Health and Wellbeing Strategic Co-Ordinating Group

Wrexham Framework Partnership Board meeting 28 February 2007: Agenda Item 4.4

Appendix 2

Thinking of our Future

Children and Young Peoples Framework Partnership:

Emotional Health and Wellbeing (CAMHS)

Strategy Consultation.

Introduction

The first stage of the consultation programme was a Children and Young Peoples Framework consultation which took place in February 2006. The summary findings of this consultation are at appendix 1a and the Children and Young Peoples Consultation Report at appendix 1b. This Children’s consultation was commissioned through NCH the Childrens Charity and funded by Wrexham Local Health Board.

The second stage of the consultation programme was a consultation workshop day for Managers and Practitioners which was held in the Memorial Hall Wrexham on 14th September 2006.

The consultation document was also distributed through the CAMHS Strategy Steering Group network to;

·  All Statutory Agencies

·  AVOW

·  Individual Voluntary Agencies

·  Statutory Agency Board Members

·  Community Health Council

·  Childrens Commissioners Office

Two levels of document were produced which included a lengthy technical / clinical document of 48 pages and a bilingual summary consultation document of 8 pages. An additional leaflet was produced bilingually and distributed at the consultation event, through agency networks, to Primary Care Practitioners and the public. All documents were web sited with the Wrexham Local Health Board and the Local Authority and online responses encouraged. In excess of 500 leaflets were distributed across the County.

The final document consultation period ended on October 27th 2006. The total consultation period from first draft to final document was 20 months. During this time the CAMHS Strategic group was constantly seeking wider views. A service mapping exercise was reported upon on the 27th January 2005 and this fed into the development of the Strategy and provided a baseline assessment from which further service mapping could take place.

Consultation Responses

The morning and afternoon consultation events hosted in excess of 80 Practitioner representatives. The Children’s consultation approached and elicited responses from a diverse range of ages and backgrounds as detailed at appendix 1a.

A first reading summary was tabled to the CAMHS Strategy group on the 20th December 2006 as attached at appendix 2.

Detailed findings and responses

Service Provision

·  There was broad agreement with the content of the service provision described in the technical / clinical document. However Practitioners attending the consultation event who were working from the consultation summary document felt that they needed more time to digest and comment upon this area. It was agreed that further electronic versions would be fielded out as a further 6 weeks of the consultation period were still available at this point for more detailed responses.

Unidentified Gaps and Shortfalls

·  It was felt by some respondents that some of the Strategy remained aspirational and dependent upon recurring funding becoming available e.g. the development of Primary Mental Health Workers.

·  Out of hours and immediate assessment / crisis response may need further development.

·  Information for young people that they can access themselves was highlighted as an area of need.

·  A young adults service was identified as an area of need. This is currently part of the Strategy.

·  Links required to fostering and adoption strategies locally.

·  Voluntary organisation representatives identified the need to make clear links with homeless services and a consistent approach to those with multiple social and psychological issues.

·  Education representatives sought to highlight deficits in the consultation and advice services. This is also a feature of the Strategy to be developed through appointment of Primary Mental Health Workers. Wrexham LHB and Framework Partnership have attempted to address this issue in a limited way through e.g. the Solutions Project in Caia Park.

Features of the Model

·  Contributors comment upon the confusion that still exists around understanding the Tier concept of wider CAMH Services as described in both the Strategic document “Everybody’s Business” and the Local Strategy.

·  Some practitioners expressed the need to strengthen the referral processes. This fits with the concept of the Electronic Multi-agency Referral System (EMARS) currently under negotiations.

·  It was acknowledged that some young people with mental health issues also required the services of the Substance Misuse Team.

·  Transition times were highlighted as key areas that needed further development. To date a transition protocol has been implemented across Wrexham through the NHS Trusts. The development of a young adult service specification will provide a step towards improving transition stages for vulnerable young people with mental health needs.

·  The need to share information across agencies and for this to be reflected in the model accords with the current development in Childrens Services to identify shared information protocols and procedures.

·  The model does not address future demographic change and this needs to be addressed when the Strategy is reviewed annually utilising local demographic information to substantiate changes to the implementation plan.

·  The need to develop training programmes across the tiers is not a major facet of the model and this area requires strengthening.

General Comments

As described in the first reading summary there was broad general support for the Strategy and in particular for new ways of working i.e. EMARS.

Individual Organisational and Public Responses

Primary Care

The response rate was poor (N=<10) but one GP expressed a desire to see the development of a General Practitioner with a special interest in Emotional Health and Wellbeing.

Childrens Services

A small number of comments have been received (N=<10) which focus upon the need to implement at least key elements of the Strategy.

One teacher expressed the need for parent workshops which would raise awareness of emotional health needs in young children.

Voluntary Agency Responses

These have been limited (N=<10) but suggest that voluntary agencies could support families during waiting times between referral and assessment.

General Public Responses and Community Health Council

·  Expressed dismay at general funding for CAMHS.

·  Concerned about waiting times to intervention.

·  Co-ordination of services to prevent duplication.

·  Improved training at Tier 1.

·  Emphasise support for development of Integrated Services, Community Intensive Treatments Services and Out of Hours Provision.

·  Supports Strategy around Transition.

·  Supports development of appropriate services for Autistic Spectrum disorders.

All external contributors to the consultation process will receive acknowledgement of their contributions and assurance that these specific issues will be considered by the Strategy Group.

Conclusions

There is a need to integrate, harmonise and co-ordinate services across professional and agency boundaries. Many of the comments are already reflected in the action plans or in current developments i.e. EMARS, mapping, co-ordination pilots and Tier 2 geographical based projects.

Next Steps / Recommendations

·  That the work commenced by the Steering Task and Finish groups be fed into the Strategy document.

·  That the consultation responses are used to inform Strategy and plans (see appendix 3).

·  That the Training Task and Finish group should develop the Tier 1 understanding and awareness of the structure.

·  That the Children and Young Peoples Framework Partnership should continue to acknowledge Emotional Health and Wellbeing as a strategic priority.

·  The revised Strategy document will be produced and will need formal adoption by Framework Partnership Board in April 07.

·  This consultation report and its findings will be produced bilingually and be web sited.

·  All contributors will be acknowledged.

·  The Task and Finish group plans to be fed through the Health and Wellbeing Strategic Co-ordinating group of Framework Partnership to Partnership Board.

Appendix 1a

SUMMARY TEMPLATE FOR RESPONSE FOR THE CHILDREN AND YOUNG PEOPLES CONSULTATION OF THE EMOTIONAL AND PSYCHOLOGICAL WELLBEING STRATEGY – CAMHS

Please use the boxes below to include the information gathered from the consultation. Expand the boxes if they are not big enough.

Please include any quotes from participants.

Please add any further information on extra pages if you so wish.

SPECIAL THANKS FOR TAKING PART

& RETURNING INFORMATION DURING THE WEEK OF 13TH – 17TH FEBRUARY

1. Please indicate the number, age, gender, ethnicity and language spoken of children and young people.

1. What thoughts were expressed about making services child-centred?

1. What is it important for us to bear in mind in developing locally based services?

1. What ideas were expressed about the coordination of early years services?

1. What were the views about us creating new services and endeavouring to respond more quickly?