IN WALES
Held at The Lake Country House Hotel,
Llangammarch Wells, Powys
18th April 2008
- Present: Dr H Holmes (Chair), Dr C Lamb, Dr R Glaze, Dr H Behi,
Dr P Gore-Rees, Dr E Kapp, Dr C Ball, Dr C Govan, Dr W Barber,
Dr A Hassan, Dr P Duthie, Dr A Dwyer, Dr S Awadalla, Dr W Lloyd,
Dr R Potter, Dr A Ubeysekara, Dr P Roots.
2.Apologies: Dr O Sola, Dr S Elsayed, Prof. R Williams, Dr K Lynch,
Dr T Lorenz, Dr U Geethanath, Dr M Hasan, Dr A Sabir, Dr D Williams,
Dr L Eve, Dr S Boyd, Dr P Reddy, Dr G Davies, Dr T Munoz, Dr S Ames,
Dr G Salmon, Dr P Halford, Dr A Darwish, Mr M Griffiths, Dr D Williams,
Dr A Ahuja, Dr H Barton, Dr P Menzies, Dr A Goel, Dr H Hayes.
3.Minutes of last meeting – 19th October 2007
4.Matters Arising
FACTS meeting with HCW, Commissioners and Clinicians from North and South Wales arranged for 24th April in Caerphilly.
Welsh Schools Debate:- No progress as yet, can go ahead re finances.
- Chair’s Report
Dr Helen Holmes
a)Many of you will know that I have changed jobs within the Cardiff and Vale area recently. I have moved from being the Consultant covering the East of Cardiff at tier 2/3 level to being Consultant for the CIT team covering Cardiff and Vale working at tier 4 level. The move took place on 1st March 2008 having been delayed from 1st Jan and 1st Feb 2008. The relevance of this to a college report is that my time and more importantly my attention has been largely taken up with things other than the Royal College of Psychiatrists and my role as chair of this group.
Due to my ongoing lack of time to do justice to the requirements of the role of Chair I have decided to step down as soon as is practical. My term of office would come to an end in the Summer of 2009, but I think that it is important to have an active representative for CAMHS in Wales before then.
The Chair of this group sits on two other college committees. These are the Executive Committee of the Welsh Division of Psychiatry and the Executive Committee of the Faculty of Child and Adolescent Psychiatry.
Discussion within the Faculty of Child and Adolescent Psychiatry has continued into the issue of the number of CCTs for psychiatry. The child and adolescent faculty is continuing in its opposition to a single CCT.
The Welsh Division was involved with the response to the proposed new Mental Health Act and is part of the Implementation Reference Group, which continues to work on the Code of Practice for Wales. The National Assembly for Wales is proposing to take backbench legislation in the form of a Legislation Competency Order with regards to the new Act, and the Division hopes to engage in this process of interpretation and implementation.
The Division has developed a two-way consultative relationship with the Welsh Assembly Government. The chair of the Division meets with government officials to discuss issues of priority for mental health services in Wales.
The Division has contributed to reviews of service developments including the strategic review of secure mental health services in Wales and the Burrows Greenwell review of the structure of mental health services across Wales. Both reviews are due to report in early 2008.
The Division Biannual General Meeting is on 25th April 2008 in Swansea. This will be a joint meeting with the Welsh Psychiatric Society. The two organisations are working with the University Departments of Psychiatry in Wales to rationalise meeting for psychiatrists.
b)Dr Lamb reported from the last Child and Adolescent Faculty Executive Committee Meeting at the Royal College of Psychiatrists in London on the 11th March 2008 as Dr Holmes had been unable to attend.
She reported that the Child and Adolescent Faculty was supporting with determination the wish to keep a separate CCT in Child and Adolescent Psychiatry. Greg Richardson, the current chair of the faculty had written to PRETB, the GMC and the Head of Education and Training and Development at the DoH to inform them of this. Copies have gone to the Children’s Commissioner in England, Wales and Scotland, to Richard Williams as Chair of the Academy of Royal Medical Colleges in Wales and to Val Anness the chair of the Welsh Division. A copy of the letter is attached to these minutes. (Appendix A)
The meeting was informed that the next Child and Adolescent Faculty Residential Meeting will be from 17th to 19th September 2008 in Liverpool. The venue of the 2009 meeting has not been confirmed.
- Training Issues
Dave Williams unable to be present. Dr Lamb reported that members of the Faculty Executive have been working on the curriculum for Child and Adolescent Psychiatry training and that this might in the future link in with the re-validation process for consultants.
- Secretary / Treasurer’s Report
Summary of accounts – 18th April 2008
Balance at 1st October 2007 = £2,269.71
Receipts
£945 in payments for October 2007 meeting
£100 in payments for October 2007 meeting
Payments
£1,175.00 to Lake Hotel for October 2007 meeting
Balance at 25th March 2008 = £2,139.71
8.Regional Representative’s Report
- John Talbot sent his apologies and announced he wished to stand down as Regional Representative as soon as possible.
- He had sent some information via Helen Holmes for feedback. There were concerns re: workforce and capacity issues in West Wales that Dr Ann West would address in more detail.
- Concern was expressed that the safeguards put in by the Royal College of Psychiatrists to ensure good training for junior doctors were being eroded in both NHS Trust and FoundationTrustHospitals.
9.Vacant posts within the Faculty of Child and Adolescent Psychiatry of the RoyalCollege of Psychiatrists in Wales.
1)Chair of Child and Adolescent Faculty (Welsh Division)
2)Regional Representative for the Child and Adolescent Psychiatry in Wales.
1)Dr Helen Holmes proposed Dr Lamb as new chair of the CAP faculty (Welsh Division). This was seconded by Dr Talbot in his absence and agreed by all present. Dr Clare Lamb was hence duly elected as Chair. This resulted in the post of secretary becoming free.
A request was made for proposals and seconds for the post of secretary. There were no willing applicants during the meeting.
Action:Helen Holmes to request nominations by e-mail.
2)Dr Robert Potter was proposed as new Regional Representative. This was seconded and supported by all present. Dr Robert Potter was hence elected as Regional Rep. This will be taken to the next exec meeting of the RoyalCollege on June 18th 2008.
10.COMPASS Indicators’ sub-group
Helen Hayes was unable to attend but Clare Ball provided feedback to the meeting. The sub-group met in November 2007 and a provisional data sheet has been developed (included for circulation).
(Appendix B)
There was a lack of clarity about whether WAG was planning to discontinue the COMPASS process. Clare Ball and colleagues planned to try to ascertain further information on this prior to going further with the work.
- Tier 4 CAMHS in Wales
1)South Wales: Harvey Jones Unit has now moved to new premises. Official opening scheduled for May. Emergency beds not yet open. Financial disputes reported with HCW. Some referrers finding this difficult as has consequences for HJU to respond to the clinical need.
2)North Wales:Final Business Case now with WAG for “new build” on AbergeleHospital site. HCW have agreed to fund current Cedar Court Unit to open 24/7. Successful recruitment of nursing staff proceeding well. New Staff Grade post soon to be advertised.
12.Audit of Vacancies
Conwy and Denbighshire 220,000 population
2.4 wte CAMHS. No vacancies.
North Wales Adolescent Service (Tier 4 CAMHS)
1.2 wte. No vacancies
Bangor 186,000 population
0.7 wte and 2 vacancies.
Flintshire 148,000 population
1 wte and 1 vacancy.
Wrexham 150,000 population
0.8 wte and 1.2 vacancy.
Powys 126,000 population
1.4 wte, 1.0 vacancy (0.6 filled by locum).
Ceredigion, Pembrokeshire and Carmarthenshire
362,000 population
2.0 wte and 1.3 vacancy
Swansea, Neath and Port Talbot 400,000 population
3.5 wte and no vacancies
Cardiff and Vale 420,000 population
3.8 Community, 2.0 HJAU and 0.8 locum, 1 vacancy (CITT)
Mid Glamorgan 440,000 population
4.2 wte and 1 vacancy with locum in post, and 1 wte CITT.
Gwent 560,000 population
6.6 wte and no vacancies.
Learning Disability – 1 wte North Wales
Higher Trainees
South Wales
SPR’s – 8 in post – 1 vacancy.
North Wales
1 ST4 post in North Wales.
12.Any Other Business
1)Dr Lamb reported that the Vice President of the Royal College of Psychiatrists, Dr Roger Banks was the lead in the College for Primary Care. He has requested the input of a Child and Adolescent Psychiatrist from Wales into the Forum for Mental Health in Primary Care. Dr Bob Potter expressed an interest and
Dr Lamb will pass his name on to Dr Banks.
2)ADHD Research. A report was made on behalf of Professor Thapar for referral of cases to the SAGE study. (Leaflet attached). Please consider referral of any patients with ADHD. Clinicians present stated that patients they had referred found the research process a positive experience. (Apendix C)
3)Dr Ann West described some difficulties and capacity and workforce in West Wales since a consultant post vacated by a colleague in January 2008. The colleague had been off sick for a long period of time prior to January. She explained that they were left with a number of difficulties and in addition the Trust and CAMHS community network were moving towards ADHD being an exclusion criterion of referral to specialist CAMHS. Dr West expressed concerns about the impact on services for children in West Wales.
Action: Dr Holmes to write to Val Anness and Dr Gary Richardson on behalf of the Welsh Group Child Psychiatrists. She will request whether Val Anness might raise the issue with the Minister for Wales.
4)Dr Lamb asked on behalf of Dr Peter Gore-Rees if any members were aware of any particular drivers/policy re therapeutic foster care in Wales. Members were not aware of any.
5)There was an acknowledgement of difficulties with respect to CAMHS Learning Disability Services across Wales.
6)Discussion took place about the proposed subjects for the next meeting. Proposals were put forward for a presentation/discussion on ‘New Ways of Working’ as applied to CAMHS and/or Bipolar Disorder in Children and Adolescents.
7)Thanks were extended to Dr Habib Behi, ST4 in North Wales and
Mr Paul Barber, trainer in Mental Health Law for excellent presentations/teaching sessions on the Mental Health Act (2007).
Thanks were also extended to Dr Awadalla, SpR, following an interesting poster presentation of an Audit on the use of Risperidone in Children.
13.Dates of next meetings:-
1)Friday 17th October 2008
2)Friday 24th April 2009
To be held at The LakeCountry House, Llangammarch Wells, Powys.