York & Selby CAMHS Service Delivery

Previous Service Delivery Model Based on the Tier Structure (HAS Report 1995). ‘Children’s mental Health is Everybody's Business’ Geographical Point of Access Role of Primary Mental Health Worker:- Consultation Initial Assessments and Short term Work Session into specialist CAMHS. Networking Education/Information

Tier System of Service Delivery

Constraints to Tier model Impact of Austerity. Service Transformation Agenda Change in multi agency landscape of provision Increase in referrals Lack of signposting opportunities. Erosion of PMHW role. Increase in waiting times at point of entry. Increase in waiting times for therapeutic interventions.

Vale of York Transformation Plan Priorities Prevention and early intervention Easier Access to support at all levels. Improved approaches in support for the most vulnerable. Committed to the Implementation of two main projects Enhanced Community Eating Disorder Team and School wellbeing project. Additional Funding to reduce waiting times. Single Point of Access for Child and Adolescent Mental Health Service.

York & Selby CAMHS Single Point of Access

Single Point Of Access Simplify access for referrers and service users. Allow the service to work to a single operating model Make best use of our expertise at the first point of contact Improve speed of Access to Family's.

York & Selby CYPS Proposed Service Model (Jan 2017) Signposted Psycho- Education SPA (Single Point of Access) Triage 30 Min Access to Service Interview Advice Discharge CAMHS Assessment (4 weeks) ED Pathway Duty/ Urgent Appointment Well Being Worker Pathways Emotional Disorders (depression, Anxiety, OCD, PTSD) Neurodevelopment (ASD, ADHD, LD) Eating Disorders (AN, BN) Speciality Pathways (Psychosis) Self Harm Assessment and Follow up Caseload Management Routine Outcome Measures/ Friends and Family Test CPA Status and Care plan Supervision Passport/ Care plan Pathway Clip-Ons Medication Family Therapy Parenting THRIVE Keys Green – Getting advice Blue – Getting help/getting more help Red – Getting risk support Discharge Passport/Care plan Discharge

Challenges of Change from Previous Service Model Reduction in CAMHS short term preventative work Reduction in capacity to attend multi agency meetings e.g. school meetings, Family Early Health Assessment’s. Less capacity for Specialist CAMHS to provide training, however Well Being Worker Service are offering training packages to schools.

Hoped for Benefits of Change Reduction of waiting times as increased assessments within Comprehensive Assessment slots will mean that clients are assessed sooner. Opportunity for staff skill mix development and to utilise range of skills as most staff will be facilitating Comprehensive Assessments. Increased capacity and utilisation of specialist skills. More direct route of referrals- accountability shared rather than individual. More robust networking and information sharing regarding service delivery across area.

Proposed benefits for families/young people. Immediate Screening and Contact with the Service. Centralised screening of required response. Signposting referrals at telephone consultation (up to 30 minute) More timely initial comprehensive assessment (ICA, working towards 28 day from point of referral) . Earlier Identification of clinical pathway.

Proposed benefits for Referrers Easier to Liaise with CAMHS Easier that referrals are more centralised. Increased partnership Working with Local Area Teams, Education etc. Centralisation Screening of Referrals regarding required Response times e.g. Rapid Access Self referrals commencing in July 2017

Benefits and Challenges for the CAMHS SPA Team Less isolating Shared Responsibility Structured and consistent Immediate access to Admin support Access to wider team. Embedded within Specialist CAMHS Team Embedded within local service delivery. Managing duty within current capacity Formation of a revised team/Consistency of approach

SPA Aspirations Referrers or family receive a phone call within 24 hours to discuss issues, advise on next steps or signpost those families who are not in need of CAMHS support to other services. To offer ICA within 4 weeks of referral Helping provide early advice for families that do not require further CAMHS assessment. From July 2017 families/young people will be able to self refer.

Remember ! This is a significant change to our service delivery. Your thoughts, ideas and views as this process evolves and develops are important!