Previous reference: Minutes 25 (2015/16) and 33 (2016/17)

The Deputy Director (Children’s Social Care) will submit a report which updates the Panel in respect of the work of the CAMHS (Child and Adolescent Mental Health Service) Psychological Assessment and Therapy Team for Looked After and Adopted Children (Document “S”).

Members’ views are requested.

                                                            (Jennifer Robb – 07701 284392)

Previous reference: Minutes 25 (2015/16) and 33 (2016/17)

The Deputy Director (Children’s Social Care) submitted a report which updated the Panel in respect of the work of the CAMHS (Child and Adolescent Mental Health Service) Psychological Assessment and Therapy Team for Looked After and Adopted Children (Document “S”).

The Clinical Lead for Looked After and Adopted Children from the Bradford District Care Trust introduced the report and highlighted the following points:

·         The service catered for looked after and adopted children and those on Special Guardianship Orders (SGOs).

·         The service had now been in operation for over twelve months and it was therefore considered a good time to undertake a review.

·         One of the main concerns was service capacity; staffing was significantly less than had originally been proposed, including in respect of Local Authority Social Worker provision

·         The average waiting time had increased and it was considered that crisis point had been reached. Discussions were on-going with commissioners about the remit and future direction of the service.

·         There were currently 45 young people on the waiting list for assessment and therapy and at the current rate of pick up this backlog would not be cleared for approximately 4 years.

·         The service had received very good feedback from professionals and carers, the available places were being booked and the service was used frequently.

·         The Consultation Clinic service was left open to those young people who were on the waiting list for assessment.

·         1660 clinical contact sessions had taken place.  It was estimated that over 50% of the direct work had involved looked after children.

She responded to Members’ questions:

·         In terms of capacity and demand; prior to the establishment of this team all cases had been referred to the core CAMHS. Awareness of the service had increased; the provision was well regarded and there were increasing numbers of repeat users (such as social workers who had found it to be helpful). The service had become saturated with both new cases and those transferred from the core CAMHS.  There were approximately 2000 eligible children/young people and it was estimated that up to 72% could need some form of mental health service at some point. There was a huge demand and need.

·         There was a genuine belief that this service was making a big difference and the limits on capacity were frustrating.

·         The full time equivalent staffing per 100 Looked After Children (LAC) was extremely low.

·         Senior Service Managers were aware of the issues; there were a number of options for the future and some potentially difficult decisions to be taken.

·         There were presently 66 open cases for therapy; the number of consultation clinics being undertaken had been halved and there was a waiting time of 7 weeks. Only one case a month could be picked up.

·         Input was provided to the residential homes apart from those covered by the B Positive initiative which had their own provision.

The Deputy Director also commented as follows:

·         Partnership working with other agencies, including this one, had been modelled on a LAC population of 870 but this had now increased to over 1000 together with a significant number of young people being cared for under SGOs.

·         It was considered the right thing to have these services for young people at the point of entry. 

·         This was an excellent service and the challenge was now with commissioning services in terms of funding.

·         The support provided for Social Workers was very valuable but there was also the need for the opportunities for direct work with young people.

·         Negotiation was undertaken in respect of provision for young people from Bradford in out of district placements and, usually, the Authority in whose care the young person was placed would be asked to provide these services.

Members discussed other potential sources of funding for this vital work, although it was noted that they may be temporary in nature or have caps imposed in terms of cost.

The Portfolio Holder commented that a cost benefit analysis should be undertaken in respect of Bradford children with outside placements and children from other authorities placed in Bradford. The matter should be considered by the Health and Wellbeing Board.

The Bradford District Clinical Commissioning Group (CCG) Co-opted Member said that this issue had been raised and was being considered by the CCG.

The Clinical Lead said that 15% of those children/young people seen by the team had been from outside the authority and they had received the same service in terms of assessment and therapy as a Bradford child. In response to a question from the Children in Care Council (CICC) representative she explained that there had been significant consideration given to the implications of charging other local authorities.

Further to other questions she also explained that:

·         A higher score in the Carer Questionnaire 6 months after a first appointment indicated a better result

·         An ‘outcomes day’ was due to take place on 4 May and this would provide a larger data-set for future analysis.

·         In terms of Strengths and Difficulties Questionnaire (SDQ) scores it had been found that borderline clinical cases tended to move to sub-clinical level after 6 months work.

Resolved –

(1)       That the Deputy Director (Children's Social Care) be requested to prepare a report, in consultation with the Clinical Lead for Looked After and Adopted Children (Child and Adolescent Mental Health Service (CAMHS)), for submission to the Bradford and Airedale Health and Wellbeing Board, in respect of the funding of the CAMHS Psychological Assessment and Therapy Service for Looked After and Adopted Children to ensure that the service is sustainable in the future.

(2)       That the strongly held view of the Corporate Parenting Panel in respect of the need for appropriate levels of funding to ensure that there are no restrictions placed on eligibility or scaling back of this vital service be reported to the Health and Wellbeing Board.

(3)       That the Deputy Director (Children's Social Care) be requested to investigate all other possible funding streams to support this necessary work for Bradford’s Looked After Children.

ACTION:       Deputy Director (Children's Social Care)