To receive a presentation from the Clinical Commissioning Group’s children and young people mental health partnership including a response to the recommendations arising from the task and finish group on Mental Health Services for Children and Young People. 

The committee received a report and presentation from Herefordshire Clinical Commissioning Group (CCG) concerning the updated Herefordshire Children and Young People Mental Health and Emotional Wellbeing Transformation Plan 2015 – 2020 and the response of the CCG to the recommendations arising from the task and finish group on Mental Health Services for Children and Young People. Jade Brooks, Deputy Director of Operations, Herefordshire CCG provided the presentation with Katherine Smith, Service Delivery Manage, Hereford CAMHS, 2gether NHS Foundation Trust. The work of the partnership was outlined and the refresh of the transformation plan. With respect to the recommendations of the task and finish group it was confirmed that they had been accepted and implemented in the action plan to the transformation plan.

The committee made the comments below in the discussion that followed:

·         The incorporation of the recommendations of the task and finish group was welcomed and it was noted that further work was required to develop plans around perinatal care.

·         The question was posed as to where the perceived weaknesses existed in the partnership. Jade Brooks responded to explain that maintaining the energy of the agencies involved in the partnership was a challenge and ensuring the successful recruitment and retention of staff within our workforce. Furthermore, the resources of the NHS were currently directed towards addressing the highest levels of need but it was hoped that funding could be released to focus on early intervention and prevention programmes. A particular challenge concerned the ability to secure mental health inpatient admissions and she reminded the committee that there were no inpatient children’s beds locally and securing beds in the West Midlands placed a pressure upon the operation of the service.

·         The committee queried transition between the Children and Young People Mental Health Partnership and adult mental health forums. Katherine Smith explained that the current national NHS programme, Commissioning for Quality and Innovation (CQUIN), included a focus on transition arrangements. It was confirmed that very few children transferred from CAMHS to adult mental health service.

·         The focus of the partnership on children and young people was recognised and understood. A query was raised regarding what account was taken of the impact on families and whether services were in place to address the wider impact of mental health disorders. Katherine Smith explained that time-limited support groups had been established by CAMHS to provide support to parents with children suffering mental health conditions.

·         The training sessions provided to schools regarding mental health conditions were raised and the importance of securing a budget for the continuation of the training. Jade Brooks confirmed that the national offer of training had been provided to secondary schools and a provider had been appointed to conduct the training. It was important that the messages communicated during the training were fed into other local bodies and agencies concerned with children’s mental health. It was hoped that there would be further clarity around the provision of the training in the recently announced green paper.

·         The statistics in the report concerning Herefordshire acknowledged that incidence of social problems, including self-harm, alcoholism and teenage pregnancies, were higher than the national average. There was an obvious impact on the mental health of children and young people and it was felt greater work should be undertaken to understand and address the causes of these issues. Jade Brooks explained that the data could only provide a limited picture of cause and effect and it was the voice of the family that could provide the broader context. CAMHs looked at dominant themes and issues in local communities to understand the impact on mental health and it was important that agencies continued to share intelligence relating to such issues.

·         Initiatives undertaken in schools and the use of technology to reach children suffering from mental health problems was raised. The use of the pupil premium to support emotional wellbeing in schools was also raised. Jade Brooks and Katherine Smith confirmed that the Strong Young Minds project was undertaken in schools and it was intended that once improvements to broadband reception across Herefordshire was completed, initiatives to make use of technology would be investigated. The Director Children’s Wellbeing confirmed that the use of the pupil premium could be used for activities that supported the raising of attainment which could also benefit the pupil’s emotional wellbeing, schools needed to account for how the money would be spent and demonstrate its effectiveness. 

·         Queries were raised regarding the cost to schools of psychologists; an assessment of spend relating to autism and Asperger’s would be of interest when the committee considered the draft Autism Strategy; and it was requested that service users were involved in the presentation of the item to committee. A query was raised regarding the new duty workers and their credentials. Jade Brooks explained that CAMHs was free at the point of delivery and it was understood that some schools used educational psychologists. Although the roles were complementary, the services existed for different purposes. It was confirmed that the new duty workers were qualified NHS staff.

·         A query was raised regarding the location of the place of safety in Hereford. Jade Brooks confirmed that a location close to the general hospital. 

Councillor CA Gandy proposed and Councillor DA Summers seconded the recommendations below. The committee agreed the recommendations unanimously.

That the committee:

-       supports the response of the CCG to the task and finish group recommendations;

-       supports the objectives of the Herefordshire Children and Young People Mental Health and Emotional Wellbeing Transformation Plan 2015 – 2020; and

-       requests an update report on the implementation of the plan in 2018.

RESOLVED – that the committee agrees the recommendations set out in the minute above.

The committee adjourned at 11.45 a.m. and reconvened at 11.49 a.m.