Agenda item

4a. CYPMHS in Barnsley cover report

4b. CYPMHS Provision in Barnsley (report of the CCG & SWYPFT)

4c. Summary of Activities to Improve & Transform the Provision of CYPMHS in Barnsley (report of the CCG & SWYPFT)

4d.  Update to the OSC Task & Finish Group on CYP Emotional Health & Wellbeing – February 2022

The following witnesses were welcomed to the meeting:

Laura McClure, Service manager Barnsley CAMHS, SWYPFT

Dr Ovidiu Sandica, consultant Child and Adolescent Psychiatrist and Medial Clinical Lead for Barnsley and Wakefield CAMHS, SWYPFT

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

Laura Nixon, Children and Young People’s Emotional health and Wellbeing Transformational lead, joint appointment for BMBC Public Health and Barnsley CCG

Jan Smith, Interim Operations Manager, Compass

Jamie Wike, Chief Operating officer, Barnsley CCG

In attendance virtually:

Lesley Pollard, Managing Director, Chilpep

The Committee received a report that provided the background to Children and Young Peoples Mental Health Services (CYPMHS) in Barnsley and appendices to that included:

·         a report provided by Barnsley CCG and South-West Yorkshire NHS Partnership Foundation Trust on the key activities of each service in detail including waiting lists for CAMHS as well as the plans and challenges for the future;

·         a report provided by Barnsley CCG and SWYPFT summarising the information on the activities undertaken to improve and transform the provision of CYPMHS in Barnsley; and

·         a report provided by the Children and Young People’s Emotional Health and Wellbeing Transformation Lead which included updates on the progress of the recommendations made by the Children and Young People Emotional Health and Wellbeing Task and Finish Group in accordance with the Groups recommendations.

A brief introduction was then given by Patrick Otway and Jan Smith who outlined the key activities, plans and challenges facing Mental Health Service provision in Barnsley.  Particular reference was made to the significant growth in demand for services, the principles underpinning the delivery of services, the impact of Covid on service provision and demand, workforce development and investment and challenge for the future.  Reference was also made to the strong ethos within Barnsley of partnership working and collaboration which would continue for the benefit of children within the borough.

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

·         there was a discussion of issues associated with eating disorders which had an impact both on physical and mental health.  These challenges were acknowledged, and it was noted that a specific eating disorder team had just been formed and appropriate appointments had been made.  It was acknowledged that currently service provision was not equitably spread thorugh Barnsley schools and work was progressing to try to address these inequalities.  It was noted, however, that the Service was working hard to ensure that all staff had the appropriate knowledge and skills to address issues raised

·         Reference was made to the establishment and launch of a new Single Point of Contact for all referrals into CAMHS/COMPASS Mental Health Support Teams.  Information was provided as to how this service would operate and the benefits to be gained which included the removal of duplicate referrals and a reduction in the feeling of being ‘bounced’ around the system.  It was noted that the major issues identified via this approach were in relation to eating disorders and emotional health and wellbeing

·         Information was provided about the lessons learned as a result of the Covid Pandemic.  In this context reference was made to the development of hybrid models involving the use of digital technology.  Services would continue to monitor and evaluate the impact and any appropriate changes made.  It was important, however, to ensure that no one was disadvantaged because of lack of access to digital solutions and also that confidentiality was maintained at all times.  Face to Face contact would still be maintained where appropriate or for more complex cases

·         Arising out of the above, it was noted that one of the primary issues arising out of the Covid Pandemic was the increase in the number of eating disorders evidenced.  Barnsley currently had the highest number of cases within the Yorkshire and Humber region in relation to self-harm and work was being undertaken to support young people and their families.  In addition, it was noted that Lauren Nixon was working with Compass to develop appropriate training packages.  In view of the high number of cases, work had been undertaken with both Rotherham, Sheffield and Doncaster to examine if there was anything they were doing differently, however, no significant differences had been identified.  It was hoped that ongoing work with schools would bring about a significant reduction in the number of cases

·         In response to detailed questioning, reference was made to the arrangements in place to ensure transition from Children and Young Peoples Mental Health Services have at aged 18+.  Work was undertaken with the Adult Mental Health Service and transition clinics were organised to ensure that needs were assessed and to ensure that the correct services were in place.  It was acknowledged, however, that improvements could always be made and to this end, work was progressing to ensure that a more cohesive model was in place to ensure that there was a smooth transition beyond the age of 18

·         Arising out of the above, reference was made to the signposting that would take place to ensure that upon transition, individuals were able to access appropriate benefits.  It was noted that clinicians would do all they could to assist by providing a summary of services provided to individuals as well as completing forms if required.  They would also provide supporting evidence in the event of assessments being required.  In addition, it was reported that Services used the same system database which assisted in smooth transition of information.  Reference was also made to the support that could be offered by DIAL

·         There was a discussion of the way in which ‘therapy’ was provided.  It was noted that CAMHS adopted a fluid approach but if evidence suggested it would be successful, a group approach would be adopted but this was not the default position

·         Information was provided about the mechanisms in place for reviewing the effectiveness of services together with details of the most recent review.  Overall, the review had been positive with responses from children and their parents saying that their needs were met with a compassionate approach.  Comments had been made about the waiting times to be seen by CAMHS but once involved with the process most clients had an excellent experience.  In relation to future developments, CAMHS was looking to develop reporting mechanisms with other partners and to identify how to share practice so that all practitioners could see the child’s ‘journey through the system’ as this would ensure consistency of approach. 

·         Information was provided about the steps being taken to improve waiting times.  It was stressed that ‘whole system’ support arrangements should ensure that only those who required the support of CAMHS were actually seen by that service as this would ensure that individuals were referred to the appropriate agency/service for support

·         Reference was made to the increase in demand for bereavement services which had significant from last summer.  Work had been undertaken with the CCG and other partners to recruit to two posts who would be in place until July 2022.  A review would then be undertaken to determine future arrangements going forward

·         Arising out of the above, information was provided about the skills of staff within the bereavement services team and of the arrangements in place to ensure their professional support and supervision

·         Information was provided about the current position with regard to the introduction of the whole system approach which would commence in Early Years/Nursery Units.  Staff were being trained to, amongst other things, spot and support wellbeing issues at an early stage as it was hoped that this would prevent the development of further mental health needs at a later date.  It was important to ensure that specialist intervention and support was provided as and when it was needed.  Arising out of this discussion, reference was also made to the counselling arrangements that were in place

·         In response to specific questioning, reference was made to the relationships between individual Services/Providers and the CCG.  Particular reference was made to the establishment of various steering groups, which were to meet to review arrangements and timescales and to examine how the CCG could provide better support.  Information was also provided about the financial arrangements, to the requirement to submit business cases to support various initiatives and to the arrangements in place to ensure that things were working as efficiently and effectively as possible.  It was also reported that the ADHC Group was looking at how partnerships were being managed and how additional support could be provided.  The CCG was very supportive of the whole system approach

·         Information was provided about current staffing levels particularly in the light of the Covid pandemic.  Whilst some staff had left, this had not been an unprecedented change and was in line with what would normally be expected.  Staff wellbeing was particularly key and arrangements appeared to be working well as evidenced by staff surveys and appraisals.  There were currently a number of vacancies and whilst there were no issues with recruitment, Services were always looking to make the working arrangements more attractive in order to improve retention rates.  From the clinical side, Dr Sandica stated that he had kept the same number of staff for the last five years and he had not lost a single medic

·         It was felt that there would be little impact on provision following forthcoming changes in relationships with the CCG.  Patrick Otway stated that he would still retain his role as Head of Commissioning and there would still be colleagues offering support, so he saw the arrangements going from strength to strength.  Jamie Wike felt that the new arrangements would provide many opportunities for continuing partnership working.  Whilst there would be some areas for further development, he still saw services continuing to work closely to meet the needs of the population albeit working arrangements may be slightly different.

RESOLVED:

(i)            That witnesses be thanked for their attendance and contribution; and

(ii)          That the report and appendices thereto be noted.