Band 4 – Psychologist 5.0 Band 3 – Unqualified 1.0 Total Clinical Staff 38.88 Administrative Staff Band 8a – Senior Manager 1.0 Band 4 – Admin and Clerical 2.76 Band 3 – Admin and Clerical 7.63 Band 2 – Admin and Clerical 2.10 Total Administrative Staff 13.49 Total Workforce 52.37 Teesside Community Eating Disorder Service data Hartlepool and Stockton on-Tees CCG and South Tees CCG Referrals 2013/14 2014/15 2015/16 Apr – Sept 2016 Total referrals 52 52 293 38 Accepted referrals 47 42 293 36 Non-accepted (re-directed) 5 (9.6%) 10 (19.2%) 0 2 Tees-wide Community Eating Disorder Service - Waiting times Q1 15/16 Percentage of children and young people seen within 4 weeks for a first appointment 100% Workforce (Tees-wide Community Eating Disorder Service) Team Staff - whole time equivalent (wte) Clinical Staff Consultant 0.20 Band 8c – Psychologist 0.10 Band 8a – Psychologist 0.40 Band 7 – Nurse Manager 1.0 Band 7 – Dietician 0.60 Band 6 – Qualified Nurse 1.0 Band 6 – Dietician 0.20 Band 4 – Unqualified Nurse 1.0 Band 3 – Unqualified Nurse 1.0 Total Clinical Staff 5.5 Administrative Staff Band 3 – Admin and Clerical 1.0 Total Administrative Staff 1.0 Total Workforce 6.5
infants in PVI nurseries (M7) Explore development of 16-19 resilience offer (M8) Develop points of access where children and young people and families can access appropriate support inclusive of peer support, information and guidance Services designed through co- production with children and young people and families More children and young people will have access to peer support Enhancement of local peer support model (M3) Peer support mapping and development (RC2) Improve access to bereavement care for children and young people More children and young people who have been bereaved will have access to timely support Children and young people are able to cope Specialist 0-5 bereavement service funded to support children in understanding grief, coping skills, giving opportunities to remember, and helping family and carers to support the child. Service will work across Teesside (M4) Improving access to effective support – a system without tiers Ensure children, young people and families have timely access to evidence based support and treatment when in need Implement access and waiting time standards for children and young people with eating disorders More children and young people will access to the Community Eating Disorder Service Implementation of waiting time standards Reduced potential for admission Additional funding has been made available to community services to enhance the current service offer
Ensure access to mental health crisis support and intervention, in line with principles within the Crisis Care Concordat The most vulnerable young people are supported and receive emergency intervention when required Comprehensive assessment for children and young people in crisis within 4 hours of referral people receive community based support as close to home as possible Positive impact on hospital admissions (unintentional and deliberate injuries; mental health) A review to be undertaken to evaluate its effectiveness alongside Intensive home treatment pilot Review need and impact of intensive home treatment and explore most effective of service delivery (potentially linked with the crisis service model) for children and young people with complex needs Care in settings that is acceptable to individual and parent/carer Admission avoidance (when appropriate) Intensive support and continuity of care post discharge from inpatient treatment to other services (facilitate stepped care) Application submitted and has been successful to develop an intensive home treatment service. The specification for this is currently under development Care for the most vulnerable Improve the experience and outcomes for the most vulnerable and disadvantaged children, ensuring they are adequately supported at key transition points Proactive of children, young people or their parents who do not attend (DNA) appointments Reduced percentage of children and young people who Do Not Attend in CAMHS A checklist of actions has been developed by TEWV when an appointment isn’t attended TEWV reviews DNAs as part of their weekly performance management arrangements TEWV have identified there is a link between waiting times and DNA’s, therefore as waiting times
have reduced so have DNAs TEWV ensure appointments are at flexible and at a place convenient for families Routine outcomes measures are being utilised to support in the reduction of DNAs. Optimise model of specialist care and support for Looked After Children and Children in Need, including those with complex behavioural and mental health needs Looked after children and children in need have timely access to services and appropriate interventions Reduction in number of placement breakdowns Review of LAC CAMHS service being undertaken by Local Authorities to understand service impact. Increased capacity for LAC and CIN services, develop appropriate care pathway and increase Primary Mental Health Worker capacity (RC3/RC6) Support for young carers Raised awareness of support available for young carers Development of Young Carer Champions Young carers identified in schools Each Local Authority has a young carers support service in place The CCG are working with the LA’s to understand how they can enhance these service to identify and support more young carers. Awareness raising in schools to increase numbers of young carers on registers (RC4) Accountability and transparency Implement robust governance structures to oversee this transformation process that incorporate the voice of the child, family and community Establish locality implementation groups to coordinate engagement with children and young people through a variety of means; and to monitor progress against the Transformation Young People are experts by experience and there should be no service about them, without them Publication of an annual report setting out key achievements, for improvement and further action required Governance updated to combine South Tees-wide transformation planning and engagement with young people with CYP IAPT planning Headstarters group for children and young people work with Middlesbrough locality Headstart Board
Appendix 3 Executive Action Plan 2015/16-2016/17 Identified local priority description Costs (full year effect) Lead Partners Outcomes Timescale Additional information CCG wide schemes ST1 Improve access to perinatal mental health care Community perinatal mental health service; business case available Tees CCG contribution £170,000 excluding CQUIN payment South Tees CCG Hartlepool & CCG Access to advice and information; deliver a timely service; support women in their own community safety and effectively avoiding unnecessary admission Service already in place, application for enhanced element will be provided in 2016/17 Service commissioned collaboratively with Hartlepool and Stockton-On-Tees CCG Will need to benchmark against new guidance once published Application submitted for additional money to enhance our existing service. ST2 Implement access and waiting time standards for children and people with eating disorders Enhancement of existing service model to be evidence compliant Additional £173,771 South Tees CCG Hartlepool & CCG Improved waiting times and access, improved outcomes, reduced admissions to Tier 4 2016/ 17 Will continue to work collaboratively with Hartlepool and Stockton-on Tees CCG We are planning to use the Eating Disorder funding to increase availability of intensive home treatment services operating between tiers 3 and 4. Eating Disorders services will
ST5 Proactive follow-up of children, young people or their parents who do not attend (DNA) appointments Develop a plan to understand the issues and what support is needed when children, young people or their parents/carers do not attend appointment explore potential CQIUN linked to assertive outreach £0 South Tees CCG Hartlepool & CCG Commissioning intention proposal 2016/17 Reduction in % of Did Not Attend appointment 2016/17 Scoping in year 1 Provider has undertaken review of DNAs and the implemented processes to reduce the number of DNAs. ST6 Locally have high numbers of presenting with Conduct Disorder Scoping exercise to gain a greater understanding around the population, service provision available. £50,000 South Tees CCG Hartlepool & Stockton CCG We are also going to review the skills within the workforce and identify opportunities and examples of interventions which could be delivered within universal settings. Ongoing We propose to work collaboratively across the region to identify areas of best practice in implementing the NICE guidance for conduct disorders and create a plan to replicate this in the South Tees area. It is expected that this will influence the working of our Tier 2 Targeted services, which are increasingly working within schools, as well as specialist Tier 3 TEWV have been asked to undertake a scoping exercise on conduct disorder to understand where children and young people are presenting and what support is needed in those settings.
ST7 Autism Spectrum Disorder ( ASD) waiting lists across Tees are increasing and lack of coordinated post diagnostic support and OT assessments for children with sensory needs Tees wide ASD steering group established and CI previously completed to reduce waiting times for children and young people Recognised that ASD multi agency and whole system change required £80,000 South Tees CCG Middlesbrough Council; Redcar and Cleveland Council; Education; TEWV; Trust; Spec Comms; Heath & Justice; PCC; YOS; H&J To appoint project manager to dedicate time to ASD for South Tees and Link with HAST as undertaken similar approach To review current pathway and undertake value mapping, undertake 3P event to redesign pathway and to develop new ASD specification for potential procurement in partnership with local authority and education 2016/17 Linked to the development of an al- age ASD strategy Job description and service specification to be developed Post to be hosted by Redcar and Cleveland Council. ST8 Training programme in Primary Care and other settings; development of Young People Mental Health and Wellbeing ‘champions’ Trainer costs; backfill £80,000 South Tees CCG Practices TEWV VCS PH Increased awareness amongst staff working in Primary Care, other settings; named champions – which would be able to offer support to peers in regard to children’s mental health and wellbeing 2015/16 16/17 To be completed as part of the Conduct disorder scoping and training pilot ST9 Embedding principles of the CYP IAPT programme Backfill arrangements to allow training £146,000 Tees-wide TEWV VCS Improved skill set of the workforce; professionals working with children and young people are able to respond to a broader range of workforce with right skills and competencies to complement existing experience Ongoing Monies identified from Waiting list initiative to ensure greater number of staff with evidence based practice skills to ensure 2nd appointment wait times reduced To enhance roll out to non TEWV staff
ST10 Project coordination to ensure CCG deliverable To coordinate steering group and CCG priorities To ensure engagement with children and people to move towards tier less model £40,000 South Tees CCG Middlesbrough Council and Redcar and Cleveland council Part time project coordinator to drive the CCG priorities and to support both leads from each local authority to deliver schemes and agree priorities for 17/18 16/17 Redcar council to host post Job description and service specification to be developed Middlesbrough schemes M1 Building capacity of Headstart programme team to coordinate and strengthen system children and young people’s emotional wellbeing service delivery To support the 0-19 age range in relation to system change, service redesign and developing integrated multi agency pathway Develop and Implement a model of prevention, resilience and early identification £56,250 MBC CCG Headstart working on wider programme management structure with Middlesbrough Council taking proposed posts though Council job evaluation protocols. 2015/16 As a result families, children and young people will receive services which are accessible appropriate and timely M2 Improve identification of perinatal/ parental mental health by promoting intervention to reduce the impact of maternal depression Parental mental health has a significant impact on bonding, attachment and parenting skills. Implement and monitoring attachment, attunement training programmes for midwives, health visitors and years workers as part of the wider workforce development strategy and attachment to be given priority as an integral family approach. £37,500 Public Health CCG Primary schools Delivered within targeted primary schools: Linthorpe Community Primary, Green Lane Primary Academy, Newham Bridge Primary, Easterside Academy and Park End Primary. Provider appointed and recruiting frontline staff for the training sessions. 12 professional per cohort from a range of disciplines including midwives, health 2015/16 words together programme supports changes in the home learning environment leading to parents displaying increased confidence in identifying supporting their child’s early literacy 25 families engaged in each school: Newham Bridge, Green lane, Easter Side, Linthorpe and Park End at a
positive outcomes ( meeting Government targets for Families Turned Around through the Troubled Families Programme) M3 Enhance the peer support model and access to support for children and young people Designed through co- production with children, young people and families Develop points of access where children and young people and families can access appropriate support inclusive of peer support, information and guidance Map existing peer support networks Enable MyPlace to with young people and re-shape peer support programmes through existing services £18,750 MAP MBC Delivery continues through MyPlace Develop programme which will increase the number of children and young people involved in the local co-production of peer support Increased number of children and young people (CYP) accessing peer support through CYP friendly settings 2015/16 Fewer children with negative emotional wellbeing issues including self-harm, low self-esteem or being bullied M4 Improve access to bereavement care for children and young people Enhance current bereavement support for children under five of age to offer Component 1 and have strategies in place for clients to access specialist Component 2 and 3 services £37,500 Public Health CCG VCS Cruse Bereavement commissioned and service commenced April 2016. Number of children under five supported through bereavement counselling services Increased capacity to deliver specialist 2015/16 Reduction in waiting list for bereavement support Increase in numbers of under-five who access component 1,2 and 3 A gap exists for the support of
Component 3 support services children locally who require specialist bereavement interventions (Component 3) which include psychological support services, specialist counselling/ psychotherapy services or specialist palliative care services. M5 Support the development of Voluntary Community Sector (VCS) capacity to introduce a model of preventative support Support the development of VCS capacity to introduce a local model of preventative support that will improve emotional wellbeing outcomes £75,000 MVDA Public health MVDA submitted proposal which requires sign off agreement by Board Model developed and agreed; increase in the number of VCO’s providing preventative support; increase in the numbers of children and people benefiting from preventative services 2015/16 Specific deliverables for the prevention elements suggested as priorities
M6 Headstart Implementation Roll out the Headstart programme across all Middlesbrough schools, with resilience workers in school providing low-level support at the pre-CAMHS level. Also funds the Headstarters programme of young people’s involvement and coordination resource. £150,000 MBC Promoting resilience, prevention and intervention Improving access to effective support 2016/17 M7 Pre-School Headstart Explore the development of a pre-school Headstart for 0-3 year olds that creates a seamless offer for parents, babies and infants in PVI nurseries. £35,000 MBC Promoting resilience, prevention and intervention Improving access to effective support 2016/17 M8 Post 16 Headstart Explore the development of a post 16 Headstart offer that support young people aged 16-19 years old £20,000 MBC Promoting resilience, prevention and early intervention Improving access to effective support 2016/17
M9 Workforce Development Implementation of a workforce development programme for the early intervention and prevention of mental health £30,000 MBC Upskill and development of the workforce 2016/17 M10 CYP IAPT – Developing the Workforce Workforce development opportunities in respect of IAPT £10,000 R&C BC MBC TEWV Development of workforce opportunities Improving access to CYP IAPT 16/17 Working jointly with R&C BC to develop and coordinate a Tees wide approach Redcar & Cleveland schemes RC1 Promoting attunement and attachment between mother/care and baby Implementation and monitoring attachment, attunement training programme for midwives, health visitors, social workers and early intervention workers. Training will be procured from external provider. Once trained, workers to provide early identification of attunement problems, offer intervention (Video Interactive Guidance and other tools) thus 15/16 £60,000 16/17 £60,000 R&C BC MBC Increase in the number and range of professionals trained; evaluation of training e.g. increased learners knowledge 2016/17 As this is also a Middlesbrough priority there is an option to jointly procure a provider to deliver workforce training.
preventing attachment disorders later in childhood. (Capacity in existing workforce to deliver intervention). This will form part of wider workforce development programme. User groups will be Mothers and infants. Redcar and Cleveland workforce to be trained RC2 Develop and implement a model for peer support with children and young people – Young Health Champions Mapping exercise re peer support networks for children and young people and parents; scope utilising existing networks, groups, local expertise Fund local provider to work with children and young people to design a navigator support programme through the services available £20,000 R&C BC Children and young people VCS Report produced of existing peer support networks across the borough; services designed through co- production with children and people and families; navigator peer support programme for young people 2015-2020 RC3 Optimise emotional and mental health support for Children in Need (including those subject to a Child Protection Plan and Looked After Children, including those with complex behavioural and mental health Improve access, capacity in specialist care and support for Looked Children (LAC) and Child in Need (CiN) and those with complex behavioural needs Develop an appropriate care pathway, which incorporates effective 15-16 £110,000 16/17 £201,000 R&C BC Middlesbrough Council, South Tees CCG, TEWV Reduced number of Out of Area Placements; reduced number of placements; reduced number of placement breakdowns Children prevented from coming into care Better emotional health in families March 2016 – March 2020 Part funded by existing budget, plus £40,000 to develop more cohesive model of mental health support for LAC. This project will inform development of commissioning plan
embed the work across all 4 projects. RC4 Support for carers Awareness sessions in schools To fund the local Provider of Young Carers for Redcar and Cleveland (Junction) to facilitate a series of awareness raising sessions in schools Increased number of Young Carers Champions in secondary schools Better awareness and identification of young carers in schools and among professionals working in adult mental health Under 18 young carers Costing for materials and transport cost of young carers £2,000 R&C BC Junction Number of Young Carer Champions Number of young carers identified in schools Increased awareness of young carers for staff 2016-2020 Target of 4 schools per year, including evaluation Further funding has been provided in 16/17 (£2k) which has been included in the full year effect, to enhance the current contract R&C BC have with the Junction to support in better awareness and identification of young carers in schools and among professionals working in adult mental health