To consider a report of the Director of All Age Commissioning (Trafford Council) and Director of Commissioning (Trafford CCG).

Associate Director of Commissioning explained the makeup of the Integrated Commissioning Unit (ICU) and their commissioning priorities. She then spoke about how commissioning was linked in with the other services being delivered by the Council. The Associate Director informed the Committee that the report provided an overview and that a more detailed update could be provided on any areas that the Committee were interested in. Trafford CCG had just published its ten year plan and children and young people’s services formed a key aspect of that plan.

The Committee were informed that the new provider of Community services within Trafford was to be MFT. Trafford CCG and MFT were currently going through due diligence prior to working out the details and finally awarding the contract. The Committee were told the governance arrangements for the transition and the process that would be followed to switch services from Pennine to MFT.

The Head of All Age Commissioning told the Committee that as she had not written the report she did not have the greatest depth of knowledge on all the services but she would do her best to answer the Committees questions. The Head of all age commissioning then went through the report. The report covered Children’s Mental Health (Wider Projects & Services), Children’s Mental Health (Healthy Young Minds), and Children’s Community Services. There were a number of services listed in each of these areas and the Head of all age Commissioning gave a brief overview of each one.

The Trafford were working on making the Rapid Assessment Interface Discharge (RAID) an all age service. This was an adult service which had great success and they were looking to expand this to include Children. There were also plans to expand the service to cover mental health in the same way as for physical health.

A new training offer for staff was being delivered to address a lack of confidence in their abilities to deal with children’s mental health issues. Feedback from the training provided showed that it had given staff members the confidence to support children with low level issues and stopped those children’s issues escalating.

There had been a number of issues in the transition from the old CAMHS model to the new Healthy Young Minds service model. The delays caused by these issues had added to the development of a long waiting list for the service. In response additional funds had been allocated as the new model was in place it was hoped that the waiting lists would be reduced quickly. A large part of the new service model was bringing parents into the process and the coproduction of services where possible.

Early help services had proven very popular and had attracted a large demand so waiting lists had developed for them. In response to the waiting lists some changes had been put in place including 42^nd street moving to holding their first meeting over the phone rather than face to face. The team were looking at other ways to reduce these waiting times.

Trafford were heavily involved in the development of the Greater Manchester CAMHS service specification which looked to enable a standardised approach to be taken across GM. The specification laid out a list of targets that Trafford were working towards including the need to hire an additional 5.8 FTE staff. The services supporting eating disorders were functioning well although there were some concerns regarding the contracts held with Pennine which had been agreed jointly with other authorities.

Within Children’s community Health Services there were waiting lists for speech and language therapy but Trafford were looking to reduce these. A new pathway had been introduced and there had been a reduction in waiting times since September. A report on the speech and language service was overdue and would be published in the next couple of months. A review of the weight management was being undertaken however in light of the transition to MFT the review had put on hold.

Following the report the Committee were given the opportunity to ask questions. The Chair asked for figures on the number of children on pathways, the numbers of children on waiting lists, and the waiting times.

A Committee member then asked who delivered the training to staff. The Head of all age Commissioning state that she did not know but would find out and pass that information onto the Committee.

The Committee Member then asked who were able to refer into services and whether the waiting lists were to get into the actual service or just initial assessment followed by further waiting. The Associate Director responded that she would look into the referral process and provide a detailed response to the Committee.

The Committee Member then asked whether the Committee could be provided with the speech and language therapy report when it was ready. The Head of All Age Commissioning confirmed that they would report back to the Committee once the report was released.

Another Committee Member requested that they are provided with details as of how the commissioning team were performing strategic commissioning. This was to include how the work reflected wider agendas and the impact that can be had through commissioning and procurement. The Head of All Age Commissioning stated that this was something that they could definitely bring to a later meeting. They explained that the brief that had been received for the report had been very vague and they welcomed input from the Committee as to what information they wanted to receive going forward. The Associate Director pointed out that the current Commissioning of services was due for a review especially in light of the creation of the ICU. There was the opportunity for commissioners to look at the wider determinants and the work of partners in order to take a more strategic approach to commissioning and service delivery as a whole.

A Member then asked whether the focus upon lower level needs and identification would have an impact upon the children who had pre-existing conditions and had higher level needs. The Head of all age Commissioning responded that there was investment being made across all parts of the service so it was hoped that improvements would be seen for all service users. Trafford were looking to develop a wide range of services to deal with the differencing need as of children. The Associate Director added that this was part of Trafford’s approach to focus upon the person rather than their condition.

Another Member asked about the Trafford overweight strategy and whether enough was being done. The Associate Director answered that commissioners recognised the issue which was why a large review had been conducted in 2017. Whilst there had been a delay on the implementation of this review it was a key priority and focus for commissioning.

The Committee Member then requested that an update on this be brought to the Committee in the next municipal year.

RESOLVED:

1)    That the report be noted.

2)    That figures on the number of children on pathways, the numbers of children on waiting lists, and the waiting times be provided to the Committee.

3)    That information regarding who provides training for staff is to be provided to the Committee.

4)    That the referral process for services be provided to the Committee.

5)    That the report on Speech and Language Therapy be shared with the Committee.

6)    That an update be provided to the Committee on Trafford’s Strategic Commissioning and how it fits into the wider agenda for the area.

7)    That an update on Trafford’s overweight strategy and implementation of the Commissioning review be added to the Committee’s work programme for 2019/2020.