Agenda and draft minutes

(1)          The Chairman welcomed Susan Cruickshank to the meeting. She was accompanied by Jo Scott (Programme Director - Kent and Medway Children Young Peoples Services, Sussex Partnership NHS Foundation Trust).

(2)          Susan outlined her role as the Clinical lead for the Children in Care (CIC), Children & Young Peoples’ Mental Health Service (ChYPS) in Kent and Medway.  She explained that KCC made a significant contribution to this service which provided mental health services to support Kent and Medway children placed with foster carers and in care homes.   It was a specialist service targeted at Kent and Medway CiC but not children who had been placed in Kent and Medway by another local authority.   CiC that had been placed in Kent were supported by the mainstream ChYPS service.  

Q – How many Kent and Medway CiC do you support and how many CiC placed in Kent are supported by the mainstream CAHMS service?

(3)          Susan stated that there were 450 Kent and Medway CiC who were currently accessing the service.  There were 20 non Kent and Medway CiC placed in Kent who were identified as accessing the mainstream ChYPS.

Q – Are these children spread across the County?

(4)          Susan replied that the majority of looked after children were placed in the Thanet area.  However, the volume of referrals vary and where they access the service would depend on where they are placed not where their social worker was based.  She stated that there were CIC team members in all 4 ChYPS hubs  located across the County and data was being complied on which areas referrals were coming from.

Q – As you have stated that 20 CiC placed in Kent accessing the mainstream CAHMS, these means that those who have tier 2 or tier 3 needs are not getting a service is that the case?

(5)          Jo explained that a lot of these young people are referred into the mainstream service via an emergency service.  If these young people are referred by their GP and meet the threshold for access to the mainstream ChYPS then they receive a service.  Also some of these CiC may receive support from the CAMHS teams in the area which they come from.  She acknowledge that the number reported as CiC accessing the mainstream service in Kent and Medway was surprisingly low and there may be under reporting.  Jo undertook to supply the Committee with the up to date figures for these CiC accessing Kent and Medway services.

Q – Can you explain why CiC need a special CAMHS?

(6)          Susan stated that this was a complicated question.  She explained that prior to coming into the care system, young people are likely to have experienced a range of traumatic events e.g. neglect and abuse. Whereas the majority of mainstream young people are less likely to have had such traumatic experiences in their earlier years, therefore CiC were at a disadvantage because of the range of problems that they had experienced. Some children were  ...  view the full minutes text for item 15.

(1)          The Chairman welcomed Nancy Sayer to the meeting and invited her to introduce herself and to briefly outline her role before answering questions from Member.

(2)          Nancy explained that as the designated Nurse for Looked after Children (LAC) for Kent and Medway she covered all 8 CCG (Clinical Commissioning Group) areas. She was a shared resource hosted by Swale CCG.  Her role was to provide expert advice on clinical matters regarding LAC, both Kent & Medway’s own LAC and those placed in Kent by other local authorities.  It was her responsibility to support the CCGs in   meet their statutory responsibilities to LAC.

Q – How do you encounter LAC and if you identify issues how is the next stage?

(3)          Nancy explained that the health service was split between providers and commissioner (CCG’s).  I work with both the commissioning groups and providers to ensure that they put in place what is required to provide a good level of service to LAC’s.  I am a bridge between the commissioners and providers. At the moment we are looking at the capacity of services to provide hands on work for LAC and if necessary look at what needs to be done to commission additional services for this group.

Q – Please provide an outline of the health needs of children and young people in care in Kent.

(4)          Nancy stated that two thirds of children entering care had one or more physical ailments. Other’s may not have had for example standard vaccinations early in life or had speech/language issues assessed and addressed.  All of these young people come with emotional needs by virtue of being in the care system. 

(5)       Nancy referred to a health needs analysis that had been carried out last October which showed that health professionals did not keep enough data on LAC and therefore it was not currently possible to accurately assess the health needs of our population of LAC.   For example the data on dental and optical needs of these children was not readily available.  In relation to the speech and language development and ASD needs it was important to make sure that there was capacity in the system to ensure that LAC are dealt with quickly.

(6)          Nancy stated that she needed to get a data tool in place so that when a child became a LAC and a health assessment was carried out within 28 days  to gather and record the information.  However currently this information tends to be handwritten and typed in free text rather than entered into a database.  Therefore information on LAC health was kept but not in a form that enabled it to be analysed.

(7)          Nancy confirmed that the evidence on LAC had not been available for the Health and Wellbeing Board’s Joint Strategic Needs Assessment.  A database was needed to enable this information to be produced easily, Medway had such a system and it was hoped that a version of this could be used in Kent.  Discussions were being carried  ...  view the full minutes text for item 16.