Subject:

An update and review of Foundation for our Future

Date of Meeting:

8 November 2021

Report of:

Executive Director Families Children & Learning

 

Contact Officer:

 

Anna Gianfrancesco, Assistant Director, Safeguarding and Care

 

 

 

Email:

 

Ward(s) affected:

All

 

 

FOR GENERAL RELEASE

 

 

1.         PURPOSE OF REPORT AND POLICY CONTEXT

 

 

1.1         The report updates Children Committee of the work of Foundation For our Futures and the progress made in Brighton and Hove on the objectives.

 

2.         RECOMMENDATIONS:    

 

 

2.1.1    The CYPS is recommended to note the work being undertaken in regard to Children’s mental Health under Foundations for Our Future. 

 

 

3.            CONTEXT/ BACKGROUND INFORMATION

 

3.1         Foundations For Our Future (FFOF) was developed and published pre covid. In research undertaken by the BMJ ( Mental health of children and young people during pandemic  10 March 2021. BMJ 2021;372:n614), it found that the mental health of the UK’s children and young people was deteriorating before the pandemic, however the health, educational, and social outcomes for children with mental health conditions are now worse than for previous cohorts.

 

3.2         It drew on studies carried out during the pandemic suggest that although some families are coping well, others are facing financial adversity, struggling to home school, and risk experiencing vicious cycles of increasing distress. Probable mental health conditions increased from 10.8% in 2017 to 16% in July 2020 across all age, sex, and ethnic groups according to England’s Mental Health of Children and Young People Survey (MHCYP). A self-selected sample of 2673 parents recruited through social media reported deteriorating mental health and increased behavioural problems among children aged 4 to 11 years between March and May 2020 (during lockdown). The more socioeconomically deprived respondents had consistently worse mental health in both surveys. This has been reflected in referrals to the Front Door for Families, where there has been an increase in referrals due to families not managing their child’s poor mental health.  

 

3.3         Foundation For Our Futures was the culmination of a thorough process of review of young people’s emotional health and wellbeing services that has taken place across Sussex. While it was developed pre covid it is even more important now that leaders in the local NHS Clinical Commissioning Groups, the NHS mental health provider Trust and the three local authorities who commissioned this review take forward its findings. The review was undertaken as they believed that services and experiences were not as they’d want them to be for young people, their families and carers and therefore, felt there was a need to understand, plan for and respond to what could be improved as well as setting ambitious recommendations for action. They provided a strong mandate and were determined that this review should deliver clear findings, however challenging they might be. While the challenges are now even greater it is even more important that these challenges are met, and the recommendations deliver.

 

3.4         The programme is manged by an Oversight Board at an Exec level, made up of the DCS from each local authority, ( East, West and Brighton and Hove) and senior leaders from the CCG’s and the provider health teams. Under this is a Project Board, made up of senior commissioners and manages for the CCG’s, Local Authority and Public Health, as well SPFT and the YMCA as the primary delivery providers. The project is managed by Simone Button, Project Director.

 

3.5         While the project is Sussex wide many of the recommendations are worked on at both a Sussex wide level to ensure there is parity across the region and on a local level to ensure it is operationalised in a way that meets local demand and links into local services. Within Brighton and Hove the locality work is embedded in the Mental Health and Wellbeing Partnership Board that is jointly managed between the CCG and FCL.

 

3.6         The work of these groups ensures there is alignment between the work of FFOF, the Children and Young People (CYP) Mental Health Programme delivering the Long Term Plan ambitions held by the Sussex Health & Care Partnership (SHCP) Mental Health Collaborative, as well as the Place based planning and delivery of local emotional wellbeing and mental health agenda at a local level.

 

3.7         20 recommendations came out of the review, outlined below.

 

3.8         Of the 20 recommendations, 3 are completed. Details of the project plan and time lines are in the appendices.

 

Recommendation 1

An Oversight Board with new co-Chairs, Sam Allen (CEO, SPFT) and Lucy Butler (Executive Director of Children, Young People and Learning, WSCC) is in place and we are in the process of appointing a young person to co-chair.

 

Recommendation 2

A signed concordat agreement is in place.

 

Recommendation 3

A Programme Director is in post with a dedicated resource now agreed to implement change.

 

A further 13  are on track- green.

 

Recommendation 4

Establish coordinated commissioning structure across Sussex.

 

·         A workshop of CCG Children’s Mental Health Commissioners, led by Paula Gorvett (Director Mental Health Commissioning, Sussex CCGs), took place on 18th August.  Commissioning responsibilities and capacity were discussed including ensuring that good interface between each Place is occurring. The amount of integrated work and communication between the CCG and local authority in each area was also considered and what steps could be made to improve that. 

·         A further workshop with LA and CCG commissioners will follow this to take the work forward to establish more integrated commissioning arrangements. 

Recommendation 5

Pan-Sussex Commissioning of Specialist Mental Health Services

 

•The appointment of a Sussex-wide Children and Young People Emotional Wellbeing and Mental Health Commissioner will help support the delivery of this recommendation.

 

Recommendation 6

Develop a Sussex-wide Strategy for Children and Young People’s Emotional Wellbeing and Mental Health

• Plans are under way to establish a co-production group of children and young people, family/carer representatives and front-line staff from Emotional Wellbeing (EWB) and Specialist Mental Health Services as well as the Programme Director, who will work together on developing the strategy. 

 

Recommendation 7

Develop an overarching Outcome Framework

 

 • A small group is working together to propose the content of the strategy and outcome framework. 

 

Recommendation 10

Commissioners to review current landscape of provision ensuring right range of services that are more navigable for CYP and families.

 

• Review of current service landscape has been completed. Gap analysis to ensure right range of services by mapping onto THRIVE framework domains has begun and will be completed following THRIVE workshops with stakeholders in the autumn. 

 

Recommendation 11

Implement a Single Point of Access (SPoA) model across Sussex

 

• Each area across Sussex is looking at a SPoA model that fits with the area, needs of their residents and service structures. Within Brighton and Hove the Children’s Mental Health and Wellbeing Parentship are taking forward this work, lead by the CCG and Local authority. Currently a business case is being pulled together that will outline the work needed to achieve a SPoA in Brighton and Hove.

 

Recommendation 12

As part of the recommended specialist services transformation and modernization process, SPFT and partners should review and re-describe current thresholds and criteria for access for CYP

 

•           Transformation work within SpCAMHS is ongoing.  A Children and Young People Sussex CAMHS website https://sussexcamhs.nhs.uk/ details referral criteria as well as information and advice about help and support for children, young people, families and professionals.

•           Going forward with the implementation of the THRIVE framework it is anticipate that there will be a move away from thresholds and focusing on more collaborative pathway working.

 

Recommendation 13

Acceleration of Mental Health Support Teams in Schools pilot

 

Recommendation 14

Demand, capacity and productivity review of all commissioned services

 

• Work is underway to ensure all commissioned services are recording performance data onto MHSDS.  This will enable robust demand and capacity analysis to take place.  We do not have clear and comprehensive information from all services at this point.  Organisations are being asked to input this data and to clearly identify their service name, however progress is slow.

 

Recommendation 15

Ensure service levels and capacity of organisations across Sussex are matched to local need.  In the interim pathways and interventions are in place to support CYP waiting

 

• SpCAMHS have measures in place to support children and young people waiting for care and to become aware of level of need changes.

• There is also an initiative that Brighton CAMHS are offering; an online drop-in group for all families who are awaiting an ASC or ADHD assessment. 

 

Recommendation 16

There should be a programme of awareness and education directed to statutory referrers describing the agreed pathway model and when and where to refer

 

•Information for statutory referrers regarding how and where to refer has been widely shared and is available from websites via one link. The SPoA will aid the referral pathway.

 

Recommendation 17

To improve accessibility services must operate more flexibly and beyond usual working/ school hours of 9-5.  In addition, services should be offered in a broader range of locations and where appropriate in non-statutory sector buildings.  The use of digital options to support accessibility should also be explored.

 

•Change in clinical practice with the additional use of video technology.  From data over a selected period 2019 – 2021, pre-pandemic 0% of contacts from Sussex CAMHS services (incl. EIP) were carried out via video, current use is 21%. 

 

•           Next steps:

o          Developing a model of digital consultation with children, young people and families/carers.

o          Digital collection of outcome measures, referral forms and assessment packs

o          Digital practice – development of skills for children and young people workforce on video consultation best practice.

o          Blended digital interventions (video/ face-face).

o          Digital offer to be across children and young people pathway.

 

 

Recommendation 20

A children and young people’s panel should be created, composed of CYP, families and carers.  This should provide the opportunity for CYP to contribute to and participate in the development of local services, strategies and plans.

 

•CYP Participation Lead took place at the beginning of September. Children and young people are actively engaged in development of Emotional Well Being and Mental Health Strategy as part of co-production group. Care leavers are working with the Brighton and Hove Mental health and Well being partnership. 

 

 

Three recommendations are amber.

 

Recommendation 8

Financial Investment: rebasing and understanding current picture of investment and ensuring commensurate with level of need and that national targets are met

And

Recommendation 9

CCG and LA partners to work together to clarify levels of investment especially in wellbeing support.  Commit to improving resource directed into public health, prevention, early intervention and promotion

 

• The ICS are commissioning work to determine the current baseline resource allocated across Sussex to Children’s EWB and MH services in each Place based area.

• A CYP planning process has been agreed to ensure that outline business cases are prepared that will be submitted through the Long Term Plan Investment process for 2022-2024 in the autumn.  This will need to include requests for additional funding to support emotional wellbeing services, earlier intervention and prevention services and support, as well as proposals being worked up to support further investment into specialist Mental Health services. 

 

Recommendation 19

A proportion of available financial resources should be delegated to CYP to prioritise for their own communities and neighbourhoods.

Commissioners and providers must also be able to demonstrate that CYP have co-designed services and pathways

 

• As part of the autumn investment process, business cases will be submitted with resource allocated for each local authority area for children and young people to prioritise.

• Children and young people will be involved in decision-making about the prioritisation process for the CYP planning and investment process.

 

One recommendation is considered to be red.

 

Recommendation 18

A Sussex wide audit and review of the specialist and targeted workforce should be undertaken

 

•A review has taken place for SpCAMHS services and a workforce plan is in place. No review or audit of EWB or targeted services outside of SPFT has yet begun. 

 

 

 

 

4.            ANALYSIS & CONSIDERATION OF ANY ALTERNATIVE OPTIONS

 

4.1         Work is progressing across Sussex to deliver the recommendations made in the Foundation For Our Futures. The appointment of the Programme Director is supporting the drive to move the recommendations forward. As can be seen above the majority of theses recommendation’s are on track. There is a risk register in place in order to ensure oversight and monitoring of those recommendations that are amber or red.

 

4.2         Work in Brighton and Hove is being taken forward by the placed based group that is jointly lead by the CCG and BHCC (Families Children and Learning).

 

 

5.            COMMUNITY ENGAGEMENT & CONSULTATION

 

5.1         Young peoples part of the FFOF programme are engaged in the programme and there will be further involvement once the Participation Lead is in place.

 

6.         CONCLUSION

 

6.1      FOFF is supporting the transformation of child mental health services across Sussex. For Brighton and Hove this work is being lead through the workstreams developing the pan Sussex work and at a local level through the placed based Partnership meetings.

 

7.         FINANCIAL & OTHER IMPLICATIONS:

 

Financial Implications:

 

7.1         There are no financial implications directly resulting form the recommendations in this report. Some of the recommendations of the FFOF review will require additional resources to be identified and this process is outlined in the report

 

            Finance Officer Consulted:     David Ellis                                     Date: 05.10.21

 

Legal Implications:

 

 

7.2         There are no direct legal implications arising from this report as it is for noting only.

 

                       

            Lawyer Consulted:                   Name Sandra O’Brien                 Date: 29/10/2021

 

 

 

            Equalities Implications:

 

 

7.3         An equalities impact assessment has not been carried out by the local authority. Foundation for our Futures carried out a needs analysis, which considered equalities as part of the work to develop the recommendations.

 

            Sustainability Implications:

 

7.4         N/A

 

Brexit Implications:

 

7.5         N/A

 

Any Other Significant Implications:

 

 

 

 

            Crime & Disorder Implications:

 

7.5       N/A

 

            Risk and Opportunity Management Implications:

 

7.6       N/A

 

            Public Health Implications:

 

7.7       N/A

 

            Corporate / Citywide Implications:

 

7.8       This project is to improve mental health services for children and young people in the city.