Agenda item

Mr I Darbyshire, Senior CAMHS Commissioning Manager, NHS Kent and Medway, was in attendance for this item.

1.         Mr Darbyshire introduced the report and explained that it had been prepared in response to a request from the Committee to have an update on how the new Mental Health and Emotional Wellbeing contracts, which started on 1 September 2012, were operating. He outlined key strands of work as:-

• the inherited backlog of cases is being addressed and the overall number of young people on waiting lists is being reduced.
• the contractor, Sussex Partnership NHS Foundation Trust (SPFT), is currently liaising with CAMHS staff to introduce  a new working model by February 2013.
• training to ensure staff refer young people correctly is taking place, supported by funding from the Strategic Health Authority.

He clarified points of fact and responded to comments from Members, as follows:- 

a)         pie-charts included in the report are difficult to read and the content of graphs and tables is confusing.  From the format of the information given, it is difficult to see how many young people are waiting for 40 weeks, for example, and what progress is being made to address this. The pie-charts had been supplied by SPFT but Mr Darbyshire undertook to ensure that there are clearer next time they are presented. To clarify the information set out in charts: KCC has not been performing well in terms of waiting lists for some time, and there are long waiting lists for some treatments.  Many referrals are for behavioural issues and the appropriateness of this type of referral needs to be investigated;

b)         concern was expressed that, as the services were contracted out to a Trust from Sussex, Kent would have to share its services with Sussex. Members were assured that this is not the case. KCC sets the contract standards, to which the Trust must adhere, and funding for Kent’s services is ring-fenced so cannot be diverted elsewhere;

c)         Kent seems to be losing services from the homeopathic hospital in Tunbridge Wells as this does not appear in the contract. Provision will not necessarily be delivered from the same premises as used by previous CAMHS services, and will include more services delivered in the community;

d)         concern was expressed about the robustness of the contract and the ability to penalise the contractor in the event of poor performance. Performance is judged by quality controls built into the contract;

e)         transition from children’s to adults’ mental health services is not mentioned in the contract but is a major and long-standing concern. This is a gap in the currant contract which will need to be addressed.  Transition could be addressed within the service system rather than within specific services;

f)          there is disparity between East and West Kent in terms of waiting times, and neither clear figures or an explanation is apparent.  Fuller figures and information will help give a clearer picture in a number of places in the report;

g)         the ‘first appointment’ referred to does indeed mean the first face-to-face discussion between a young person and a professional who can assess their condition. The waiting times quoted are for routine referrals; if a case is urgent, an appointment can be arranged the same day if need be.  However, not all young people who are referred will need to see a specialist;

h)         only 1% of young people with Asperger’s syndrome have been formally diagnosed as such. Mr Darbyshire undertook to look into delays in the case of a young man with Asperger’s syndrome which was referred to in the meeting by the family’s local Member;   

i)          the new Young Healthy Minds contract started on 3 September 2012, so services should be up and running before the end of the current financial year; this seems a long lead-in period but the reason for this is not apparent;  and

j)          in response to a question, Mr Darbyshire explained that ‘ACCENT’ stands for Adolescents and Children in Care Emotional Needs Team. This is a CAMHS consultation service for Children in Care and is for foster carers and the children and young people placed with them by KCC. Its purpose is to support placements through helping carers, children and young people and associated professionals to understand mental health issues that may be affecting the child or adolescent and how this may be impacting on the placement’s stability. 

2.         Mr N J D Chard proposed and Mr K A Ferrin seconded that a further report be made to the Cabinet Committee’s next meeting which will address the concerns raised by Members during debate, set out above, and that the Chief Executive of the contractor, Sussex Partnership NHS Foundation Trust, be asked to attend the meeting to respond to those concerns.

Agreed without a vote.

3.         RESOLVED that:-

a)         the information set out in the report and given in response to comments and questions be noted, with thanks; and

b)         a further report be made to the Cabinet Committee’s March meeting which will address the concerns raised by Members, set out above, and the Chief Executive of the contractor, Sussex Partnership NHS Foundation Trust, be asked to attend the meeting to respond to those concerns.