Agenda item

To consider a report of the Executive Director Core Services (Item 4a attached) in respect of Barnsley Clinical Commissioning Group’s (CCG’s) Report on CAMHS (Item 4b attached).

The following witnesses were welcomed to the meeting:

Martin Tune, Acting Chief Nurse, Barnsley CCG

Patrick Otway, Head of Commissioning (Mental Health, Children's and Maternity) Barnsley CCG

Dave Ramsay, Deputy Director of Operations for SWYPFT

Claire Strachan, General Manager, Barnsley CAMHS, SYPWFT

Mark Smith, Vice-Chair, Healthwatch Barnsley

Patrick Otway introduced this item and gave Members an overview of the report which detailed the performance of the Barnsley Child and Adolescent Mental Health Service (CAMHS).  It was explained that Barnsley CAMHS reflects national trends in terms of rising demand and insufficient capacity to meet this huge unmet need.  There are lengthy waiting times, particularly for children and young people with a learning disability or with a diagnosis of Autistic Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).  Barnsley is currently undertaking a peer review, ‘buddying’ with Doncaster.  This has already highlighted a number of issues, including difficulties around the transition from children’s to adult services together with a need for a more robust workforce strategy.  A final meeting is to be held on 9^th November, from which an action plan will be developed.

In the ensuing discussion, and in response to detailed questioning, the following matters were highlighted:

Chilypep and its sub-group, OASIS had led on the consultation with young people to ensure they were fully involved in shaping mental health services as part of the Local Transformation Plan (LTP).  Chilypep’s report  will be used to develop a service improvement plan.  Care leavers and looked after children were actively involved in the consultation.

Healthwatch had also consulted with 73 parents and carers and 65 professionals in their revisit to their report on CAMHS in 2015.  It was highlighted that Healthwatch’s consultation in 2018 identified lack of support from GPs, with 45 out of 65 people not offered support following referral to CAMHS.  Referrals from GPs had risen recently, due in part to a GP training event and a single point of access (SPA).  ASD and ADHD steering groups have now been established to offer support to individuals waiting to hear from CAMHS.

The Wellspring Academy Trust is funded to lead on the provision of school-led mental health therapeutic support across Barnsley’s 10 secondary schools.  Mindspace provides low level emotional health and wellbeing support to secondary school pupils and has built up strong collaborative partnerships with CAMHS, Chilypep and Early Help services.  It is hoped that this support will be mirrored in primary schools.  Training is also provided in schools around anxiety, self-harm and other mental health issues.

A member expressed concern that the service was now fragmented, with some duplication, lack of coordination and communication difficulties evident.  Reassurances were given that the service provides value for money and is fully integrated but is delivered flexibly in a variety of places. 

Members were advised that there are a number of pathways for young people aged 17 to access mental health services; they do not have to wait until they are aged 18 to access adult services.  It was explained that an initial assessment will be carried out within 5 weeks to identify how their needs can be best met.  If significant needs are identified, they will be referred to adult services.  The IAPT service meets the needs of 16/17 year olds and there is a clear transition policy in place.  Cases are discussed by a multi-disciplinary team of professionals to decide the best pathway.  At the point of initial referral they will also be signposted to support networks, social care and family centres etc., for family support.  Crisis response times are very good. 

It was acknowledged that in terms of waiting times, 280 people had been waiting for more than 6 months for intervention, which is too long.  Mindspace had been evaluated positively by children and young people in schools but as yet this is not reflected in reduced waiting lists.  No information is held with reference to how many people choose to access ASD/ADHD services privately due to the lengthy waiting list. 

It was explained that the Accessing Information ‘one-stop shop’ previously led by the YOT Manager is now part of the Chilypep work as part of a universal scheme.  In addition, the Mindspace website is developing a service ‘map’ which will help young people identify the services available and to self-refer.  For young people who do not have a mobile phone to access this, a town centre hub is also being developed, staffed by volunteers and with self-referral options, similar to a scheme in Birmingham. 

Members expressed concern at the number of other authority looked after children who were accessing Barnsley CAMHS services and felt that this could be at the detriment of Barnsley children.  It was felt that a report should be submitted to the Corporate Parenting Panel to address this.

A Member queried what would happen if a child was referred to a particular pathway which was deemed inappropriate at a later date and if they would then have a further wait.  It was explained that although needs can change, the pathway should remain the same following a combined assessment as there are a range of different interventions to meet needs, delivered by different agencies.

When questioned regarding meeting the neds of children from BME or LGBT communities, the committee were advised that assessments are comprehensive and take account of all a child’s needs.  If specialist skills are required then these are sought however this has not been the case in Barnsley.  If required, interpreters would be brought in to assist those where English is an additional language.

No data is available around the number of children and young people 18 and under who self-harm and are already known to CAMHS.  Public Health collate data up to the age of 25.  Work is ongoing with colleagues at the hospital regarding children who present in a crisis situation at the Accident and Emergency department.  There is limited data available on their experience.

As yet there is no information about Barnsley’s expression of interest in becoming an NHS England ‘Trailblazer’  pilot.  The successful Trailblazer sites will be announced in the next two weeks.  If Barnsley is successful, decisions about priorities and how the funding will be spent will be made collectively with partners to ensure that it is the best fit for the Barnsley community and for families.

RESOLVED that:

(i)    The report be noted and witnesses be thanked for their attendance and contribution;

(ii)  A six-monthly update be provided regarding GP referral;

(iii)A detailed  evaluation be provided regarding the effectiveness of Mindspace and Thrive together with data on pathway timescales for various conditions;

(iv)Parenting workshops be provided specifically in relation to dealing with children and young people who self-harm;

(v)  Reports are submitted to the Corporate Parenting Panel in relation to other authority looked after children who access Barnsley CAMHS, and that;

(vi)Future reports to the Committee are written concisely in Plain English, avoiding acronyms, addressing key points and including a glossary of terms, with supplementary information included in the appendices.