Child and Adolescent Mental Health Services – Tier 3

Service SpecificationLisa Wells

Commissioning and Redesign Lead – Women and Children’s Services

Shropshire Clinical Commissioning GroupLisa.wells@shropshireccg.nhs.uk

Structure of CAMHS in Shropshire

Shropshire CCG commissions: ‘Core’ CAMHS Tier 3 Service CAMHS Learning Disability Service Reaching Out Service

One provider across Shropshire and Telford and Wrekin – Shropshire NHS Community Trust

Background

A review was commissioned by Shropshire PCT and Shropshire County Council in 2011 to consider comprehensive CAMHS provision in Shropshire (not just Specialist Tier 3 CAMHS)

The two key findings from the Review: the lack of a robust commissioning strategy for a

Comprehensive CAMHS in Shropshire secondly specialist Tier 3 CAMHS is seen as a service that

works in isolation to the broader primary care services, education and social care

Areas for development

A number of areas for improvement were identified: Data collection and needs assessment Understanding of pathways Understanding of criteria/threshold for the service Long waiting times Urgent referrals are not seen soon enough Issues with transition to adult mental health services Links to other services

Achievements to date

Revised service specification for Tier 3 CAMHS and Reaching Out Service (ROS) across Shropshire and Telford

Single point of access for referrals to CAMHS - via Compass Service Development and Improvement Plan Joint CQUIN for transition for 2014/2015 between CAMHS and

Adult Mental Health Services (provided by SSSFT) Clear timescales for referrals Improved data collection and reporting to commissioners

including weekly updates on waiting times

Next steps

Development of Compass including electronic referral form Development and communication of a range of clear pathways

for diagnosis and management of conditions A scoping exercise exploring the demand for extending hours

provision Improvements to the 24 hour on-call arrangements, including

scoping and reviewing the current provision Development of joint working protocols to support the discharge

of patients from acute settings who require Tier 3 CAMHS Scoping the service requirements identified as a result of Special

Educational Needs and Disabilities (SEND) Reforms