Issue - meetings

8.1       The Committee considered a report providing an update on the Child and Adolescent Mental Health Services (CAMHS) in East Sussex, including the progress being made to reduce assessment waiting times and the impact of additional investment in CAMHS on service provision and performance.

8.2       The Committee asked whether all children and young people with mental health problems were being supported by CAMHS.

8.3       Alison Nuttall, Sussex Partnership Foundation Trust (SPFT) Operational Director for CAMHS & Specialist Services, answered that there is a shared Single Point of Access (SPoA) for children and young people with emotional wellbeing and mental health needs. All referrals were triaged through the SPoA to identify where a child’s needs would be best met, which would not always be the specialist services provided by SPFT. Lou Carter, East Sussex County Council Assistant Director (Communication, Planning and Performance), added that there were a number of other support options for a child or young person as part of the Early Help service which could mean they do not need to be referred to CAMHS.

8.4       The Committee asked when all children in schools will be covered by Mental Health Support Teams (MHSTs) and how mental health support was being offered in schools.

8.5       Lou Carter confirmed that it was not possible to say when there might be full coverage of MHSTs, but there was ongoing system-working to improve the Early Help and prevention offer and to ensure schools were aware of the full support offer for different levels of need. A poster had been developed and is to be circulated to schools which would make it clearer what services are available for different levels of need, and a broader piece of work is ongoing to make it clear where support for children and young people could be accessed across Sussex. Lou agreed to share the poster with the Committee when it was finalised.

8.6       The Committee asked for more detail on how waiting times for CAMHS were handled.

8.7       Alison Wallis, SPFT Clinical Director for CAMHS & Specialist Services, answered that CAMHS was a needs-led service so that the children and young people seen first were those who were most unwell and for whom alternative services and support would not necessarily meet their need. CAMHS had well-known resource challenges that meant many children and young people were not being seen as soon as anyone would like. Those most in need waited between 0-13 weeks and represented the largest numbers on the waiting list. There were lower numbers of less unwell children who may wait longer. SPFT closely monitored those who are on waiting lists, and make proactive contact with families to reassure them that they remain on waiting lists and to remind them to contact CAMHS if their child has a change in presentation. John Child, SPFT Chief Operational Officer added that the complexity and acuity of need had increased since the pandemic which added to waiting list times as those with complex needs take longer to assess.  ...  view the full minutes text for item 8

15.1.    The Committee considered a report providing an update on the Child and Adolescent Mental Health Services (CAMHS) in East Sussex, including the progress being made to reduce assessment waiting times and the impact of additional investment in CAMHS on service provision and performance.

15.2.    The Committee asked how young people on the waiting list are monitored and kept safe whilst they await an assessment.

15.3.    Jessica Britton explained that significant resources have been prioritised locally in 2021/22 and 2022/23 to support specialist CAMHS services, particularly eating disorder services and the neurodiversity assessment pathway. There is a programme of work to understand the resources and staffing required to meet the demands of the waiting list and there will be a significant piece of work to support it.

15.4.    Alison Wallis said that CAMHS is a needs-led service meaning those young people who are most unwell do get seen more quickly. This results in a number of young people who are not as high priority being on the routine waiting list. All referrals are via the Single Point of Access and Advice (SPoA) and if there is not sufficient information from the referral to prioritise the patient, the referrer, patient, or their parents will be contacted to understand how quickly they need to be seen. Alison Wallis set out some of the support provided to children and young people, and their families, once on the waiting list, including:

•           SPFT sends clear information to the family about who they should contact if they become more concerned about their child;

•           NHS Sussex has also commissioned AMAZE to provide navigation support for parents for the support they can give their children whilst they wait;

•           SPFT sets clear expectations of the service families will receive and how CAMHS will meet them;

•           If someone is concerned about the deterioration, they can contact the Duty Team that have slots available for longer consultations with the child, both over the phone or face to face;

•           Families are proactively contacted every six months to see if there are any concerns or change in their child’s presentation; if so, it will be reviewed;

•           A lead practitioner is assigned to a young person who is waiting if there are concerns about them. The Lead Practitioner regularly contacts the child, their family and those in close contact with both, such as social workers or schools, to develop an understanding of how the child is functioning to see if there is a need to do something about that child’s priority within the waiting list;

•           CAMHS has multi-agency conversations with social care, schools and youth offending services to discuss how best to support a child if necessary, including an evidence-based intervention from CAMHS, or community support that can reduce their symptoms;

•           Work is also underway as a partnership with a local university to develop training on how to support people with neurodevelopmental disorders in their home setting, in order to help understand how best  ...  view the full minutes text for item 15

30.1     The Committee considered a briefing on Child and Adolescent Mental Health Services (CAMHS), and Children’s and Young People’s Emotional Wellbeing and Mental Health by the Sussex Partnership NHS Foundation Trust (SPFT) and the Sussex Health and Care Partnership (SHCP). A copy of the presentation slides used for the briefing is included under item 5 of the agenda for the meeting.

30.2     The Committee noted that some early support is provided via referrals from schools and asked what happens if children are excluded or not in school for another reason.

30.3     Alison Wallis, Clinical Director (SPFT) outlined that although there are referrals from schools, referrals cans also be made by GP’s or via self-referral. However, it is acknowledged that providing help and support is much more difficult if children or young people are not known to services. SPFT are working to increase the knowledge and information about mental health and wellbeing services (e.g. the i-Rock project), so that they are visible in the community and services are easier to access. Rachel Walker, Operational Director (SPFT) added that school support teams are also working with Pupil Referral units and special schools to enable access to services.

30.4     The slides in the briefing indicate that there are long waiting times for some services. The Committee asked what prioritisation is there for those who have been waiting and when does SPFT expect to see a significant improvement in waiting times.

30.5     Rachel Walker responded that those waiting for Autistic Spectrum Condition (ASC) services will be seen over the current calendar year, so all people waiting for an assessment will be seen this year, this is because an independent provider has been sourced to support with the those waiting the longest for assessment. There is also a system wide response to expand capacity and tackle the increase in demand. Work is also being undertaken to understand why there has been an increase in young people needing services. It is acknowledged that waiting times are too long and are impacting on outcomes for young people. Work is underway to make sure services recover and young people receive the services they need.

30.6     The Committee asked where the additional investment had been spent on services, particularly CAMHS, and what difference had this made?

30.7     Rachel Walker outlined that the additional investment had been spent on Autism assessments with approximately 600 assessments transferred to an external provider. Money has been spent on recruiting additional staff for Attention Deficit Hyperactivity Disorder (ADHD) services, which has a prevalence rate which is three to four times higher in East Sussex than in either Brighton and Hove or West Sussex.  Additional staff have also been recruited to provide Cognitive Behavioural Therapy (CBT), with the majority of referrals being for depression and anxiety. The additional money is being focussed on where there are the largest number of referrals and on those that have been waiting the longest. The additional funding will continue into the next year and beyond in order to achieve  ...  view the full minutes text for item 30