Children and Young People Mental Health
Transformation plansQ3 return
  1. Mental health needs and activity
The mental health needs assessment for Bolton has recently been refreshed; the data within this report has been used to develop activity assumptions.
There are 15,050 CYP in Bolton aged 5 – 19 years who would benefit from a MH intervention not suitable to CAMHS.
Objective / 2016/17 / 2017/18 / 2018/19 / 2019/20 / 2020/21
80% of the needs based group is thriving and would benefit from EHWB support only. / In development / 56% / 64% / 72% / 80%
Activity Projections / 8,428 / 9,632 / 10,836 / 12,040
There are 4,400 Children and young people (aged 5 – 16) in Bolton who are eligible to be seen by a NHS funded community mental health provider. Bolton FT provide a community mental health service for patients aged 5 – 18 years. A further 1,990 16-19 year olds suffer from a common mental health problem. Within Bolton there are three community mental health providers Bolton FT CAMHS (5 – 18 year olds), IAPT (16 – 18 year olds) and Early Intervention in Psychosis 14 years old +
In order to model current activity levels the tier 3 population base for 5 – 19 year old have been taken into consideration.
Objective / 2016/17 / 2017/18 / 2018/19 / 2019/20 / 2020/21
At least 35% of CYP with a diagnosable MH condition receive treatment from an NHS-funded community MH service / 28% / 30% / 32% / 34% / 35%
Population projections to receive specialist community MH services / 1,790 / 1,917 / 2,044 / 2,173 / 2,237
Assumptions based on Bolton CCG ¼ referrals into children’s MH services* / 1,980 / 1,980 / 1,980 / 1,980 / 1,980
Activity assumptions / 64 / 193 / 257
  • Data source NHS digital
The children’s community MH team have already achieved the standard for 2016/17 and 2017/18. However further work needs to be undertaken to clarify referral pathways and to better understand the detail and number children accessing IAPT (16 – 18) and EIP (14 years+) services.
  1. Project Outline
The CYPMH transformation plan outlines the direction of travel within Bolton in relation to children and young person’s mental health and wellbeing. It takes into account the recommendations from Future in Mind along with the views of service users, providersand VCSE plus the recently published 5 year forward view for mental health.
Bolton CCG are active members of the Greater Manchester Future In Mind Group and are working collaboratively to identify collaborative commissioning priorities. A desk top review of the transformation plans has been undertaken to ensure alignment with national and Greater Manchester priorities, as follows:
To support the implementation of the Greater Manchester I Thrive model /
  • Development of a mobile app to enable children and young people to manage their own health and wellbeing.
  • Bolton Thrive Alliance partners have been identified. Plans in place for the Alliance to develop and deliver emotional health and wellbeing activities. Models for the delivery of low level interventions will form part of the CAMHS pathway development.
  • Pathways between voluntary sector, GPs, 5-19 service and CAMHS are being developed.
  • Recruitment of 3 CAMHS nurses to support secondary school clusters.
  • Commenced roll out of CYP IAPTmethodology to wider community services

Use of Royal Colleges of Psychiatrists education portal MindEd /
  • Agreement on which modules of MindEd should be placed within contracts, service specifications and education packages across Bolton conurbation.
  • MindEd will be an integral part of the health and wellbeing app.

Workforce development /
  • Workforce mapping within CAMHS complete,
  • EHWB workforce within 5-19 service and further development within 3rd sector.
  • Roll out of CYPIAPT methodology into community settings.

Crisis Care / Bolton CCG are actively involved in the GM crisis pathway development programme which includes:
  • Improving access to 24:7 Mental Health provision and 7 Day Community Provision for Children and Young People (CYP).
  • Development of GM crisis care standards
  • Extension of the RAID service to under 16 year olds.
  • Review of the current on call rota.

Tier 4 /
  • Reduce Bolton’s Tier 4 bed usage evaluating current crisis and further developing pathways.
  • NHSE member of GM Future In Mind meeting and working collaboratively to ascertain total bed stock required.
  • Implementation of CAMHS transformation plan aims to reduce Bolton’s Tier 4 bed usage by strengthening local pathways.

Vulnerable groups / During 2016/17 Bolton CCG and partners have:
  • DeliveredCrisis Response and De-escalation Leaders in Emergency Services (CRADLES) training for all 270 GMP Bolton Police officers. The intensive one-day training package has been developed by GMW staff from Criminal Justice and Social Work Teams within Bolton.
  • Working with the local authority to improve support for LAC
  • Fort Alice has been commissioned to provide psychological therapy for children and families affected by domestic abuse.
  • Links established with the Greater Manchester LD early intervention group which is tasked with developing a case for change and recommendations on new early intervention models.
Further work to be undertaken with stakeholders includes :
  • Custody liaison and diversion services development
  • YOT around reducing re-offending and improving the health and wellbeing of youth offenders.

ADHD /
  • Contract variation in place with Bolton FT to continue to deliver ADHD QB test
  • Review of the GMSCN ADHD action plan
  • Work underway to redesign local Childrens ADHD pathway

Community Eating Disorder Service (CEDS) /
  • CEDS Business Case approved at CCG Executive 28th September 2016.
  • CEDS Business Case approved at CCG Board in October 2016.
  • Continue to work collaboratively with providers and lead commissioner (Wigan CCG) on the children’s community eating disorders service.

Service user involvement /
  • Children and young people were involved in the development of the co-produced CAMHS transformation plan as part of the Building Health Partnerships project
  • Children and young people with the support of BAND are leading on the development of the EHWB mobile application
  • Children and young people with the support of CAMHS are leading on a local MH anti stigma campaign
  • Children and young people were members of the evaluation panel for 3rd sector Thrive expression of interest.
  • A young person has been supported to lead on the development of a youth LGBT service user group

  1. Budget

Allocation / Planned Spend (Budget) / YTD Spend / FOT Spend
CYP MH / 673,000 / 434,750 (end of Q3) / 673,000
CYP ED / 170,000 / 28,000 / 168,000
  1. Issues and Opportunities

Refresh of plans /
  • Plans aligned to Greater Manchester priorities as described in point 2 above.

CAMHS Staffing shortages /
  • Opportunity to work with Health Education England and partners to look at new workforce models

  1. Major Risks
  1. CCG Assurance

As part of the CCG assurance process Bolton CCG submit returns to NHS England on the implementation of the CAMHS transformation plan. These returns have beenassessed by NHS England and reported within the NHS England CCG Improvement and assessment dashboard. The dashboard for January 2017 indicates that Bolton CCG is in Quartile 1 (High) for children and young people’s mental health transformation with a score of 85% compliance.

  1. Governance

Governance arrangements for the implementation of the CAMHS transformation plan have been reviewed and reports are now submitted to the Maternity & Childrens strategy and planning group and the MH Strategy and Planning Group. The local governance structure diagram is included below.

Author: Sherida Collins

Mental Health Commissioning Manager