Agenda item

To consider a report of the Commissioning Manager – Integrated Commissioning Unit.

Steve Tatham introduced himself as the commissioning manager from the ‘Integrated Commissioning Unit’ – a service jointly provided by the Central and Eastern Cheshire Primary Care Trust (CECPCT) and Cheshire East Council.

In outlining the most salient points from the report, Steve Tatham firstly referred to the high and increasing demand for ‘Autistic Spectrum Diagnostic Services’ in the Eastern part of Cheshire East (Macclesfield, Congleton and Alsager). He reported that this had led to longer waiting times for assessment but that this was being addressed by implementing an integrated single point of access for children, families and professionals who might require advice, training, consultation, assessment and ongoing support.

Steve Tatham continued to note that ‘The Integrated Commissioning Unit’ commissioned mental health services on a continued support basis from two bases in Macclesfield and Crewe. He explained that this meant the service model was based around a ‘tiered approach’ of universal, targeted and specialist services respectively. Attention was drawn to the appendix provided which gave a more detailed breakdown of the range of services available.

Steve Tatham reported that within this service model, prevention and intervention were two key themes. He explained that in line with this, Cheshire East Council in partnership with Cheshire West and Chester, PCT’s and Clinical Commissioning Groups were establishing two new nationally led evidenced based programmes which were due to start in April 2012. These were as follows:

-       The ‘Family Nurse Partnership (FNP) programme – Intensive and therapeutic support for 100 first time teenage mothers

-       A ‘Multi-Systemic Therapy’ (MST) programme – Intensive support to prevent children and young people entering care and/or custody. 

In terms of the ‘Family Nurse Partnership’ programme, it was queried whether it was appropriate to deal with teenage pregnancy as a mental health issue. Steve Tatham explained that as teenage parents tended to be isolated, evidence showed that they were more prone to post-natal depression and other related issues. Therefore the aim of the programme was to try and provide assistance to improve the life chances of both the parent and child.

It was questioned why the Eastern part of the Borough had longer waiting times for autistic spectrum assessments. Steve Tatham explained that this was due to the historical legacy of how the PCT footprint used to function. In the ‘central’ part of Cheshire which included areas such as Crewe and Middlewich there had been a history of integration and harmonisation of services which was not present in the East. It was expected that this would be addressed by putting in place an integrated single access point in the Eastern part of the Borough.

A comment was made with regards to the process of applying for Individual Pupil Funding (IPF). It was asserted that the process was difficult and that it was very rarely granted. It was queried therefore, whether the process could be simplified. Fintan Bradley reported that this was one of the issues that the ongoing SEN Review was looking at and that they were exploring reducing the bureaucracy around the IPF.

It was stated that a number of children in care would benefit from support from the CAMHS service. It was asserted however, that this care was very often slow to arrive and by the time it had been made available, the child had already moved on. It was queried therefore whether children in care had a ‘fast track’ option available to them for accessing CAMHS services. Steve Tatham reported that the CECPCT had invested £100,000 to support cared for children. He acknowledged however that the threshold for accessing these services was relatively high and that the challenge, as was with all children, was widening access to low-level preventative support; something which the service was seeking further investment in. Steve Tatham also noted that the service needed to start asking children themselves about the services they received in order to make improvements.

Referring to the recommendation which suggested the Committee support further investment into a preventative approach to the emotional health and wellbeing of children and young people and their families, a number of queries were made regarding how this investment would be constituted. Indeed, it was firstly asked what current funding was in place proportionately from each organisation and who managed this in terms of allocation for CAMHS as a whole and the preventative agenda. Secondly, it was questioned how the investment needs had been worked out, where it was expected the money would be spent and from which organisations proportionately would the extra funds come from. Steve Tatham confirmed that he would distribute this information to the Committee for consideration.

It was queried where a young person in Cheshire East would be placed in they required a residential bed. Steve Tatham confirmed that these beds were commissioned on a Cheshire and Merseyside footprint and therefore the beds were in Chester. He acknowledged that this was not ideal in terms of travel distance for relatives but that it was not affordable to have a unit in Cheshire East for three to four young people.

As a final point, it was suggested that it would be useful for the Committee to receive a geographical map indicating where services relating to CAMHS were located. Steve Tatham confirmed that he would distribute this to the Committee.

RESOLVED –

a)    That the report be received

b)    That the Committee support the work to integrate the existing autism provision into a single ‘multi-agency’ pathway to improve the autism assessment and support pathways across the authority.

c)    That the Committee support further progress in preventative approaches and services to meeting the emotional health and wellbeing needs of children, young people and their families/carers.

d)    That more detail on the financial background and requirements for increasing investment into preventative approaches be circulated to the Committee for consideration. That this information include:

a.    What current funding was in place proportionately from each organisation for CAMHS as a whole and for the preventative agenda?

b.    Who managed the current budget in terms of allocation?

c.    How the investment needs had been worked out.

d.    Where it was expected the money would be spent and from which organisations proportionately would the extra funds come from.

e)    That a geographical map indicating where services relating to CAMHS were located be circulated to the Committee.