GP and Clinical Lead for Children and Young People Welcome Dr Bhumika Mittal GP and Clinical Lead for Children and Young People

Voting Q1 How well do you understand co-production? (Scale 1 – 5) Q2 How big a priority do you feel improving children and young people’s emotional wellbeing is? (High, medium, low, don’t know) Q3 As an individual, how interested are you in this work? (Scale of 1 to 5)

Co-Production: An Appetite For Change Head of Integrated Commissioning Daniel Taegtmeyer Head of Integrated Commissioning and Transformation 18 January 2018

Emotional Wellbeing, Mental Health Children and Young people 50% of all adult/lifetime mental illness first presents by age 14yrs, 75% by age of 24 A quarter (23.2%) of Bromley’s population is between 0-18 years (2014). National prevalence rates suggest 1 in 10 children and young people will experience difficulties with their emotional wellbeing and/or mental health. 7500 in Bromley

CAMHs Transformation Plans and “Future in Mind” Future in Mind – Government commitment and strategy to improve emotional wellbeing and mental health of CYP populations Theme Promoting resilience, prevention and early intervention Improving access to effective support – a system without tiers Care for the most vulnerable Accountability and transparency Developing the workforce Co-design future system and service models with CYP and communities

Bromley CAMHs Transformation Plans 2015 – 2018 : Principles Increasing capacity across the system Reducing waiting times Increasing access to services Offering the right support at the right time in the right place Improving patient experience of services Laying the ground work for system redesign – a proactive model Leveraging in co-design and co-production principles.

We can only achieve change if we collaborate. Transformation We have made a start but there is much more for us to do: We can only achieve change if we collaborate.

For Consideration today…. A system that supports children and young people to keep well Citizens are assets to families, communities, providers and the system No child or family is overlooked Reducing crisis presentations and Deliberate Self Harm (OD) Improving the crisis care offer The role of peer to peer support Developing consistent approaches to risk assessment, risk management and risk tolerance across all agencies Reducing school based and social media stress The role of digital assets to support communities 0 -25 years service model Delivering care closer to home Valuing a skilled, confident multi-disciplinary workforce

Design From Within We care about the wellbeing and future of all our children and young people Children and Young People are placed front and centre in all our reflections, planning and discussions. Tackling stigma and genuine listening to children and young people Co-Production and asset based approaches align with our values, facilitating a shift in approach to designing and delivering services For sustainable change we need champions and partners who are keen to learn, engage, innovate, actively contribute, co-design and ultimately co-own the system with citizens

What is Co-production Juliana Ansah, Co-production Manager Helen Sharp, New Economics Foundation   https://m.youtube.com/watch?v=u-f7hHa8xN4

Co-Production refers to an approach to service delivery that radically reimagines the traditional dynamic of expert service-deliverer working on behalf of the passive end-user. Instead the design, delivery and review of services are undertaken by both professionals and service-users/citizens. A co-production approach envisages a relationship of mutuality between services and service user, at all stages of a service’s life. It recognises that all parties have vital contributions to make to improve the quality of life for people and communities

Six principles of co-production 1. See people as assets 2. Building on our capabilities 3. Developing mutuality and reciprocity 4. Blur distinctions between producers & consumers 5. Grow people’s networks 6. Facilitating not delivering

Co-production in Bromley Co-production research in 2016 Outcomes

Co-production Project Co-production Manager Juliana Ansah Co-production Manager What we plan to do Where we are to date

Co-production Timeline OCT NOV DEC JAN FEB MAR APR MAY JUN Youth Forum Core Steering Group INSIGHT DESIGN TESTING REPORT Local Event #1 INTERACTIVE Testing event End of January—an event in each cluster Quick Win Testing -Create visual indicator -Meet Community Services -Develop Core Group -Read Relevant Reports -Create Monitoring Docs -Develop surveys and focus groups Local Event #2 EVENT Local Event #3

Co-production Project Feedback so far Analysis of responses Feedback from AAC and Y13 focus group

Surveys The CCG have received over 1200 completed surveys from CYP in Bromley in 5 week. AAC survey Easy read survey Paper survey Online Survey

1. Who/what helps you to stay emotionally well?

Focus Groups

Who are you most likely to share news with when you are emotionally well? A year 13 class at a grammar school (left) and a year 9 class in a girls school (above)

Who are you most likely to share news with when you are NOT emotionally well? A year 13 class at a grammar school (left) and a year 9 class in a girls school (above)

Data is still being collected

Voting Please use Mentimetre to vote for two outcomes from each section Bromley CYP Outcomes Framework for Mental Health Services External Factors Good Functioning Personal Resources Supportive friends and peers Relatedness peers and adults Empathy Confidential services Autonomy Self-esteem Community belonging Choice Patience Close family Emotional intelligence Accepting emotions Wellbeing focused schools Community connectedness Directing emotions

Where in Bromley do the top six outcomes already exist? Mapping Where in Bromley do the top six outcomes already exist? Using post-it notes, write down each of the top six outcomes and place each one on an area that is currently achieving that outcome. Service sheets are on your tables.

Reshaping the way we work Please use the expertise and resource around your table to help build, draw or design a system which illustrates one of the top six outcomes. 35 minutes

Reshaping the way we work Each table to explain the model for your outcome 1 min per table.

Challenges and pledges What do you think are the challenges to this approach and what is needed to overcome these? 10 mins How can you pledge to support this work? Please write your individual pledges on the cards provided and hand into your facilitator.

Voting Q1 How well do you understand co-production? (Scale 1 – 5) Q2 How big a priority do you feel improving children and young people’s emotional wellbeing is? (High, medium, low, don’t know) Q3 As an individual, how interested are you in this work? (Scale of 1 to 5)

Thank you all for your participation. Finish Thank you all for your participation. What happens next? Nazmin Mansuria, Senior Commissioning Manager (Children)

For more information about Co-production in Bromley and how you can get more involved email: Broccg.coproduction@nhs.net

Details of the New Economic Foundation (NEF) CYP Emotional Health and Wellbeing Report can be accessed here: Report