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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. Why are we doing this?. - PowerPoint PPT Presentation
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ACCESSING APPROPRIATE CAMHS IN ESSEX - the Single
Gateway Pilot
Lonica Vanclay, ECC and Karen Egglestone, Catch 22 – 20th March
Tina Russell, ECC and Michelle Hembling, The Junction 29th March
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 18th 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’…
The tapestry of CAMHS provision
ECC (LA) CAMHS Tier 2 Team
Counselling (Schools)
CAMHS Family Therapies
Diagnosis, medication, teaching, consultation
Leverton secure children’s 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 1Tier 1
UniversalUniversal
Tier 2Tier 2
TargetedTargeted
Tier 3Tier 3
ComplexComplex
Tier 4Tier 4
AcuteAcuteCommunication and Language skills development & Family Support
Communication and Language skills
Early Years Provision Education Psychology Service
Children’s centres / Early years activities / Support
Private provision – spot purchased
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.
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
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
Outcomes for Services• Developed a common highlevel children’s
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!!
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
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
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.
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
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
CAMHS Single GatewayExpected 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
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?
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
Further Information
Overall Approach:Lonica VanclayLonica.Vanclay@essex.gov.uk
Gateway: CAMHS Single Gateway – North Essex Holmer Court Essex Street (off Headgate) Colchester CO3 3BT
Any Questions?
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