Agenda item

To provide a summary of the Transformational Planning Programme across Lancashire for Children and Young People’s Emotional Health and Wellbeing and progress to date in Blackpool, challenges, opportunities, next steps and involvement of children and young people.

Ms Helen Lammond-Smith, Head of Commissioning, Blackpool Clinical Commissioning Group and Blackpool Council presented the report on Transformation Planning for Children and Young People’s Emotional Health and Wellbeing across Lancashire. Ms Elaine Walker, Emotional Health and Wellbeing Manager, Blackpool Teaching Hospitals was also present.

Transformation Planning Impact

Member queried the impact of Transformation Planning, including the Head Start Programme, noting that the report referred to Transformation Planning being timely ensuring various programmes would be developed together.  Ms Lammond-Smith explained that Head Start (supporting the emotional resilience of 10-14 year olds) and other programmes involved long-term work with Transformation Planning, helping to ensure the programmes were co-ordinated. However, there were currently no direct performance outcome measures.

Ms Walker clarified that Head Start monitoring meetings did take place. Examples of achievements included developing ‘out-of-hours’ services, Youtherapy (80 people  supported to date), resilience coaches, and ‘bake and talk’ and ‘walk and talk’ counsellors at schools. Head Start work within Blackpool had been recognised as being effective.

‘Out-of-area’ services

The Chairman referred to publicised concerns that the nearest in-patient mental health facility for local young people (13-18 years old) was ‘out of area’, some 40 miles away in Heysham, which was a one hour drive. He also referred to potential inequalities for people with limited financial means. Members enquired whether numbers of service users had been considered based on their geographic residence. They were concerned that there would be too few beds for Blackpool residents. Young people attending the meeting referred to the number of people they knew who needed support far exceeded the spaces available at the Heysham site. They gave examples of young people with severe depression being taken into a clinical environment but without in-patient beds and added that vulnerable young people were at increased risk by being placed in wards with adults. There were also pressures of older teenagers being in the same ward as someone of primary age.

Mr Steve Winterson, Director of Strategic Partnerships and Engagement, Lancashire Care Foundation Trust explained that previously there had been two sites within Lancashire, but this was a specialised facility which was better provided on a dedicated site housing a range of medical staff. A full options appraisal and demand modelling had been undertaken, which had included consultation with young people. The level of provision had been based on complex case demand.

He continued that the ‘Cove’ in Heysham was an old NHS building which had the right environment allowing 18 beds for young people across Lancashire, of which two were set aside for Blackpool residents.  The facility needed to be value for money. People would be admitted and discharged so the numbers were realistic and currently there was no waiting list. He added that it was important that young people did not have to share facilities on adult wards and smaller dedicated wards were not appropriate for the facilities being offered. Hospital placements were still a last option before more effective community support environments.

Mr Winterson added that a visit to The Cove could be arranged for Members and that any future discussion of the site would be supported by the attendance of clinical leads.

Ms Lammond-Smith added that Child and Adolescent Mental Health Services (CAMHS) within Blackpool were better provided than elsewhere in Lancashire. Furthermore, in-patient beds did not provide the best option for people’s care but the facility offered appropriate capacity. Mr Winterson added that assistance based on individual needs would be considered but transport budgets were limited and not ring-fenced. Support was also offered to carers.

Support for people with crisis issues

Members referred to suicide issues and enquired whether support services were readily available for people at risk. Ms Lammond-Smith explained that the Transformation Planning included a number of innovative ways of working with young people as outlined in the report, e.g. developing the Child and Adolescent Mental Health Services offer to include appointments within neighbourhoods (North and South Shore Medical Centres). Likewise the Child and Adolescent Self-Harm Emergency Response service (CASHER) for people aged under 25 years old would be available as a ‘drop-in’ centre in the central western part of town (Broughton Street). Neighbourhood ‘hub’ teams of the main service areas would continue to evolve and include mental health and social care professionals. The ‘Core 24’ service was being developed to make available comprehensive support at all times by the end of 2018-2019. She added that mental health support was being funded and delivered at the Lancashire and South Cumbria level, reflecting the geographical approach of wider Sustainability and Transformation Planning. The funding would tackle longer-term issues including mental health and substance misuse.

Ms Walker added that the Self-Harm ‘drop-in’ service was now running and had just held a second meeting with seven young people from the Talbot and Brunswick ward areas. The service had become available out-of-hours too. Emotional health and wellbeing support was provided including mental health.

Working with the voluntary sector

The Chairman made the point that it was important for commissioners of services and service providers to work with the voluntary sector, e.g. UR Potential and Blackpool Boys and Girls Club, which received limited support. Representatives from the Boys and Girls Club issued an open invite to visit and use the premises. They felt that the sector including UR Potential was pursuing sustainable work so needed to be more widely used to further cement sustainability.  Ms Lammond-Smith confirmed that meetings had taken place involving the voluntary sector and neighbourhoods covering services for young people and adults. There was also a Voluntary Sector Forum. Working with the sector needed to be further promoted and she suggested that a good venue for neighbourhood team meetings could be the Carers’ Centre.

Service users’ views and experience

Members noted that a patient experience survey had been undertaken by Healthwatch Blackpool concerning the Child and Adolescent Mental Health Services and requested a copy of the findings. Ms Walker explained that the survey had been undertaken at the Whitegate ‘Walk-in’ Centre with mainly positive outcomes. Not unsurprisingly, people had concerns about needing to use ‘out-of-area’ mental health services. In response to Members’ recognition of the Centre’s effectiveness and need to promote awareness, Ms Walker confirmed that leaflets were issued to GP practices and Children’s Services.

Young people attending the meeting gave their views based on their own experiences. One attendee had needed mental health support for the last four years and referred to being passed around throughout the system. She cited long waiting times of several months trying to access Child and Adolescent Mental Health Services and Youtherapy, with assessments taking place every few months but the support required much longer.  During that period of time, people’s needs became greater. She added that lists of people needing support would increase as would the number of people committing self-harm.  She further added that young people left the Child and Adolescent Mental Health Services at 16 years old but then faced a significant gap in access to Adult Services.

Ms Lammond-Smith explained that there were plans to re-design services to tackle gaps in services. Adult carer representatives attending the meeting urged that families and carers were invited to be involved in the re-design of services including training needs. They were ‘experts by experience’. Ms Walker added that the Council’s new Vulnerable Adolescent Hub (VAH) which was a move towards offering a more cohesive ‘one-stop’ shop for young people. She highlighted the importance of mental health support being the responsibility of all organisations.

Young people made reference to former police officers acting as school counsellors did not work citing young people lacked trust in officers being able to provide neutral confidential support when issues faced by young people may technically have been illegal. Ms Lammond-Smith explained that all staff supporting young people had to be well trained.  Ms Walker added that the Youtherapy service offered a regular ‘drop-in’ service and had already engaged several young people.

The Committee agreed:

1.             To receive a written demographic breakdown of service users and available facilities at ‘The Cove’ from the Lancashire Care Foundation Trust.

2.             To receive a copy of Healthwatch Blackpool’s patient experience survey findings concerning the Child and Adolescent Mental Health Services.