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
Slide 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 18 th Birthday who have
mental health problems and disorders should have access to timely,
integrated, high quality, multi-disciplinary services to ensure
effective assessment, treatment and support for them and their
families
Slide 3
The tapestry of CAMHS provision ECC (LA) CAMHS Tier 2 Team
Counselling (Schools) CAMHS Family Therapies Diagnosis, medication,
teaching, consultation Leverton secure childrens home Brookside
in-patient ward NEPFT/SEPT Longview/Poplar in-patient ward Tier 3
NEPFT Team in North SEPT in South Group Therapies Healthy schools
Midwifery Services PSHE in schools Pastoral Teams (Secondary
Schools) SEAL Peer and Learning Mentors Anti-Bullying Policies and
Activities Schools Health Visitor support Home School Liaison
Workers Group and skills programmes to develop self esteem and
confidence (Schools & Voluntary Organisations) Partnership
commissioned and voluntary sector provided services eg Catch 22,
The Junction, Place2Be, Young Concern Tier 1 Universal Tier 2
Targeted Tier 3 Complex Tier 4 Acute Communication and Language
skills development & Family Support Communication and Language
skills Early Years Provision Education Psychology Service Childrens
centres / Early years activities / Support Private provision spot
purchased
Slide 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.
Slide 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
Slide 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
Slide 7
Outcomes for Services Developed a common highlevel childrens
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!!
Slide 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
Slide 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
Slide 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.
Slide 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
Slide 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
Slide 13
CAMHS Single Gateway Expected 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
Slide 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?
Slide 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
Slide 16
Further Information Overall Approach: Lonica Vanclay
[email protected] Gateway: CAMHS Single Gateway North
Essex Holmer Court Essex Street (off Headgate) Colchester CO3
3BT