Agenda item

(To receive a report from Jonas Gibson, Commissioning Manager, which asks for the Committee's views on Child and Adolescent Mental Health Services, which will be considered by the Executive Councillor for Adult Care, Health and Children's Services on 16 March 2018)

Consideration was given to a report from Jonas Gibson, Commissioning Manager and Lynda Whitton, Commissioning Officer, which invited the Committee to consider a report on the Child and Adolescent Mental Health Service, which was due to considered by the Executive Councillor for Adult Care, Health and Children's Services on 16 March 2018.

A copy of the Executive Councillor report was attached to the report at Appendix 1 for the Committee's consideration.

The Committee was advised that the Children's Strategic Commissioning Service was currently commissioning the Child and Adolescent Mental Health Service (CAMHS) on behalf of the four Clinical Commissioning Groups and Lincolnshire County Council (LCC). It was highlighted that the current service was currently being provided by Lincolnshire NHS Partnership Foundation Trust (LPFT).

It was reported that Children's Services had been delegated the lead commissioning responsibility for CAMHS on behalf of the four Clinical Commissioning Groups, by way of a Section 75 Agreement, which was due to end on 31 March 2019.

It was reported further that there was a contractual agreement in place between LCC and Lincolnshire NHS Partnership Trust (LPFT), which was due to end on 31 March 2018.

Following a re-structure of the service as a result of extra funding, LPFT had been working towards increased targets to ensure a swifter and better service was provided to those accessing the service.

The report sought approval from the Executive Councillor for Adult Care, Health and Children's Services for Children's Services to enter into a further two year agreement with LPFT to enable the service to continue whilst a large scale review of the service was undertaken to inform future joint strategic commissioning intentions of mental health services in Lincolnshire and the agreed approach for sourcing these services from April 2020.

It was noted that the proposed contractual arrangements for the interim two year period would change from a contract for services to a Provider Section 75 Agreement, which would delegate functions to LPFT.  A request was also going to be submitted to each of the CCG's to extend their existing funding under the Better Care Fund Section 75 Agreement for a further year up to 31 March 2020.

The Committee was invited to consider whether it supported the recommendations and to make any additional comments to the Executive Councillor.

A discussion ensued, from which the following comments were raised:-

·         Concerns were raised about whether professionals understood the difference between Healthy Minds and CAMHS and who to refer young people to.  It was noted that Healthy Minds was still new but there were clear pathways for services to be accessed in the best interests of the child.  CAMHS was only available for those with diagnosed mental health issues, which was why Healthy Minds has been commissioned.  The Committee agreed that there was a need to avoid Healthy Minds being seen as "CAMHS Light";

·         It was queried how eating disorders were dealt with given that they were very complex to deal with as the person suffering might not see it or want help.  Officers confirmed that it was delivered to the national specification and was a community based service. The Young People Eating Disorder Service worked intensively with young people using the National Institute for Health and Care Excellence (NICE) Guidance eating disorder pathway to keep them at home, but the young person could be referred to a psychiatric or mental health bed if need be. There were strict waiting times which were currently being met.  It was highlighted, however, that more work needed to be undertaken around early identification and prevention;

·         Concerns were raised about the length of the average waiting time for routine assessments of 4.4 weeks and the average wait time for routine treatment of 9.8 weeks.  The Committee agreed that these waiting times were too long for a young person to wait, whilst acknowledging the national waiting time was 18 weeks.  Officers highlighted that this would be looked at as part of the consultation, but for waiting times to decrease, there would be an impact on costs and staffing;

·         Page 75 - Admissions to Ash Villa – Confirmation  was given that Ash Villa was not a secure unit; and

·         Section 75 Agreement – The Committee was advised that the proposed Section 75 Agreement, would enable the Council to continue to provide a sufficient level of provision with scope to increase the quality of services that children with mental health conditions received across Lincolnshire.

RESOLVED

1.    The Committee unanimously supported the recommendations contained in the Executive Councillor report.

2.    The Committee requested that the following comments be passed on to the Executive Councillor for Adult Care, Health and Children's Services:-     

o   Concerns were raised about whether professionals understood the difference between Healthy Minds and CAMHS and who to refer young people to.  It was noted that Healthy Minds was still new but there were clear pathways for which services to access in the best interests of the child.  CAMHS was only available for those with diagnosed mental health issues, which was why Healthy Minds has been commissioned.  The Committee agreed that there was a need to avoid Healthy Minds being seen as "CAMHS Light";

o   It was queried how eating disorders were dealt with given that they were very complex to deal with as the person suffering might not see it or want help.  Officers confirmed that it was delivered to the national specification and was a community based service. The Young People Eating Disorder Service worked intensively with young people using the National Institute for Health and Care Excellence (NICE) Guidance eating disorder pathway to keep them at home, but the young person could be referred to a psychiatric or mental health bed if need be. There were strict waiting times which were currently being met.  It was highlighted, however, that more work needed to be undertaken around early identification and prevention; and

o   Concerns were raised about the length of the average waiting time for routine assessments of 4.4 weeks and the average wait time for routine treatment of 9.8 weeks.  The Committee agreed that these waiting times were too long for a young person to wait, whilst acknowledging the national waiting time was 18 weeks.  Officers highlighted that this would be looked at as part of the consultation, but for waiting times to decrease, there would be an impact on costs and staffing.