1. Healthy Young Minds Matter: Commissioning to improve the emotional health & wellbeing of children and young people in Gloucestershire Helen Ford, Project Lead Children and Maternity Commissioning Team September 2009

2. Key questions and issues Why are we redesigning? Current services Engagement and stakeholder views Proposed service model What we want in Gloucestershire Questions?

3. Healthy Young Minds Matter Service Redesign Project Why do we need to redesign? Progress has been made with existing systems and services have improved, e.g. shorter waiting times (March 2009 – 91% seen within 8 weeks) but…..:- We have got as far as this process will take us There remain gaps in service and/or the ways that they work together, e.g. there are not effective links across the levels of provision Most efficient use of resources needed

4. Current Services Tier/Level 2 Primary mental health in some areas and a few areas of focus eg Looked after children National ‘Targeted Mental Health in schools’ pathfinder Voluntary and community sector Some individual services via Budget Holding Lead Professional Some school counsellors independently provided Tier3/4 Level 3 –Specialist CAMHS (Including mental health linked to Youth Offending) –Infant mental health –Learning Disability service –Conduct disorder groups –Specialist therapeutic element of substance misuse

5. Current Services Tier3/4 Level 3 –Intervention Team for Looked after children –In-patient care out of county, mixture of NHS contracts and private provision –Some individual outreach commissioned

6. Engagement and involvement of stakeholders Significant programme of involvement that will continue Children and young people –What we already know from national and local sources –Gathering views of a wide range of young people including; Looked after children Those with existing emotional wellbeing issues BME groups Didn’t like the name CAMHS Want more information on what is out there Want help in a variety of settings, but important is confidential “Don’t let the bullies know”

7. Engagement and involvement Parents, carers and stakeholders –2 parents events, widely advertised –Met with groups with the aim of getting the views of ‘seldom heard’ parents in e.g. Children Centre, family projects –Key groups visited, e.g. social workers, GP’s, schools, including special schools and the Head of the Virtual School for Looked After Children –Questionnaire capturing themes asking for feedback on website Broad agreement for themes Website – www.gloshealthyminds.nhs.uk

8. Healthy Young Minds Matter Stakeholder feedback Demand outstrips capacity Inflexible availability out of normal 9-5. Mainly clinic based, difficulties of access for families Some not clear how to access and differing access pathways Limited access for practitioners, including GPs and schools to a mental health worker Very limited services available in the community for children with severe, acute and complex needs Limited services for children who do not meet the threshold for specialist CAMHS

9. Stakeholder feedback Mental health assessments at weekends for those in Paediatric wards who have self harmed Coordination with local voluntary sector provision Priority access and support for Looked after Children Support for children who are perpetrators of sexual abuse More support and information for parents of children with difficulties More information to help practitioners support children

10. Proposed Service Model Our planning and development of this service model is based on: The key principles identified, agreed and consulted upon in the Gloucestershire Emotional Health and Wellbeing Strategy 2008 Features identified in the National CAMHS Review 2008 The learning from our pathfinder National and local needs analysis Views of children, young people, parents and practitioners Research into what works and evidence

11. Healthy Young Minds Matter Proposed Service Model

12. What we want in Gloucestershire Provision from tier 2-4/level 2-3.Not eating disorders Services that are highly visible Easy point of access. Clear pathway Clear focus on prevention and early intervention throughout the levels. Building on and emphasising a stepped care approach Both the earlier and more complex needs of Looked after Children and other vulnerable groups will be met Community based services in the main for those with acute and complex needs

13. Integrated model for –Specialist substance misuse –Learning disabilities –Youth offending –Children in care A lead provider (or consortium) arrangement to manage the network. Inclusion of VCS. –young person gets the right service in the right place at the right time Principles of ‘step up’ and ‘step down’ care, using the wider children's services network and accommodation –quick and innovative response to the needs of children, young people and their parents What we want in Gloucestershire

14. Involving children and young people Evidence based Focus on building a culture of improving outcomes Creative, representing good value for money Safe and effective Be proactive and adapt to changing needs What we want in Gloucestershire

15. Healthy young minds really do matter in Gloucestershire Committed to improving outcomes for children and young people in Gloucestershire Track record of working collaboratively with providers Developed an outline service model with input from key players We want to refine this in partnership with you

16. Healthy young minds really do matter in Gloucestershire! Website will provide information for bidders ongoing www.gloshealthyminds.nhs.uk Any Questions?