Child and Adolescent Mental Health Services Scrutiny Work Stream Report
To receive a report from the Scrutiny Work Stream.
(8.30 – 8.35 pm)
Councillor Doug Taylor (Leader of the Council) invited Councillor Nesil Cazimoglu, as Vice Chair of the Scrutiny Work Stream, to present the report (No.113) to the Cabinet.
Councillor Nesil Cazimoglu presented the report and the following issues arose.
1. That the Government’s Children and Young People’s Mental Health and Wellbeing Taskforce had found that around 75% of mental health problems in adult life (not including dementia) start by the age of 18. Early help stops young people falling into crisis and avoids expensive and longer-term treatment in adulthood. One in ten children needed support or treatment for mental health problems.
2. That the Scrutiny work stream had acknowledged the current difficult financial climate. A number of recommendations had been made and agreed by the Cabinet Member and Executive Director as set out in Appendix A of the report. The specific recommendations were highlighted to Cabinet and the implications in moving forward including maximum waiting times; public health funding; and, future procurement support.
3. That the Care Quality Commission had recently completed an initial review of mental health services for children and young people. The Government had issued a Green Paper setting out a number of recommendations which officers were currently reviewing.
4. Members welcomed the report. It was an important area of work and the current budget restrictions were acknowledged. The Council would continue to work closely with its partners to achieve the best outcomes possible and to fully utilise all of the services available.
5. The positive impact of the fluoride programme, as detailed in paragraph 11.6 of the report.
6. That the Government had recently commissioned a national review of Child and Adolescent Mental Health Services; ten local authorities had been inspected, including Enfield. It had been concluded that the services provided had been effective but that more were required. It was anticipated that the review would conclude next year.
7. That whilst it was the intention to provide care as close to home as possible for children in crisis (section 9.2 of the report referred), all cases were considered on an individual basis and the most appropriate care provided.
8. The statements made with regard to public health funding, as set out in paragraphs 11.10 and 11.11 of the report. It was noted that the funding available had to meet a number of legally prescribed functions and therefore the discretionary element of funding available was limited. The increasing pressure on available funding was acknowledged together with the need for continual review to ensure that the resources available were being allocated effectively.
9. The importance of awareness raising of the services available to children and young people.
Councillor Nesil Cazimoglu expressed her thanks to the Chair of the Scrutiny work stream and the officers who had supported the work undertaken.
Alternative Options Considered: None
DECISION: The Cabinet noted, for information, the following recommendations and the actions agreed by the Cabinet Member and Executive Director as set out in Appendix A of the report and listed below:
1. Members were concerned that by their last meeting the Future in Mind Resubmitted plan had still not been assured by NHS England and that the CAMHS service was currently breaching on waiting times for some clients. The work stream had recommended that the CCG ensure that the CAMHS service had sufficient staff in place to deliver the service including a maximum waiting time of 13 weeks in line with the national target. (Sections 10, 12.3 and 12.4 of the report referred).
2. The work stream had felt that public health funding assisted in the make-up of the fabric of mental health support for children and young people in the community. The work stream had recommended that the Council continued to ensure that the Public Health Budget in Enfield was allocated to services that were most needed and made the most impact on health needs in the borough and that interventions had elements supporting good mental health. (Paragraphs 11.1 – 11.11, and 12.7 of the report referred).
3. That representation from the work stream (letter from the Chair) would be made to National Government regarding Public Health allocated funding to ensure equitable funding was based on local need and with greater flexibility how the funding was spent. (Paragraphs 11.11 – 11.14 and 12.8 of the report referred).
4. That the Council and CAMHS explore and optimise all opportunities for further joint working between Public Health and CAMHS including Tier 2 services. (Paragraphs 11.7, 11.8 and 12.9 of the report referred).
5. That the Council review the proposed reduction in support from the Procurement Hub towards contract management for Children’s Services to ensure appropriate action was taken to mitigate against this potential risk and any gap was filled. (Sections 10.14 – 10.16 and 12.10 of the report referred).
6. Noted that the work stream supported the development of quality standards for mental health services for schools. (Paragraphs 5.4 – 5.6 and 12.5 of the report referred).
Reason: To improve outcomes for children and young people in this very complex and challenging area.