AGENDA ITEM

REPORT TO CHILDREN AND YOUNG PEOPLE HEALTH AND WELLBEING COMMISSIONING GROUP

17TH APRIL 2014

REPORT OF DIRECTOR OF PUBLIC HEALTH

MENTAL HEALTH NEEDS ASSESSMENT AND MENTAL HEALTH AND WELLBEING STRATEGY FOR CHILDREN AND YOUNG PEOPLE

SUMMARY

This paper provides an update on the health needs assessment (HNA) regarding mental health and wellbeing; and presents the framework for the Strategyfor mental health and wellbeing for children and young people (‘the Strategy’). A Strategy is being developed for Tees, together with a local action plan for Stockton Borough. The action plan will be based on the outcomes of the HNA.

RECOMMENDATIONS

The Children and Young People’s Health and Wellbeing Commissioning Group (CYPHWCG) is asked to receivethe update and provide comments on the Strategy structure and the HNA to-date.

DETAIL

  1. Previous papers to the CYPHWCG have outlined the scope of the HNA for children and young people’s mental health and wellbeing; and the progress in developing and commissioning the Targeted Mental Health in Schools service.
  1. A previous Tees CAMHS Strategy was in place 2008-12. Since then, the CCG (and the PCT prior to April 2013) has been leading work to develop the current CAMHS service. Revisions have been made accordingly to the service specification, including the development of an Integrated CAMHS Service which will focus on provision through Primary Mental Health Workers and capacity-building in the children and young people’s workforce. (The TAMHS service will focus on the schools workforce).
  1. As commissioner of the Child and Adolescent Mental Health Service (CAMHS), the CCG has secured the support of North of England Commissioning Support (NECS) to write a Strategy for Children and Young People’s Mental Health and Wellbeing together with key partner organisations. The Strategy was originally intended to focus on CAMHS services but partners made the decision to broaden its scope to mental health and wellbeing overall. Strategy development is being facilitated through a stakeholder group (the Tees CAMHS Transformation Group), including: NECS; Local Authority Children’s Services representatives; Public Health; the Middlesbrough Voluntary Development Agency representative (as a link to VDA equivalents across Tees); and the provider of CAMHS services in Tees (Tees, Esk and Wear Valleys NHS Foundation Trust).
  1. The framework for the Strategyis appended to this report. NECS and Local Authority leads are currently populating further detail. The framework has been developed through working with stakeholders, in the context of national policy context, available data, evidence of good practice and current service provision. The Strategy will also account for local policies and strategies in place, such as the Early Help Strategy. Current relevant Stockton strategies include:
  • Early Help Strategy
  • Alcohol Strategy
  • Domestic Abuse Strategy

A Stockton Borough action plan for sexual health will also be developed based on the health needs assessment which has just been completed, which be part of the approach to risk-taking behaviour encompassing mental health and wellbeing and resilience. The Strategy will also need to link to suicide prevention work locally.

  1. Constituent organisations of the stakeholder group will facilitate consultation and engagement with a range of stakeholders. The VDAs and their equivalent will support engagement with children and young people on the Strategy.
  1. The Strategy will set out the high-level approach across Tees to improving and protecting mental health and wellbeing for children and young people. The stakeholder group aims to complete the Strategy by June 2014. It is proposed the Strategy is signed off in Stockton by the Health and Wellbeing Board.
  1. A health needs assessment on the mental health and wellbeing of children and young people in Stockton Borough is being carried out. The HNA assesses local data and services for Stockton Borough and will be focussed on local engagement of children and young people including vulnerable groups. This will inform the local action plan for Stockton Borough, to ensure the Strategy is implemented and monitored meaningfully locally.
  1. The emergent themes from the HNA and proposed outputs are appended (Appendix 1) to this report. These have been developed through a working group to:
  • Map current local service provision
  • Map and request access to current service data and population data
  • Understand previous consultation work
  • Bring together the VCS and schools in Stockton Borough to discuss current provision and need; and the potential for future commissioning options
  1. Work will be undertaken with the Tees Valley Public Health Shared Service to model disease prevalence for Stockton Borough, given the paucity of available actual data nationally.

FINANCIAL IMPLICATIONS

  1. SBC will wish to consider implications for future service commissioning and development based on the outcomes of the HNA and key aims of the Strategy. CYPWHCG partners may also wish to consider joint commissioning opportunities in future. The work will help realise savings in the longer-term through reduced numbers of children and young people requiring more intensive, higher-level support.

LEGAL IMPLICATIONS

  1. There are no specific legal implications of this proposal.

RISK ASSESSMENT

  1. Each commissioning partner organisation has clear governance arrangements in place to manage risk associated with commissioning services.

SUSTAINABLE COMMUNITY STRATEGY IMPLICATIONS

  1. Implementation of the work will have a positive impact on both the Sustainable Community Strategy and Joint Health and Wellbeing Strategy themes through positive outcomes for education, health and wellbeing.

CONSULTATION

  1. Consultation is an integral part of the health needs assessment process, which will inform future commissioning.

Name of Contact Officer:Emma Thomas

Post Title:Joint Commissioning Manager – Children (NECS)

Telephone No:0191 374 4206

Email address:

Name of Contact Officer:Sarah Bowman

Post Title:Consultant in Public Health

Telephone No:01642 526828

Email address:

Appendix 1: Emergent themes from the Health Needs Assessment (at 21st March 2014)

Service provision and access

  1. There is some anecdotal evidence of access issues for services directly commissioned for mental health and wellbeing (TaMHS, CAMHS)
  2. Apart from services directly commissioned for mental health and wellbeing, there are other services (mainly VCS) providing various elements of mental health and wellbeing prevention and treatment
  3. From broader discussions, there is a question as to whether the services in point 2 are offered based on a agency’s strengths and the picture they have of need; and whether this matches with a more comprehensive picture of need (and unmet need)
  4. Services tend to be ‘stand-alone’
  5. There is a significant amount of cross-over between the offers of different services e.g. many offer counselling support
  6. Some organisations have areas of specific expertise. It is important these are maximised by ensuring specialist organisations bid for services within their areas of expertise. There may be a temptation for organisations to become more generalist, in order to secure further funding opportunities
  7. There is no single picture of provision across the board
  8. There is a question as to whether the VCS are proactively seeking business based around their areas of expertise; and exploiting opportunities to network with potential customers (e.g. response to the HNA questionnaires has been low to-date)
  9. Schools have expressed a significant need for support and have observed a significant and increasing level of need in their young people
  10. Many schools provide support as far as they can
  11. Schools have expressed a concern with access to CAMHS services
  12. Many schools have expressed satisfaction with TaMHS provision to-date; some schools have also expressed a level of dissatisfaction regarding some elements of TaMHS / suggestions for improvement

Data

  1. Data does not appear to be routinely collected and / or reported by many services (directly commissioned / SBC internal services; and VCS services)
  2. Actual data is unavailable re: unmet need and is based on modelled predictions

Communication

  1. Schools (as a major universal point of contact with most young people) do not have a good overview of the services available to them for support / referral. They need clear information on services and referral pathways

Consultation

  1. Recurring themes are emerging from the consultation data to-date

Provisional outputs

  • Commissioning framework for mental health and wellbeing, capturing a clear ‘offer’ to schools, children and young people and other stakeholders
  • Framework could be made up of provision through public sector bodies and VCS organisations. Providers should be encouraged to focus on their area of specialism (to exploit a corner of the market) and to form consortia to bid for elements of the framework contract
  • There may be a universal element to the contract; supplemented by targeted provision
  • The framework would need to be supported by a communications plan, tailored to all key stakeholders about the offer
  • Guidance for Catalyst to help them support VCS organisations re: capacity-building in the sector to bid for the contract; and to specify the areas of the framework and expertise required, that the VCS could bid for (including encouraging specialism of VCS organisations and encouraging consortia bids where appropriate)

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