In virtual attendance for this item: Caroline Selkirk, Executive Director for Health Improvement, K&M CCG, Jane O’Rourke Associate Director, Kent Children’s & Maternity Commissioning Team, K&M CCG, Brid Johnson, Director of Operations, Essex and Kent NELFT, Gill Burns, Service Director Children, NELFT.
1. The Chair welcomed the virtual attendees and invited them to introduce the paper.
2. Ms O’Rourke outlined the position with the service, highlighting a 40-50% increase in referrals, covering areas including trauma, domestic abuse, depression and anxiety. Cases of eating disorders had risen from 156 a month pre-pandemic to 211 in March 2021.
3. To meet the increased demand, NELFT had increased their home-treatment and crisis offers, as well as expanding support teams placed in schools.
4. There was a large amount of work underway relating to neuro-developmental pathways, including providing additional services whilst patients were on the waiting list. A prototype model was in development, which aimed to increase the number of children on the pathway at one time.
5. NHS England had praised the work of a local multi-agency task and finish group to tackle mental health crisis issues in children and young people. Ms O’Rourke drew upon the system-wide approach that had developed between parents, public health, schools, the CCG and provider to improve the CYPMHS service. She paid tribute to NELFT, and the positive feedback received regarding the work of clinicians.
6. Ms O’Rourke explained that the (national) demand for Tier 4 beds was unsustainable and locally the high demand was forecast to continue for the next year but then start to reduce. NELFT would be opening an additional 6 beds at Kent and Medway Adolescent Hospital in Staplehurst. Members questioned if this was “new” or simply replacing the beds that had existed under the previous provider (SLAM) – Ms Johnson confirmed it was additional capacity.
7. A Member asked what the follow-up strategy would be for individuals referred under the ASC project mentioned in the agenda report (whereby over 2,000 families with children aged 13 to 16 years old would be contacted to conduct a Clinical Harm Review). It was explained that the Harm Review was a proactive way of keeping in touch with vulnerable families, and that they were always encouraged to make contact if they had concerns (though not all did). Ms Johnson explained the provider did their best to ensure the relevant services were available to offer support, and that they were working across the system to try to ensure that adequate capacity existed.
8. A Member asked if treatment was provided by student mental health therapists. Ms Johnson explained that a private provider was used for patients over 17 years old. She assured the Committee that pathways were being fully reviewed to ensure they provided adequate support for those who needed it.
9. Following a question about recruitment and retention, Ms Burns acknowledged that there were national shortages. NELFT’s Inpatient Unit recently recruited to 14 vacant posts. Difficult posts to fill included those in the crisis team and those with shift work. There needed to be an emphasis on staff development, as well as attracting long term agency workers into full time roles. Over the next few years there would be 70-80 newly qualified mental health workers placed in schools.
10. Ms Burns confirmed that a young person would not return to the beginning of the ADHD pathway if they were incorrectly placed on the Autism pathway.
11. Throughout the discussion the virtual connection was intermittent. Members wishing to raise unanswered questions were invited to submit these via the Clerk.
12. RESOLVED that the report on Children & Young People's Emotional Wellbeing & Mental Health Service be noted and Kent & Medway CCG be invited to provide an update at the appropriate time.