Agenda item

(To receive a report from Lincolnshire Partnership NHS Foundation Trust (LPFT), which provides the Committee with an update on the LPFT Child Adolescent Mental Health Service proposed service change to move to a permanent Intensive Home Treatment Team service.  Senior management representatives from NHS England and NHS Improvement; and LPFT will be in attendance for this item)  

The Committee gave consideration to a report which provided an update on the Lincolnshire Partnership NHS Foundation Trust (LPFT) Child and Adolescent Mental Health Service (CAMHS) and the proposed service change from in-patient care to a permanent Intensive Home Treatment Team service.

The Chairman invited Jane Marshall, Director of Strategy, Planning and Partnership and Andrew Horton, Lead Commissioner, NHS England and NHS Improvement – Specialised Commissioning (Midlands) to present the report, which was detailed on pages 17 to 22 of the report pack.

It was highlighted that on 22 July 2020; the Committee had given consideration to a report, which had advised of the impact of the new model of care in place in Lincolnshire.  At the aforementioned meeting, the Committee had asked that engagement should take place with the Lincolnshire public, to seek their views as to whether the new model of care should be a permanent change.

It was highlighted further that the report, which had been considered by the Committee on 22 July 2020, had demonstrated that the service was meeting all key indicators of quality, and the new model of care was delivering improved care to meet the needs of Lincolnshire children and young people, in the absence of a General Adolescent Unit in the county.

The Committee was advised that NHS England had embarked on targeted engagement activity to assess views and feedback on the new community model of care compared to in-patient care.  Some examples of the statements received were shown on page 18 of the report.

The Committee noted that the most recent engagement exercise was designed to assess the views on the pilot and also on in-patient care in Lincolnshire.  A copy of the letter and questionnaire sent to service users was set out in Appendix A, for the Committee's consideration.  It was noted further that a copy of the engagement letter and questionnaire had been circulated to patient representative groups, counsellors and case workers, young people and their carers, all of whom either had experience of in-patient care, or the community pilot, as well as charities who worked with young people and mental health.  The Committee was advised that the engagement activity was due to close on 19 February 2021.

During discussion, the Committee raised the following comments:

·       Response rate so far to the engagement.  The Committee was advised that to date there had not been a large number of responses to the current engagement exercise.  The Committee was reminded that a lot of engagement had already happened prior to the current engagement exercise  The Committee was advised that details of pre-engagement feedback; and results of the current engagement exercise feedback would be shared with the Committee at a future meeting;

·       The current vacancy rates for CAMHS.  The Committee was advised that although working through the pandemic had brought challenges to the team.  The team overall were managing to cope due to their multi-disciplinary roles.  It was noted however, that there was a shortage of Band 5 nursing staff;

·       When would evaluation information relating to the pilot exercise be available to the public?  The Committee was reassured that the evaluation information would be made available as soon as possible and would be available for the Committee to consider at their June meeting;

·       Clarification was sought relating to page 18, third paragraph, which stated that general adolescent units were out of scope at this stage.  The Committee was advised that non general adolescent units were out of scope for this exercise as they were for a different group of children and young people.  Most non general adolescent unit beds were catered for out of county at specialist centres.  It was however highlighted that the Lincolnshire pilot was already reducing the number of young people with eating disorders being catered for out of county, as a result of the early intervention of the Intensive Home Treatment service.  It was agreed that a list of mental health definitions would be made available to the Committee;

·       Page 21, final paragraph stated that in-patient care could be provided on another site within Lincolnshire.  One member asked where that site would be located?  It was highlighted that this would be a decision to consider, if raised via the engagement, as to whether in-patient care provision was required in Lincolnshire.  Confirmation was given that no decision had been made as to any location; and

·       Following the above, a further comment made was that if the decision was not to have an in-patient site in Lincolnshire, what support would be available to children and families with regard transport and accommodation.  The Committee noted that the service would do everything possible in the first instance to avoid admittance, and that with the early intervention; only a small number of young people would need to go out of area for specialist care.  The young people that had to go out of area, places would be sought through the provider collaboration for the East Midlands.  It was suggested that further consideration should be given to the provider collaboratives; and

·       The need to review provision for the period when a child transitions into adult services.  Reassurance was given that systems and practices were being improved and strengthened. 

RESOLVED

1.    That the joint report from Lincolnshire Partnership Foundation Trust and NHS Improvement on CAMHS Intensive Home Treatment Team be noted.

2.     That a further update be received by the Committee at its June meeting, which should also include information relating to provider collaboratives.