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ACCESSING APPROPRIATE CAMHS IN ESSEX - the Single Gateway Pilot

ACCESSING APPROPRIATE CAMHS IN ESSEX - the Single Gateway Pilot. Lonica Vanclay, ECC and Karen Egglestone, Catch 22 – 20 th March Tina Russell, ECC and Michelle Hembling, The Junction 29 th March. Why are we doing this?.

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ACCESSING APPROPRIATE CAMHS IN ESSEX - the Single Gateway Pilot

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  1. ACCESSING APPROPRIATE CAMHS IN ESSEX - the Single Gateway Pilot Lonica Vanclay, ECC and Karen Egglestone, Catch 22 – 20th March Tina Russell, ECC and Michelle Hembling, The Junction 29th March

  2. Why are we doing this? Standard 9 of the National Service Framework for Children, Young People & Maternity Services states: …’all C&YP from birth to their 18th Birthday who have mental health problems and disorders should have access to timely, integrated, high quality, multi-disciplinary servicesto ensure effective assessment, treatment and support for them and their families’…

  3. The tapestry of CAMHS provision Tier 2 Targeted Tier 3 Complex Counselling (Schools) Tier 3 NEPFT Team in North SEPT in South ECC (LA) CAMHS Tier 2 Team CAMHS Family Therapies Group and skills programmes to develop self esteem and confidence (Schools & Voluntary Organisations) Group Therapies Diagnosis, medication, teaching, consultation Tier 1 Universal Tier 4 Acute Communication and Language skills development & Family Support Early Years Provision Education Psychology Service Healthy schools PSHE in schools SEAL Partnership commissioned and voluntary sector provided services eg Catch 22, The Junction, Place2Be, Young Concern NEPFT/SEPT Longview/Poplar in-patient ward Peer and Learning Mentors Home School Liaison Workers Pastoral Teams (Secondary Schools) Brookside in-patient ward Anti-Bullying Policies and Activities – Schools Communication and Language skills Leverton secure children’s home Health Visitor support Private provision – spot purchased Midwifery Services Children’s centres / Early years activities / Support

  4. Commissioning approach • Strategic partnership structure – County Joint Commissioning Committee (ECC/LA, NHS, Schools Forum) and County CAMHS Partnership (with providers incl schools, voluntary sector ) • 4 Locality Commissioning and Delivery Boards • Joint commissioning – health, school and LA £ for Tier 2 some locally commissioned; LA seconded staff to Tier 3. • Aligned commissioning – schools commission themselves (and vol sector provide) • Partnership produced a commissioning toolkit resource to assist schools with commissioning for emotional health and wellbeing and Commissioning Support Officers (LA employed but Schools Forum agreed) to assist.

  5. Challenges with a Tapestry of Services • Resources and capacity………….. • Sufficient knowledge of all services and across services • Developing good working relationships • Building a comprehensive overview

  6. Involvement of the Voluntary Sector • By localising commissioning (4 quadrants) and open tendering in line with a Strategic Approach agreed by the Partnership of a “tapestry” we enabled voluntary sector provision. • We know vol sector is more accessible, flexible – and wanted them to have a role. • Structured their focus on early intervention – built into LA CAMHS Tier 2 teams remit to support and advise vol sector

  7. Outcomes for Services • Developed a common highlevel children’s outcomes framework • Promote use of SDQ, Outcomes Star or SOUL with categories of met/positive change; partly met/no or little change and not met/negative change • Collation is a challenge!!

  8. Benefits of voluntary sector involvement • Harnesses and maximises different commissioner resources and provider expertise • Choice for users about location and type on intervention • Single gateway can direct appropriately and reduce duplication and ping pong

  9. Challenges with voluntary sector engagement • Different provision in different quadrants • Collating information into a provider directory for the gateway to use • Improving awareness of referrers (esp schools and GPs) and trust/confidence in the vol sector provision

  10. What is the CAMHS Single Gateway? • A single referral access point to CAMHS across the North Essex Cluster (and a similar one in South Essex) • Simple, efficient, consistent & standardised approach • Streamlining referrals avoiding delays in assessment/treatment • Integrated, promoting cross-agency working • Advice & guidance for referrers • Data collection point to help identify gaps, emerging need etc • A comprehensive referral screening service which will signpost/direct referrals to most appropriate CAMHS • Improved experience for C&YP, families & referrers • Reduction in inappropriate referrals • Reduced inequalities • Based in one building, manned by CAMHS professionals from all Tiers – voluntary, ECC Tier 2 and Tier 3.

  11. Operational process • Referrer discusses any concerns about emotional and mental health of the C&YP with – Parents/Carer and if appropriate with the C&YP and obtains consent to refer to CAMHS Single Gateway • Can phone to discuss • Refer by email, safe haven fax or post • Referral screened by a team member and - if Tier 1/early community Tier 2 – referrer given information about service for family to contact - directed straight to appropriate Tier 2 or 3 service - forwarded to relevant MultiAgency Panel if other agencies also needed/involved

  12. Why this approach? • Earlier pilot (BCFPI) of standard screening tool highlighted benefits of this – less ping pong between services • There are benefits in a tapestry of services – choice, location/access, range of methods - but referrers esp schools and GPs were confused about where to go • Wanted to continue to commission and build awareness of the range of services • Action research pilot approach • Existing providers operate (rather than a separate assessment/referral function) at least initially to help build understanding across providers/tiers

  13. CAMHS Single GatewayExpected Outcomes • Evidence that the MH & Emotional needs of C&YP are being screened in a consistent way • Easy, efficient and equitable access to CAMHS when C&YP need them • Reduction in inappropriate referrals and ‘ping-pong’ between Tiers • Greater integration of CAMHS across all Tiers and better use of resources • Better levels of support for Referrers • Identification of service gaps, emerging areas of need to inform future commissioning

  14. Challenges for Gateway • Resources and capacity………….. • Balance local knowledge/relationships with one centralised service • Different processes across organisations complicates and sometimes duplicates data recording etc • Interface with Social Care and other single gateways into services – one single gateway for all or specialist knowledge/advice • What level of professional/clinical expertise to operate the gateway?

  15. Key concluding messages • Start with building a partnership strategic framework • Make time to develop engagement and mutual understanding and respect • Recognise strengths and differences (USP) of each partner and harness them • Simplify access but build a tapestry of services • Huge benefits result from a unified approach to ensuring the most appropriate service for families and real partnership working

  16. Further Information Overall Approach: Lonica Vanclay Lonica.Vanclay@essex.gov.uk Gateway: CAMHS Single Gateway – North Essex Holmer Court Essex Street (off Headgate) Colchester CO3 3BT

  17. Any Questions?

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