Agenda item

To consider and endorse the Local Transformation Plan (LTP) for Children and Young People’s Mental Health and Wellbeing 2021-2022 - Rachel Jackson and Rob Sabin (WCC), Chris Evans (CWPT)

This item was introduced by Rachel Jackson and Rob Sabin of WCC, together with Chris Evans of CWPT.

The ‘Future in Mind’ review, released in 2015, set out a series of recommendations to improve outcomes for children and young people’s (CYP)         mental health and emotional wellbeing. The key principles of the review were set out within the report and reflected in NHS guidance and ambitions. This included a requirement for local areas to develop specific Local Transformation Plans (LTP) for CYP on an annual basis to demonstrate how the NHS ambition was       being fulfilled. The Coventry and Warwickshire CYP Mental Health and Emotional Wellbeing LTP had been updated for 2021-22 and was submitted for the Board’s endorsement. It had been developed collaboratively between the two local authorities (WCC and Coventry City Council), the CWCCG and CWPT.  The emerging ambitions were reported and had been included in the LTP delivery plan for 2021-22.  A copy of the LTP was appended to the report for consideration.

Rachel Jackson highlighted key sections of the report providing examples of the initiatives on early help and prevention, the eating disorder pathway, strengthening the multi-agency approach to services for CYP and digital services. Feedback was being sought from CYP in crisis to shape co-production of the service offer for 18-25 year-olds. Transition work was also planned.

There had been a number of challenges, with reference to system capacity demand for children in crisis, CYP presenting with more complexity of need, access to services, timeliness and effectiveness of service delivery. Similar capacity issues were reported for the eating disorder pathway. Reference to the additional difficulties caused by the Covid pandemic for children looked after, those with special educational needs and disabilities (SEND) and with the Youth Justice Service. The ability to engage with CYP and measure outcomes had similarly been impacted. These challenges had been taken on board in formulating the ambitions which were set out in the report.

Questions and comments were invited with responses provided as indicated:

• Reference to the outcome of the SEND inspection, which was awaited, the increases in SEN cases and the lack of real improvement in this area. Points about wider social issues, family issues and poverty, which required a partnership approach. The funding aspects were raised.
• Discussion about the governance process, the key lines of enquiry provided by NHS England and requirement for both this Board and that for Coventry to sign off the plan. Comment on the valuable local knowledge and opinions amongst Board members which should inform the process. These points would be made to NHS England.
• A view that there was a lack of support and funding for children in rural areas. It seemed from contact with school headteachers and parents of children that there was an issue to be addressed. Officers confirmed that any school could make a referral for CAMHS services. An outline was given of the other support available, including for professionals in schools. There were plans to expand the support teams piloted in the south of Warwickshire to both Nuneaton & Bedworth and North Warwickshire. Despite communications efforts, it seemed some schools were unaware of the services available. The member asked that consideration be given to future pilots starting in North Warwickshire rather than other parts of the county.
• Chris Evans spoke of the benefits of online/digital solutions to overcome the geographic challenges in service delivery, and these could be developed further. He mentioned use of the online dimensions tool or seeking a consultation with the primary care team via the RISE website.
• The Chair asked that a report be provided to a future board meeting on the learning from the support teams and roll out of the service to the rest of the County.
• Sarah Raistrick commended the report and suggested other resources which Board members may wish to visit, being the Kooth digital application and the Dear Life website. She also spoke about the crisis helpline, which had been valuable in helping people. The developing work on eating disorders and the long waiting times for autism patients were also referenced.
• The Chair referred to the breadth of this plan and need to revisit key strands of it. She reminded of the challenges before the pandemic and the position had exacerbated because of it. She asked how the plan would address this position and sought a summation. Officers confirmed that there were workforce challenges, a need for finance and a dialogue with NHS England to future proof services. The LTP provided a snapshot of the current position. Further points about integration of services and collaboration at all levels including with education and social care. Reference to place-based working and the need for trained staff to meet the needs of those requiring support. Monitoring of the LTP was raised an offer to provide a further update to the Board in six months.
• From the system perspective, CWPT had received additional resources recently and it would be useful to understand how this was being allocated between services for adults and those for children and young people. Linked to this was the workforce challenges due to staff vacancies and it was questioned how this would be tackled. Points about autism and learning disability and the transition arrangements into adulthood, with reference to the challenges experienced in Norfolk.
• There had been a significant uplift in funding for children’s mental health services. However, there were workforce challenges particularly for some areas, with reference to the eating disorder work as an example. A creative and innovative approach was being taken to address staffing shortages. This was evidenced by the joint work with acute hospitals and local authorities to provide services for children in crisis. It was considered that the local system was ahead of other parts of the region.
• The Chair asked that a breakdown be provided of the additional funding allocations for adult services, those for children and young people and for specialist areas like autism services.
• Reference to the All Age Autism Strategy and the links within the LTP to support the implementation of that strategy.
• A point that there were numerous strategies. For elected members, understanding how these aligned and when targets would be achieved were important, so that the impact of the strategies and the benefit for children, young people and their families could be seen. There were examples of improvements, but a need as a system to address this collectively and through this board to provide a robust challenge. A need to share data and to work in partnership. The Chair agreed that future reports should reference timing and impact.
• A discussion about the links between the LTP, the Integrated Care System (ICS) and each of the ‘places’. It was confirmed that integration was a key element of the plan. Detail on the ICS and its governance structures were to be determined.

Resolved

That the Health and Wellbeing Board endorses the Local Transformation Plan for Children and Young People’s Mental Health and Wellbeing 2021-22.