Agenda item

(Report by Mr R Gough, Cabinet Member for Education and Health Reform and Mr P Leeson, Corporate Director for Education, Learning and Skills)

(Ms S Dunn, Head of Skills and Employability, was present for this item)

1.         Mr Leeson introduced the report and advised that the first phase of the review and reorganising of the Preventative Referral Unit (PRUs) provision was held in 2013. The second and last phase of the review was the review of the provision of the Health Needs PRUs, one in East Kent; and one in West Kent. Those provisions addressed the needs for the pupils with long term health needs and mental health needs and included The Oakfields Unit, which was a CAMS Tier 4 hospital for the short term care of severely ill children.  The review was about access and organisation; and the needs of young people that needed to be responded to.  It was now expected that the physical medical short term needs of young people would be the responsibility of their mainstream school.  

2.         Mr Leeson and Ms Dunn responded to comments and questions by Members which included the following:

·         In response to a question, Mr Leeson advised that the current Child and Adolescent Mental Health Services (CAMHS)contract was still in place but there were a number of things happening to improve it. Although Sussex Partnership worked to make some improvements regarding assessment waiting times and response times, all the data suggested that it was generally unsatisfactory. The concerns regarding CAMHS had been considered by the Health and Wellbeing Board and Kent County Council had written to central government regarding its concerns.  Regarding this piece of work, there had been discussions with CAMHS service colleagues so that when this reformed provision moved forward Kent could be insure that there was a commitment from CAMHS for support when children were referred.

·         A comment was made that this review was welcomed as a start to monitoring the work of CAMHS.

·         In reply to a question, it was advised that there had been a lot of consultation with the Health Services on this review.  This was a Tier 3 provision for children with complex needs and CAMHS support was necessary.

·         In response to a question, Ms Dunn advised that this provision was the education of children with mental health needs.  Schools needed to be clear about their role in supporting young people with mental health needs.  This provision was for the top end, Tier 3 and 4.  Discussions had also been held with GPs about having a clear process on the early work at Tiers 1 and 2 that can be carried out on early prevention and early intervention that would mean young people may not need to enter Tier 3 provision.

·         Mr Gough advised that there had been improvements in assessment times and maintaining those improvements was a priority.  The Health Overview and Scrutiny Cabinet Committee considered this issue; and it was also considered by the Health and Wellbeing Board with regards commissioning. As a result a group had been set up to look at areas where KCC and Health could work together, of which CAMHS was one.

·         In response to a question, Mr Leeson advised that children with mental health problems came from all areas of society.  Looking at the profile of children with mental health issues there was a lot of self-harming; identity issue for both girls and boys, there was a lot of suicide in boys and the biggest cause of death in the young was suicide [75% of suicides were young men]. There was an increase in the number of children being identified with emotional difficulties and some of those difficulties escalated to a diagnosable mental health condition.  This was a national issue.  There was a significant level of need and there was a gap in the levels of need and the levels of provision available.  It stopped children learning and progressing in life and becoming well-adjusted adults.  Both the resources of the Health Services and the education system needed to be better used. Kent was putting in place training including intervention training for teachers and advice for school on how to build up children’s emotional resilience as part of the core offer in schools.  Kent had put in a bid to the National Lottery for the Head Start Fund and had been promised £500k for projects.  If those projects were successful this funding could be increased to up £10 million over the next 5 years to support children’s mental health wellbeing. 

·         The Chairman advised that he was the governor at a school that hired its own mental health nurse. 

·         A request was made for an update report at a future meeting.

3.         RESOLVED that:-

a)        the responses to the comments and questions by Members and a update report be submitted to a future meeting be noted;

b)        the results of the consultation be noted;

c)         the Education Cabinet Committee endorsed the proposal to be taken by the Cabinet Member for Education and Health Reform and the Corporate Director of Education, Learning and Skills on the new delivery model for Health Needs provision in Kent, which involved proposals to:

                              i.        Separate the provision for Medical Needs and Mental Health Needs;

                            ii.        Create one PRU which encompasses the Oakfield Unit and 6 resourced provisions across the County with outreach provision for Mental Health Needs; and

                           iii.        Provide a service to mainstream schools for pupils with Medical Needs; and.

d)        an update report be submitted to a future meeting.