To receive a report from the Executive Member for Children’s Services.

The Corporate Director of Children’s services gave a brief introduction to the report that had been circulated with the agenda. The Committee were informed that there were a number of services which provided support for Children and Young people’s mental health and wellbeing and that the report was focused mainly upon the Council’s CAMHS service, which was a commissioned service.  During the Pandemic there had been increased demand for mental health and wellbeing support both among children and young people’s services and adult services.

Following the Corporate Director of Children’s Services introduction the Specialist Commissioner provided a response to the questions that had been received in advance. The Committee were informed that the CAMHS service had been functioning as usual during the pandemic taking new referrals and continuing to meet with children and young people on a face to face basis where clinically necessary. Telephone and video appointments were used where appropriate and the services had linked in with schools to ensure appropriate support was available. Duty workers had contacted all new referrals to ensure that they were going to the most appropriate service.  The Council had seen a reduction in the number of referrals compared to the previous year; this reduction had been seen across all mental health services the council provided. While the number of referrals had decreased the level of activity within the service had increased as staff strove to contact service users to ensure they were coping. Waiting times had reduced from the previous year and as of July no child had waited longer than 5 weeks to receive an appointment. The level of referrals had increased to normal levels in recent weeks and the referrals that were coming through were more complex, which had been seen across all mental health services. 

In relation to recovery and surge planning the Royal Manchester Children’s Hospital, who provided Trafford’s CAMHS service, had set up two groups. One group was developing the surge plan to cope with the expected increase in referrals as children returned to school after summer. The other group was reviewing the work done throughout the COVID 19 pandemic to see what the service would keep in place as it was unlikely that the service would go back to the way it was before. The service was likely to become a blend of the pre COVID service and the current service with increased provision of telephone and video based support on top of face to face support.  The service had found that there were children and young people who preferred to access the service via telephone and video support and others who preferred to meet face to face with their clinician.

Another piece of work within the service was to employ a five subject matter expert who would be a key link for schools. A specific contact had been created for that worker so schools could go to them directly for advice and sign posting. All mental health services had been involved in the virtual mental health hub where a number of sub groups had been set up to ensure that services had plans in place for when schools reopened in September 2020.  The support provided included videos schools could access which explained the range of services available to them. Schools welcomed the mental health toolkit that the Council had created to be provided to children when they returned to school.

Following the update Committee Members were given the opportunity to raise any questions. Councillor Winstanley asked for clarification around the terminology in the report and what constituted a first assessment. The Councillor also asked what a booked appointment was. The Specialist Commissioner responded that both appointments could be via telephone, video, or in person depending on the need. When a referral came in it was triaged and a first appointment made with a timescale dependent upon urgency and availability of the service and young person. The first assessment was not always carried out by a clinician and so the Council also measured the waiting time between the referral and when the young person received treatment.

Councillor Dillon asked what the qualifications of the triage team were, whether any children and young people had been hospitalised during the COVID 19 period, what the response time for children who had been hospitalised was, and whether the child or young person would be seen in hospital. The Specialist Commissioner responded that there had been hospital admissions during the pandemic and the route for those children and young people was the crisis care pathway.  Trafford Commissioned the all age mental health service which delivered services at Trafford General, Wythenshawe, and Manchester Royal Infirmary. The standard waiting time for someone accessing this pathway was 1 hour to be seen by the all age mental health liaising team. The latest data showed that they had achieved that standard in June but had missed it in April and the exact data would be shared with the Committee following the meeting. The CAMHS team then performed a seven day follow up appointment with the child or young person.  Again the data on the seven day follow up was not available at the meeting but would be provided afterwards. The Committee were informed that there had been an increase in the number of children and young people who had been hospitalised during the period.  Regarding the qualification levels of staff the Specialist Commissioner needed to check with the service for the exact information but the Committee were assured that all staff were qualified mental health practitioners.

Councillor Thompson asked whether the Committee could receive monitoring data on the outcomes that children and young people achieved through the service. The Specialist Commissioner responded that monitoring data could be provided for both the CAMHS service and the other mental health services. The Committee were informed that services used different methods of assessment with some using goal based outcomes, some used strength and difficulty questionnaires, and the CAMHS used CHIESQ which was Children’s Experience of Service questionnaire. All services also recorded case studies and the Specialist Commissioner informed the Committee that an in depth report on performance data could be provided for all mental health services. The Commissioning Team ran an annual questionnaire with children and young people and stakeholders as part of the local transformation plan. Following the survey a “you said we did” plan was created to show respondents the impact that their feedback had on the service. The Specialist Commissioner told the Committee that she would prepare a document with all of the information in it.

The Corporate Director of Children’s Services added that while the Council did not provide the service directly they were committed to understanding what the service was like for Trafford’s children and young people. Trafford worked closely with providers to ensure that a robust performance framework was in place. The framework did not just look at waiting times but Children and Young People’s experience of the services from first contact through to treatment.

RESOLVED:

1)    That the report be noted.

2)    That the Committee are to receive performance data on the 1 hour waiting time for the crisis care pathway and seven day follow up be sent to the Committee.

3)    That the qualifications of the triage team be provided to the Committee.

4)    That the Committee are to receive monitoring data for all children and young people’s mental health services.