Report of the Executive Director of Nursing & Safeguarding, Manchester Health and Care Commissioning

This report provides an overview of transformation work in relation to children and young people’s health services, with a focus on mental health. 

The Committee received a report of the Professor Craig Harris, Executive Director of Nursing and Safeguarding, Manchester Health and Care Commissioning which provided detailed information on the actions taken to deliver the children and young people’s transformation programme, to ensure the system provided the best support for all children and young people and the right support at the right time for those who were most vulnerable.

Professor Harris referred to the main points and themes within the report which included:

·                Providing a description and ambition of the Children and Young People’s (CYP) plan;

·                An update on the Children and Young People’s summit and how this had informed the development of the CYP transformation programme and work streams;

·                A description of the CYP integrated commissioning strategy;

·                A description of the CYP transformation steering group and programme work streams;

·                Information on Special Educational Needs and Disability (SEND) and transforming care;

·                Measures to prevent avoidable hospital admissions and reduce the length of stay in hospital;

·                The protocols, procedures and quality assurance for children with complex needs;

·                Children and young people’s mental health and care that focused on prevention, early identification, early intervention and self-care;

·                Vulnerable groups (including safeguarding and Our Children);

·                Greater Manchester Health and Social Care Partnership CYP health and wellbeing framework;

·                What was known about CYP mental health in Manchester;

·                CYP mental health outcomes; and

·                The Greater Manchester Review of Children’s Services.

Councillor Midgley, Mental Health Champion, had been invited to address the Committee. She said that she welcomed the report and the holistic approach to children and young people’s health. She reported that, in her experience, staff working in Child and Adolescent Mental Health Services (CAMHS) were dedicated and caring professionals; however, she had concerns regarding the caseloads of staff.  She commented that additional funding and research into this important area of care was required. She asked for clarification regarding waiting times for young people accessing services. She further commented that more needed to be done to offer community-based prevention services, stating that investment in these models of care would be more cost effective than crisis services and ultimately better for young people and their families. She enquired about the important role of the Voluntary and Community Sector and how this work was being coordinated. 

Some of the key points and themes that arose from the Committee’s discussions were:

·                Welcoming the voice of young people being present throughout the work described;

·                Did Our Children (children looked after by the local authority) have the same access to CAHMS and what provision was made for any children who were placed out of area;

·                Further information was sought regarding the Kooth service;

·                An explanation was sought regarding the reported 64% increase in requests for Education, Health and Care Plans (EHCPs);

·                To request that a specific report on CAMHS be submitted to the Committee that included case studies, information on the delivery and future planning of services in the context of financial cuts and an analysis of outcomes; and

·                To request a future update report on Children and Young People’s Health including information on young people’s dental health, obesity, malnutrition and school nurses.

Professor Harris acknowledged the request from the Committee for a specific report on CAHMS and confirmed that this would be provided. He said that there was dedicated funding for CAHMS but that the demand on services had increased. He said it was acknowledged that services need to be transformed and redesigned to deliver a holistic model of care for children and young people with an emphasis on prevention and improving the early help offer. He confirmed that Our Children did have access to CAHMS and for those children placed out of area, services would be commissioned in the host area. In regard to the issue of out of area placements for children and young people he said that the ambition was to reduce the number of these to zero by 2021. He commented that work was underway to coordinate the Voluntary and Community Sector offer and further information on this work stream would be provided in the CAHMS report.  He advised that information on caseloads and waiting times would also be included in the report.

The Executive Member for Adults, Health and Wellbeing recommended that the report on CAHMS should include information on the transition from children’s to adult services and that any relevant reports that were to be considered by the Health and Wellbeing Board would be shared with the Committee.

Darren Parsonage, the Deputy Head of Commissioning, Manchester Health and Care Commissioning, reported that the Kooth service was a free, 24/7 online counselling service for 11-18 year olds. He said that users could access this anonymously, access 1-2-1 counselling and participate in monitored chat room group discussions. He informed Members that workers from this service had engaged and delivered sessions with pupils in schools that had received positive feedback from both staff and young people. He reported that this service was also promoted in GP practices across the city.  

The Strategic Director of Children’s and Education Services explained that the reported increase in requests for EHCPs was as a result of the growing school age population in the city.

Decisions

1.         To request that a report on Child and Adolescent Mental Health Services be submitted to the Committee.

2.         To request that an update report on Children and Young People’s Health be considered at the May 2019 meeting and that this report include information on dental health, obesity, malnutrition and school nurses.

3.         To request that the Chair, on behalf of the Committee, write to the relevant Government Minister to lobby for additional funding for children and young people’s mental health services.

4.             To note that any relevant reports to the Health and Wellbeing Board would also be circulated to Committee Members.