Delivering CAMH Services from an Acute Hospital NHS Foundation Trust

1. Delivering CAMH Services from an Acute Hospital NHS Foundation Trust David Eltringham Assistant Director (CAMHS)

2. Birmingham

4. Birmingham Children’s Hospital NHS Foundation Trust • Founded 1862 • Acute / Specialist Children’s Hospital • 280 in-patient/day-case beds (inc CAMHS) • 20 PICU beds • City Centre Location • Turnover £160 million • 2,600 Staff

5. Improving Emotional Health Improving access to excellent services Better outcomes Developing a transformational culture Improving relationships with partners

6. The 4-Tier Structure of the Delivery of Children and Young Person’s Mental Health Services in Birmingham (Numbers of Children at Risk Decrease as Risk Increases) Residential Services Highly Specialist Services Often Residential or Inpatient Inpatients At High Risk T4 At High Risk Looked After Children’s Mental Health Service (homes) T4 T1 Youth Offending Service (At Risk) CAMHS Specialist Service e.g. Looked After Service Specialist Services T3 Special Schools T3 SENAS, BSS, PRU At Risk CAMHS Specialists working together as a multidisciplinary service Voluntary Organisation MH Services DAT Child Psychiatry Targeted Services Clinical Psychologists & Educational Psychologists In Need & Vulnerable T2 T2 Community Paediatrics Nursing Youth Offending (Prevention) Connexions Therapy Services Community Development Workers Social Work Primary Mental Health Worker Primary Care (GP’s, HV’s) Education Welfare Services T1 All Children Universal Services Community Schools & Extended School Clusters Connexions Children’s Centres Voluntary Sector Organisations Type Of Service Provision Service Providers Level of Risk KEY: SENAS = Specialist Educational Needs Assessment Service BSS = Behaviour Support Service PRU = Pupil Referral Unit Taken from the ‘Inter-Agency Commissioning Strategy for the Mental Health and Psychological wellbeing of children and young people in Birmingham 2005 – 2008’ (Oct 2006 update)

7. Birmingham Children’s Hospital and CAMHS • Tier 3 • Locally Commissioned • Three localities • South • Heart of Birmingham • East and North • Co-terminus with PCT’s • Locality Management Model • City-wide Services • Youth Offending Service • Substance Misuse • Looked After Children • Learning Disaboilities

8. Birmingham Children’s Hospital and CAMHS • Tier 4 • Regional Service • Commissioned by SCT on behalf of 17 PCT’s • Parkview Clinic • Ward 3 at Steelhouse Lane • 44 physical beds

9. The Children’s Trust and Tier 3 CAMHS Cabinet CYP Board CAMHS Policy and Strategy Group CAMHS Commissioning Group CYP Operational Group CAMHS DMT Performance Management Group

10. Directorate Delivery Structure Clinical Director Assistant Director Tier 4 Locality: South Locality: HoB Locality: BEN Psychiatry Psychology Psychotherapy Nursing Systemic Therapy

11. Reporting Structure Tier 4 Clinical Lead Clinical Director Deputy CD Clin Gov Lead Assistant Director Lead Tier 4 Manager Lead Locality Manager Head of Psychiatry Head of Psychotherapy Head of Systemic Therapy CAMHS Nurse Manager T4 Mgr LM BEN LM HoB

12. Our Vision • Improved access to excellent service • A well developed transformational culture • Improved relationships with our partners

13. Key Challenges • Tier 3 • 13 Week referral to first appointment (Now) • 18 Week referral to treatment (March 2009) • Transformational culture • Relationships with Commissioners/Partners • Information systems

14. Key Challenges • Tier 4 • Contract Target (11,680 OBD’s) • 44 beds at 85% (13,651 OBD’s) • Relationships with Commissioners and partners • Transformational culture • Access to beds out of hours