East of England Community FCAMHS Stakeholder Event – summary and feedback Dec 2018

1. East of England Community FCAMHS Stakeholder Event – summary and feedback Dec 2018

2. Introduction/Background • FCAMHS is a Regional Specialist Child and Adolescent Mental Health Service for High Risk Young People with Complex Needs. • Set up to address Unmet need • Commissioned by NHS England • Country wide pilot split into 13 regional services • Aim of pilot service is to ensure Parity of provision • For East of England the bid was won by CPFT

3. Possible Referrers include: • Safeguarding • SCH • YOS • STC • SARC • Inpatient • LAC • MST • Education • CSC • CPS / Police • GPs / HVs • Residential • CJS East of England- Map of Geographical Area Norfolk Cambridgeshire and Peterborough Suffolk Bedfordshire Essex Hertfordshire

4. Referral Criteria • under 18 years old at the time of referral (no lower age threshold) • presenting with severe disorders of conduct and emotion, neurodevelopmental or serious mental health problems or where there are legitimate concerns about the existence of such disorders • usually involved in dangerous, high-risk behaviours towards others whether they are in contact with the youth justice system or not • in exceptional cases, are not high risk (not primarily dangerous to others) but have highly complex needs (including legal complexities) and are causing major concern across agencies

5. CAMHS vs FCAMHS – Acceptance criteria

6. Looked after children • Who we see: Complexity • ACEs • LAC, CPP • ‘edge of care’ • in secure estate • CJS/Police, • special educational needs • abuse, CSE , ‘missing’ episodes • multi agency involvement • al education • Multi agency involvement • Previous abuse • Child sexual exploitation

7. Who we see: Possible Risk Behaviours • Sexually harmful behaviour • Internet offending • Terrorism/Radicalisation • Stalking • Fire setting • Violence • Property damage • Threats

8. Who we see: Typesof Mental Health Concerns • NOT diagnosis led • Neurodevelopmental difficulties • Mental Illness • Conduct Disorder • Comorbidities • Learning Disability

9. What we do • Clinical • Advice • Consultation • Multiagency liaison • Assessment • Intervention where indicated. • Mediate transitions in and out of secure care • FCAMHS also has a non-clinical element covered in further slides

10. What we do Intervention Assessment Referrer/ lead agency remains involved throughout Multiagency Liaison Joint working Consultation Advice

11. Few Practical Points for Referrers • Joint work • No care-coordination • Collateral and Supporting Information • Information Sharing • Current response times

12. What FCAMHS is not commissioned to be • Aloof from other provision • A repository for all local cases with complex needs • A service which is able to provide targeted interventions for all specific high risk groups • A (long) report-writing service (unless specifically required) • A gatekeeping service

13. Operational Structure Directorate admin Lead Directorate Clinical Director Directorate General manager Band 4 Senior Admin Appointed 1.0 WTE Service Manager Appointed 0.8 WTE Clinical Lead/ / Consultant Psychiatrist Interim in Post Band 3 Peer Support worker Appointed 0.4 WTE Band 3 Admin Appointed 1.0 WTE Band 7 SMHP Vacant 1.0 WTE Band 7 Social Worker Appointed 1.0 WTE Band 8a / 7 MHP Vacant 1.0 WTE Band 8c Consultant Psychologist Secondment Started 1.0 WTE Band 8a Psychologist Appointed 0.8 WTE Band 6/7 Psychologist Appointed 1.0 WTE Band 7 SMHP (Nurse) Appointed 1.0WTE

14. Activity 1 - Current Pathways

15. Activity 2 – Training Opportunities

16. Exercise 2 – Training requests Risk Assessments Specific clinical interventions

17. Non-Clinical Functions and Expected Outcomes of FCAMHS

18. What we do - Non-Clinical: • Development of joint working arrangements • Development of strategic links between local, regional and national networks. • Identifying gaps in local and regional service provision. FCAMHS – leadership role. • Provide training for practitioners from all agencies in relation to areas within the service’s specialist remit

19. Expected Outcomes • Provision of clinical and non-clinical service functions • Assessment in child’s locality/current placement • Access, transition to and discharge from secure settings • Admission to secure settings only when indicated • Safe, timely and effective assessment • Improve mental health and wellbeing by identifying and addressing mental health needs of high risk young people

20. Expected Outcomes (cont.) • Minimisation of risk to self and others • Individualised developmentally-appropriate framework of care • YP and Family involved in decision making • Safeguarding principles embedded in service • Service accessible to all young people from the catchment area, even if currently placed OOA

21. THANK YOU