Minutes:
Karen Sharp (Head of Public Health Commissioning, Kent County Council) and Dave Holman (Head of Mental Health Programme Area and Sevenoaks Locality Commissioning, NHS West Kent CCG) were in attendance for this item.
(1) The Chairman welcomed the guests to the Committee. Mr Holman began by providing an update on the draft service specifications; the service specifications were at an early stage and changing daily. The draft specifications had been presented to all Kent and Medway CCGs and would be finalised in December 2015. He reported that a joint contract procurement board had been established and would be chaired by Ian Ayres and Andrew Ireland; the board would sign off the final specifications. Ms Sharp highlighted page 135 in the Agenda pack which set out the differences between the current and new model. She reported that new model had been developed by Kent County Council and NHS West Kent CCG and outlined a whole system approach to emotional wellbeing and mental health. Mr Holman confirmed that the Mental Health specification was for the additional and specialist level of Children and Young People Mental Health Services (ChYPS) previously referred to as Tier 2 and 3 Child and Adolescent Mental Health Services (CAMHS). He noted the involvement of UCL in developing Key Performance Indicators and the support of NHS England.
(2) Members of the Committee then proceeded to ask a number of questions and make a number of comments. A Member stated the need for an executive summary for each specification and enquired about eating disorders services as part of the specification. Mr Holman explained that an all age care pathway for eating disorders was being developed. He reported that NHS West Kent CCG, Kent County Council and Sussex Partnership NHS Foundation Trust had submitted a bid to NHS England for an allocation of the £30 million Future in Mind funding to improve eating disorder services. He noted that the current age and need criteria for eating disorder services was high; the criteria needed to ensure that young people could access services. He stated that he would highlight eating disorders services in the next revision of the service specification. He reported than an Executive Summary was being developed as a result of feedback from the CCGs. Ms Sharp explained that services would be provided in a universal setting such as schools and GP surgeries as a result of feedback from children and young people who participated in the consultation.
(3) Members raised concerns about the lack of performance indicators particularly around capacity and details of how performance would be measured in the service specifications. Mr Holman explained that performance indicators were being developed and would be included in the final specifications. Ms Sharp stated that the capacity would be built in as part of the contract; investing in preventative and universal services would reduce the demand on intensive and specialist provision as early help services would support more children and young people and help to prevent their needs from escalating. She noted that Kent County Council and NHS West Kent CCG had been awarded National Lottery funding to train teachers to teach and build resilience in children and young people.
(4) In response to a specific question about crisis care, Mr Holman explained that there was one Section 136 Place of Safety in Kent which was located in Dartford. He reported that the CCG was in negotiations to install a further two Places of Safety including a children’s only Place of Safety following a successful pilot in Sussex. He reported that since the development of the Kent and Medway Mental Health Crisis Concordat there had been better engagement with the Police and improved access to liaison psychiatry within Accident & Emergency. He noted that Sussex Partnership NHS Foundation Trust had developed a home treatment service and was seeing all urgent referrals within 24 hours as specified in the contract.
(5) A Member made reference to the specialist services in the specification and enquired about the demand for services. Mr Holman explained that the rise in demand for mental health and wellbeing services was a very difficult and growing issue affecting society. He stated the importance of enhancing universal services to reduce demand on specialist services. He reported that all the specialist multidisciplinary services listed in the service specification were already part of the current contract and were funded by the CCG.
(6) The Committee resolved to go into open session to discuss their recommendation.