Agenda item

To receive a report from the Head of Scrutiny and Member Development introducing a summary paper in relation to Leeds’ Child and Adolescent Mental Health Services (CAMHS) and Targeted Mental Health in Schools (TaMHS). 

The Head of Scrutiny and Member Development submitted a report introducing a summary paper in relation to Leeds’ Child and Adolescent Mental Health Services (CAMHS) and Targeted Mental Health in Schools (TaMHS).

The following representatives were in attendance:

·  Matt Ward (Chief Operating Officer) – NHS Leeds South & East CCG

·  Jane Mischenko (Commissioning Lead – Children and Maternity Services) – NHS Leeds CCGs

·  Paul Bollom (Head of Commissioning and Market Management) - Children's Services, Leeds City Council

Those in attendance gave a brief introduction and outline of the report.  As part of the introduction, a number of points were highlighted, including:

·  There were significant concerns about access to CAMHS, nationally.  This was also reflected regionally and locally.

·  There was a level of unmet demand for services, which was reflected by feedback from stakeholders.

·  A review of service provision had recently started and this was the highest priority area for Children’s Commissioning. The report and recommendations to be reported to the Integrated Commissioning Executive (ICE) by March 2015.

·  Support and services for children were provided through a mixture of provision.

·  There was a complexity to the commissioning and provision of services, but recognition that changes are needed around access to emotional and mental health services.

·  There were a number of challenges, including:

Ø  Providing the same level of access to services for children and young people, when compared to services for adults.

Ø  The need for early interventions and support, i.e. upstreaming services.

Ø  Significant demand and capacity issues.

Ø  Recognition that the review may not resolve all the current issues. 

·  The use of seed-funding to support Targeted Mental Health in Schools (TaMHS) was seen as a particular strength in Leeds.

·  The review would seek to build on current strengths and consider the challenges facing the City.  The review would include:

Ø  Refreshing the local health needs assessment (currently 2 years old), with the backdrop of the national prevalence information being based on 2004 data and updated national prevalence information unlikely to be available until 2016/17.

Ø  Modelling current patient flows across the system.

Ø  Benchmarking activity, looking at key performance data such as activity, waiting times, turnover etc.

Members of the Scrutiny Board reflected on the details presented and raised a number of specific matters, including:

·  The need for a clearer overall spending/ funding analysis across CAMHS and TaMHS, including the different tiers of provision.

·  Saddened that, excluding dementia, 50% of mental illnesses in adult life start before age 15 and 75% by age 18. There appeared to be a clear need to focus on early interventions and appropriate access to such services. 

·  The involvement of children and families in the design of services was crucial.

·  Notwithstanding attempts to understand local needs, concern in relation to, what appeared to be, out of date national prevalence data.

·  Concern there may be inconsistent TaMHS provision across the City due to different arrangements and priorities within school clusters.  The Scrutiny Board should reflect on the School Clusters enquiry report produced by the Scrutiny Board (Children and Families). 

·  The relationship between emotional wellbeing and attendance and behaviour in Leeds.

·  The relative protected nature of schools budgets (when compared to other public services) and the challenge/ opportunity for NHS commissioners to work more closely with the school community.

·  The need for the Scrutiny Board to consider the evaluation reports in relation to TaMHS services.

·  Queries around whether there had been any analysis of current provision against national / local policies.

·  The transition between child and adult services.

·  Some concern about the lack of clarity and transparency around the role of the Integrated Commissioning Executive (ICE).

·  The need to have access to the full report recently presented to the ICE.

·  The need to provide data around the level of current provision and existing/ future demand for services.

In summing up the discussion, the Chair confirmed the Board’s intention to invite contributions from a range of stakeholders and it was hoped that the Scrutiny Board’s inquiry would feed into the review reporting in March 2015 (as discussed during the meeting).

The Chair also confirmed the need for a range of information to be made available to the Scrutiny Board, including:

·  Performance data in relation to access, waiting times and outcomes.

·  Information around demand for services and current capacity.

·  A copy of the full report recently presented to the Integrated Commissioning Executive (ICE).

·  Information regarding the consistency of TaMHS provision across the City

·  Relevant details from the School Clusters enquiry report produced by the Scrutiny Board (Children and Families)

·  Specific details associated with current transitional arrangements between services for children and services for adults.

·  A clearer overall spending/ funding analysis for CAMHS and TaMHS services across the City, including the different tiers of provision.

RESOLVED –

(a)  To note the report and information presented and discussed at the meeting.

(b)  That the additional information requested at the meeting (as detailed above) be provided and presented to the Scrutiny Board, ideally at its meeting in December 2014. 

On conclusion of the discussion, the Chair thanked those in attendance for their open contributions to the discussion. 

(Councillor James Lewis left the meeting at 12:00 noon during consideration of this item).