time;

·           Andy Fitton stated that very acute cases of crisis were dealt with by hospitals or the police, who were both able to deal with such cases.  He also stated that there was a mental health help line which could be accessed by dialling 111;

·           Councillor Hare asked if there was anything that the local authority could do to help reduce the waiting times of ADHD assessments.  Andy Fitton stated that work to support the child could be initiated before a formal diagnosis, particularly at schools;

·           In relation to anxiety and depression, Andy Fitton stated that it was important to support people at an early stage before their needs escalated;

·           Councillor Bishop-Firth asked if there was a reason for the high levels of anxiety and depression in the Borough and if there were any particular groups which were at risk;

·           Andy Fitton stated that Public Health would be able to provide a review on the issues raised around anxiety and depression;

·           Councillor Helliar-Symonds expressed concern over the length of time children were having to wait for assessments.  In view of the fact that intervention could start at schools before a formal diagnosis, she asked what training was being offered to teachers at schools;

·           Andy Fitton stated that training was offered to schools.  This consisted of two levels of training, one level was for the whole school and the other level was for key staff focusing on specific conditions; 

·           Sal Thirlway stated that the School Improvement Team worked alongside the Educational Psychology Team at schools developing programmes;

·           Gillian Cole, Service Manager Schools stated that there were programmes being developed with schools.  There was a Therapeutic Thinking programme and also the Wellbeing for Education programme.  Senior leaders were being invited to attend two sessions where training material would be provided so that it could be cascaded back to schools.  Other focused sessions were being planned for the spring;

·           Councillor Helliar-Symonds asked if the offer of training extended to independent schools.  Andy Fitton stated that training to independent schools was delivered on request, however there was an issue with capacity to contact them directly;

·           Councillor Helliar-Symonds was interested to know if online services were as good as face-to-face services.  Andy Fitton stated that there was no clear evidence yet, as this was a new way of delivering services.  However, the initial feedback was mixed, it worked really well for some children and others preferred face-to-face.  He envisaged that in the future that would be a mixed offer of online and face-to-face delivery.

RESOLVED That:

1)     The Committee would receive an update on the monitoring and evaluation of Kooth when available;

2)     Andy Fitton would update the Committee on the waiting times for ADHD assessments and depression and anxiety treatments;

3)     Public Health England would be invited to a future meeting to review self-harm, eating disorders, anxiety and depression amongst young people in the Borough;

4)     The report be noted.