Agenda item

The Chair invited David Lockwood, Head of CYP and Perinatal Mental Health, Andrew Nichols-Clarke, Senior Development Lead, Health and Justice Children Programme, Yvonne Carey, Senior Programme Manager, NHSE QTT and Kate Brooker, Independent Social Worker, NHSE QTT to present to the Board. The three presentations (pages 15 – 70 in agenda) outlined the range of activity the National Health Service England (NHSE) had been undertaking concerning children’s mental health, the wider activity being undertaken by the NHS, alongside specific programmes of work; the Mental Health, Learning Disability and Autism Inpatient Quality Transformation Programme and the Framework for Integrated Care were discussed.

Members comments:

·       A concern was raised regarding the work of the Vanguards being a small part of the overall need of the country and there was a request for information on how NHSE would see this roll out, alongside the local mental health hubs and the recruitment issues being faced.

·       A member acknowledged the large role domestic abuse plays in mental health related family interventions.

·       There was a concern raised regarding the effect of the closure of youth services and what is being done to address this.

·       A member welcomed better partnership working to rethink how to support young people, however noted the presentation referred to a lot of services that are underfunded and barely exist in some places.

·       It was raised that it would be difficult to evaluate the effectiveness of the Vanguards and the transferability of the desired outcomes to another area.

·       A member requested information on if there is work being done at a national level to provide sufficient provision and secure units to reduce councils’ placements competition and reduce costs.

·       It was highlighted that local authorities and the third sector have an important role in tackling health inequalities by providing early intervention to marginalized communities.

·       A member encouraged a focus on early intervention and working with local authorities on mental wellbeing to increase prevention. 

·       There was a concern raised regarding how to increase the profile of children’s issues within Integrated Care Boards (ICBs) and Health and Wellbeing Boards (HWBs).

NHSE responded to comments:

·       It was acknowledged that the scale of the challenge is large, and it would be a long process before need can be fully met.Sustainable funding and a focus on joining up sectors and partners is the focus going forward to be able to meet need.

·       The Vanguards are of a small scale due to funding currently. The Framework to Integrated Care is evidence based, thus needed to be tested to understand if it works within the community and the system. Each Vanguard is being evaluated individually, which will provide the evidence base to make a case for wider roll out.

·       The Department of Digital, Culture, Media and Sport (DCMS) colleagues have started a scoping exercise on youth workers, looking at what provision is available and how it can be improved – which NHSE will start feeding into with the results of the Vanguards.

·       NHSE and the Department for Education (DfE) are doing a joint piece of work to help address high-cost placements and understand how to support this continued work by looking at Deprivation of Liberty Safeguarding (DoLS) and complex needs pathways for young people.

·       There is further investment in the secure estate both across justice and welfare. New and secure children’s homes are being developed in London and the West Midlands. The work of the Vanguards is to provide early intervention to stop the high need of placements.

·       Experts from Sonnet Advisory are looking into how impact can be measured in the system and how a system can change to be trauma-informed to support these young people.

·       Colleagues encouraged a united voice to increase the emphasis on early intervention and prevention and increase the profile of children in relevant Boards.

Decision

The Board noted and commented on the presentations from NHS England colleagues on activities taken related to children’s mental health to date and considered areas of discussion listed under paragraph 23 and the next steps.

Actions

·       NHSE to share information about the interventions, for instance the work of the DoLS for Member feedback to encourage an ongoing dialogue between the LGA and NHSE.

·       Officers to invite NHSE to future task group meeting and back to the Board eventually.