1. Child and Adolescent Mental Health Services – Tier 3 Service Specification Lisa Wells Commissioning and Redesign Lead – Women and Children’s Services Shropshire Clinical Commissioning Group Lisa.wells@shropshireccg.nhs.uk

2. Structure of CAMHS in Shropshire  Shropshire CCG commissions:  ‘Core’ CAMHS Tier 3 Service  CAMHS Learning Disability Service  Reaching Out Service  One provider across Shropshire and Telford and Wrekin – Shropshire NHS Community Trust

3. Background  A review was commissioned by Shropshire PCT and Shropshire County Council in 2011 to consider comprehensive CAMHS provision in Shropshire (not just Specialist Tier 3 CAMHS)  The two key findings from the Review:  the lack of a robust commissioning strategy for a Comprehensive CAMHS in Shropshire  secondly specialist Tier 3 CAMHS is seen as a service that works in isolation to the broader primary care services, education and social care

4. Areas for development  A number of areas for improvement were identified:  Data collection and needs assessment  Understanding of pathways  Understanding of criteria/threshold for the service  Long waiting times  Urgent referrals are not seen soon enough  Issues with transition to adult mental health services  Links to other services

5. Achievements to date  Revised service specification for Tier 3 CAMHS and Reaching Out Service (ROS) across Shropshire and Telford  Single point of access for referrals to CAMHS - via Compass  Service Development and Improvement Plan  Joint CQUIN for transition for 2014/2015 between CAMHS and Adult Mental Health Services (provided by SSSFT)  Clear timescales for referrals  Improved data collection and reporting to commissioners including weekly updates on waiting times

6. Next steps  Development of Compass including electronic referral form  Development and communication of a range of clear pathways for diagnosis and management of conditions  A scoping exercise exploring the demand for extending hours provision  Improvements to the 24 hour on-call arrangements, including scoping and reviewing the current provision  Development of joint working protocols to support the discharge of patients from acute settings who require Tier 3 CAMHS  Scoping the service requirements identified as a result of Special Educational Needs and Disabilities (SEND) Reforms