1. East of England Community FCAMHS
Stakeholder Event – summary and feedback
Dec 2018

2. Introduction/Background
FCAMHS is a Regional Specialist Child and Adolescent Mental Health Service for High Risk Young People with Complex Needs.
Set up to address Unmet need
Commissioned by NHS England
Country wide pilot split into 13 regional services
Aim of pilot service is to ensure Parity of provision
For East of England the bid was won by CPFT

3. Possible Referrers include: East of England- Map of Geographical Area
Safeguarding
SCH
YOS
STC
SARC
Inpatient
LAC
MST
Education
CSC
CPS / Police
GPs / HVs
Residential
CJS
East of England- Map of Geographical Area
Norfolk
Cambridgeshire and Peterborough
Bedfordshire
Hertfordshire
Suffolk
Essex

4. Referral Criteria
under 18 years old at the time of referral (no lower age threshold)
presenting with severe disorders of conduct and emotion, neurodevelopmental or serious mental health problems or where there are legitimate concerns about the existence of such disorders
usually involved in dangerous, high-risk behaviours towards others whether they are in contact with the youth justice system or not
in exceptional cases, are not high risk (not primarily dangerous to others) but have highly complex needs (including legal complexities) and are causing major concern across agencies

5. CAMHS vs FCAMHS – Acceptance criteria
Concerns about self-harm
Not appropriate if self-harm if primary risk concern
Age Threshold may vary
Children need to be under 18 at time of referral
Tend to discharge (not always the case):
-if no diagnosis present
-if children have CD
-if no intervention possible
Not diagnosis-led
(eg. Features of CD and/or LD)
CAMHS care coordinate/are the lead health professional in a case referred to FCAMHS
FCAMHS do not care coordinate
Locality based- tend to see children at specific clinic locations
Regional:
-often, we do not see children directly
-when we do, we will arrange to see them at a place where they feel safe eg. educational setting or home setting.

6. Who we see: Complexity ACEs LAC, CPP ‘edge of care’ in secure estate
Looked after children
Who we see: Complexity
ACEs
LAC, CPP
‘edge of care’
in secure estate
CJS/Police,
special educational needs
abuse, CSE , ‘missing’ episodes
multi agency involvement
al education
Multi agency involvement
Previous abuse
Child sexual exploitation

7. Who we see: Possible Risk Behaviours
Sexually harmful behaviour
Internet offending
Terrorism/Radicalisation
Stalking
Fire setting
Violence
Property damage
Threats

8. Who we see: Types of Mental Health Concerns
NOT diagnosis led
Neurodevelopmental difficulties
Mental Illness
Conduct Disorder
Comorbidities
Learning Disability

9. What we do Clinical Advice Consultation Multiagency liaison Assessment
Intervention where indicated.
Mediate transitions in and out of secure care
FCAMHS also has a non-clinical element covered in further slides

10. What we do Assessment Multiagency Liaison Consultation Advice
Intervention
Referrer/ lead agency remains involved throughout
Joint working

11. Few Practical Points for Referrers
Joint work
No care-coordination
Collateral and Supporting Information
Information Sharing
Current response times

12. Aloof from other provision
What FCAMHS is not commissioned to be
Aloof from other provision
A repository for all local cases with complex needs
A service which is able to provide targeted interventions for all specific high risk groups
A (long) report-writing service (unless specifically required)
A gatekeeping service

13. Operational Structure
Directorate admin Lead
Directorate General manager
Directorate Clinical Director
Band 4 Senior Admin
Appointed
1.0 WTE
Service Manager
Appointed
0.8 WTE
Clinical Lead/ / Consultant Psychiatrist
Interim in Post
Band 3 Peer Support worker
Appointed
0.4 WTE
Band 3 Admin
Appointed
1.0 WTE
Band 8c Consultant Psychologist
Secondment Started
1.0 WTE
Band 8a Psychologist
Appointed
0.8 WTE
Band 6/7
Psychologist
Appointed
1.0 WTE
Band 7 SMHP (Nurse)
Appointed
1.0WTE
Band 7
Social Worker
Appointed
1.0 WTE
Band 8a / 7
MHP
Vacant
1.0 WTE
Band 7 SMHP
Vacant
1.0 WTE

14. Activity 1 - Current Pathways
Inquire
What links and services currently exist for this group of young people?
Good Models: What do you feel is working well?
Imagine
What would you like FCAMHS to provide in order to help you support these young people?

15. Activity 2 – Training Opportunities
Inquire
Are there any topics that you would like FCAMHS to provide training to your team on?

16. Exercise 2 – Training requests
Risk Assessments
Specific clinical interventions

17. Non-Clinical Functions and Expected Outcomes of FCAMHS

18. What we do - Non-Clinical:
Development of joint working arrangements
Development of strategic links between local, regional and national networks.
Identifying gaps in local and regional service provision. FCAMHS – leadership role.
Provide training for practitioners from all agencies in relation to areas within the service’s specialist remit

19. Expected Outcomes
Provision of clinical and non-clinical service functions
Assessment in child’s locality/current placement
Access, transition to and discharge from secure settings
Admission to secure settings only when indicated
Safe, timely and effective assessment
Improve mental health and wellbeing by identifying and addressing mental health needs of high risk young people

20. Expected Outcomes (cont.)
Minimisation of risk to self and others
Individualised developmentally-appropriate framework of care
YP and Family involved in decision making
Safeguarding principles embedded in service
Service accessible to all young people from the catchment area, even if currently placed OOA

21. THANK YOU