Agenda item

To consider a report of the Executive Director Core Services (Item 4a attached) in respect of Children and Young People’s Mental Health Services in Barnsley (Item 4b attached).

Members of the Committee were invited to consider a report of the Executive Director Core Services in respect of Children and Young People’s Mental Health Services in Barnsley. 

The following witnesses were welcomed to the meeting:

David Ramsay, Deputy Director of Specialist Services, SWYPFT

Kate Jones, Barnsley CAMHS Service Manager, SWYPFT

Dr Ovidiu Sandica, Consultant Child & Adolescent Psychiatrist and Medical Clinical Lead for Barnsley & Wakefield CAMHS, SWYPFT

Lucy Hinchliffe, Commissioning and Transformation Manager, Barnsley CCG

Lauren Nixon, Children and Young People’s Emotional Health and Wellbeing Transformation Lead, joint appointment for BMBC Public Health and Barnsley CCG

Lesley Pollard, Managing Director, Chilypep

Chloe Whitham, Volunteer, Chilypep

Dave Ramsay introduced the report, providing a detailed report to the background to the performance of Barnsley Child and Adolescent Mental Health Services (CAMHS) from 2014 to date.  It was highlighted that the report also covers the work of Chilypep (children and young people's empowerment project) together with MHST (Mental Health School Team), previously provided by Mindspace, but now Compass.  A previous OSC raised concerns around long waiting times and the increasing pressures around ADHD cases.  There have been a number of key improvements since then, including a 7 day crisis response service with intensive home-based treatment available, a 24-hour response into BHNFT for young people in crisis, work around strengthening pathways and strengthening of the school support service.  Covid has brought challenges but has also provided an opportunity to look at new ways of working digitally, which has been well received by children and families.  In Sept 2019, 330 children and young people were waiting for treatment, with 230 waiting for more than 12 months.  Currently, the waiting list is 66, which means that now no child waits more than 12 months for treatment.   Next steps include securing the funding envelope for the new service with the CCG; agreeing priorities for development and a further development of the single point of access to ensure the service is responsive to every request for support.  Some of the new ways of working which have developed during Covid will be retained going forward.  Lesley Pollard explained that Chilypep has been heavily involved in the waiting list reduction initiative alongside CAMHS and Mindspace.  Funding has been extended for one of the programmes (BRV work with boys), albeit some of the programmes were difficult to deliver virtually such as groupwork. The number of referrals received for BRV were double those contracted for during Covid, and there is now a waiting list which is being worked through.  A project around personal health budgets was very successful and supported a reduction in the waiting list or prevented young people from being added to the waiting list, but funding for this has not been extended. 

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

It was acknowledged that work has been done in developing the crisis service, although there remains a gap in the system, with children having to attend A and E outside of hours.  There is an ambition to develop the service up to age 25 included within the specification over a period of time (resource dependent) and also strengthening support to Children in Care up to age 25 on a phased basis.  Chilypep are the lead provider for the Wellbeing hub, which may develop differently following lessons learned through Covid.

In terms of transitions, there are transition clinics available for young people transitioning to adult mental health services from the age of 17 1/2 which should help to alleviate anxieties and give a view as to what future adult provision will look like. 

The Children and Young People's Emotional Wellbeing Hub will be developed to act as a drop-in facility and will provide a single point of contact to access appropriate services, extending into CAMHS and other emotional wellbeing services to support children and young people in Barnsley.  The site for the hub has been secured on the second floor of the YMCA building in the town centre, with the lease signed prior to the lockdown.  The new-build Youth Zone won't be around for a few years but all the developments around the town centre will be linked together to avoid duplication of existing services, with 'spokes' in the community.  The Children and Young People's Emotional Wellbeing Group is looking at developing workstreams to drive forward service improvements, looking across the whole system to engage young people, particularly those not in mainstream education settings.  Dave Ramsay confirmed that CAMHS will support the development of the Hub.

Work is being done by all partners including CAMHS and Educational Psychology around the post-Covid situation.  This includes providing training to ensure all staff (including school staff) work in a trauma informed way to support children and young people.  CCG funding is being sought to make services permanent.  The MHST contract which is being delivered by Compass began on 1st February working with schools, and is a key partner in joining up the lower level offer with the CAMHS service, making referrals everyone's business and making links with other early intervention services to ensure a robust offer.  Compass, the new provider for MHST’s, and Chilypep also have a role to play in supporting schools to embed a positive emotional wellbeing approach across schools, providing training, support and toolkits.  Barnsley will be bidding for a share of the £79m of funding for mental health services for children and young people which was recently announced and in particular how funding could be used to support the most vulnerable.  

It was acknowledged that it is important to ensure staff emotional wellbeing is supported.  This is done through regular supervision, review of caseloads and 'protected time' to enable staff to attend a variety of wellbeing sessions.  Occupational Health support and training and development is also available for staff to ensure they have the skills to deliver.  Chilypep and Compass staff are supported through staff assessments, action plans, regular team meetings and virtual social gatherings.  Staff are doing the best they can in difficult times.  

The post of Children and Young People’s Emotional Health and Wellbeing Transformation Lead was created to look at the current landscape of children and young people's emotional wellbeing services.  A report will be prepared by the end of March which will identify strengths, gaps, funding requirements and will include promotion of service offers.  Although there is lots of support available, this can be difficult to navigate and the system needs to be consolidated.  Smaller pieces of work (such as TADs) are often commissioned by Area Councils and schools. Rachel Payling has information about Area Council funding as it can differ by area.  It was felt that this should be discussed at Area Council Chairs' meetings.

Barnsley has just set up a pilot bereavement service with Compass to support children and young people with bereavement, which will be going Borough wide from 1st April.  Within Public Health a 12 month post is being created to support trauma informed practice across the Borough, helping those with adverse childhood experiences (ACEs) and pulling on all services across Barnsley.

Outcomes for young people using Chilypep or Compass services are monitored in a variety of ways.  If it is felt that a service isn't working for a young person they can be re-referred to CAMHS.  Funding has recently been secured for two trainee Wellbeing Practitioners for 1 year by Chilypep.  Development of the Single Point of Contact (SPOC) should also help improve support for young people.  The South Yorkshire Eating Disorder Association (SYEDA) deliver a low level intervention for children and young people with eating disorders and body/self-esteem issues. The current CAMHS service doesn't include eating disorders although referrals for this are increasing in Barnsley and specialist inpatient treatment beds are not staffed up for this because of Covid. 

There has been an increase in some children and young people experiencing increased  anxiety and depression, particularly those with other neurological problems such as ADHD.  The stopping and starting of school arrangements has also been unsettling for lots of young people.  Chilypep have seen young people presenting with anxiety, isolation, and stress and worry around the financial impact of Covid on families.  It is hoped that the needs of all children and young people will continue to be met, although the wider service developments will take time. 

RESOLVED that: 

(i)            Witnesses be thanked for their attendance and contribution;

(ii)          Information on what each area council commissions regarding emotional wellbeing services be circulated to all members;

(iii)         Services ensure they are promoted via printed literature, as not everyone has access to online facilities, and

(iv)         Services ensure that when they apply for funding for mental health services, they should also incorporate funding to support staff wellbeing.