Agenda item

To consider the new EWMH services, Mindworks Surrey.

The Executive Director for Children’s Community Services, Surrey and Borders NHS Foundation Trust (SABP), the Director of Children and Young People’s Services, SABP, the Children’s Emotional Health Alliance Programme Director, SABP, and the Chief Executive, Surrey Wellbeing Partnership, updated the Committee on Mindworks Surrey.

With the aid of presentation slides circulated in advance with the agenda papers, the Committee was advised of the partnership approach of Mindworks and the iThrive framework being used since April 2021.  The meeting was informed that the Mindworks contract was for seven years, with an option to extend for a further three years.  The meeting was informed that the iThrive framework was replacing the traditional delivery of children and adolescent mental health services.

The Children’s Emotional Health Alliance Programme Director, SABP, outlined the organisations and partners delivering Mindworks and the role of the Tavistock and Portman NHS Foundation Trust in the development of the framework for Surrey.  The meeting was advised that the main Mindworks services were based around seven areas: access and advice; school-based needs; building resilience; intensive interventions (including the children and young people’s eating disorder services); crisis admission avoidance; reaching out; and neurodevelopmental services.

The Children’s Emotional Health Alliance Programme Director, SABP, informed the meeting of the ongoing challenge of recruiting staff to the Mindworks service across Surrey, but indicated that all seven new service areas were being delivered.  The Committee was advised of an out-of-hours phone line providing advice to parents and carers of children with neurodevelopmental need, such as autism or ADHD.

The Committee was advised of the school-based needs offer in Surrey, including multiple teams working collectively.  The Children’s Emotional Health Alliance Programme Director, SABP, indicated that every district or borough within Surrey had a named primary mental health worker and a community wellbeing lead, and would have a mental health support team.  The meeting was advised that the mental health support team for Guildford would be in place in September 2022.

The Children’s Emotional Health Alliance Programme Director, SABP, informed the Committee of the Amplify participation group, designed by young people and led by a young person with expert by experience.  The meeting was advised of the Mindworks launch event organised by Amplify and to be held on 14 May 2022 at Sandown Racecourse, Esher. 

The Children’s Emotional Health Alliance Programme Director, SABP, confirmed that demand for Mindworks services was increasing and partners were working collectively to reduce waiting times for services. 

During the ensuing discussion a number of questions were asked, and clarifications offered:

·        In reply to a question from a member of the Committee about the impact of the pandemic, the Executive Director for Children’s Community Services, SABP, confirmed an increase in both the number of children presenting in crisis and the complexity of their conditions.  She stated that improved collaboration with Mindworks partners meant that children were able to access help much earlier than under the previous CAMHS (children and adolescent mental health services).  The Director of Children and Young People’s Services, SABP, outlined the school-based offer of Mindworks in Surrey and the improvements in early intervention.  In addition, the Committee was advised of the introduction of more transparent and collaborative governance arrangements.

·        In response to questions, the Children’s Emotional Health Alliance Programme Director, SABP, indicated that the Mindworks contract was overspent, and a decision had been taken not to manage financial risk ahead of clinical risk. 

·        In reply to a question about funding, the Director of Children and Young People’s Services, SABP, advised that children’s eating disorders had seen a threefold increase in referrals during the pandemic.  The Executive Director for Children’s Community Services, SABP, informed the meeting that there was an ongoing national and regional response to the increase in mental health illness and referred to the flexible response possible under the Mindworks partnership in Surrey.  The Chief Executive, Surrey Wellbeing Partnership, advised the Committee that involvement of the voluntary sector through the Mindworks Surrey offer facilitated increased agility and workload sharing between organisations.  

·        In reply to a question, the Executive Director for Children’s Community Services, SABP, stated that waiting times had improved significantly compared with rates from two years previous.  The Director of Children and Young People’s Services, SABP, advised that children waiting for diagnosis of a neurodevelopmental disorder were currently waiting too long due to the demand for the service.  She expressed confidence that children in a crisis were being seen in a timely way and that children requiring assessment were able to access the broader Mindworks Surrey offer immediately.  In addition, the Director of Children and Young People’s Services, SABP, informed the meeting that the urgent care and short-term treatment teams had been stepped up during the pandemic.

·        A member of the Committee questioned the current vacancy rate and was informed by the Director of Children and Young People’s Services, SABP, that staff turnover was approximately 17 percent, compared to a figure of 14 percent for SABP.  The Director of Children and Young People’s Services, SABP, stated that the workforce as specified in the Mindworks contract was almost fully recruited but indicated that recruitment was an ongoing challenge.

·        The Executive Director for Children’s Community Services, SABP, advised the meeting of the opening of a twelve-bed inpatient unit in Surrey at April Cottage, Horley, in the spring of 2023. 

·        In response to a query, the Executive Director for Children’s Community Services, SABP, updated the Committee on discussions at recently introduced regional meetings. 

·        A member of the Committee noted that the information submitted on the referrals received into Mindworks Surrey from GP practices did not include surgeries in the west of the Borough in Ash and Tongham.  The Executive Director for Children’s Community Services, SABP, stated that the Children’s Emotional Health Alliance Programme Director, SABP, would look into the matter.

·        With reference to the information submitted to the Committee on referrals received into Mindworks Surrey from GP practices, a member of the Committee asked what had been learnt from such data.  The Children’s Emotional Health Alliance Programme Director, SABP, indicated that a breakdown of referral information, not based on geographical areas, or a data pack illustrating trends could be provided to Committee members.  The Committee was advised that data was usually collated and analysed by service area rather than by GP practice.

·        In reply to a question about service challenges, the Executive Director for Children’s Community Services, SABP, informed the Committee of the increase since 2020 in the number of young children referred to services, resourcing the expansion of school-based services to primary schools and, following the loss of the universal offer for all families at children’s centres across Surrey, long-term investment in prevention services. 

·        In response to a member of the Committee suggesting the value in apprenticeships, the Director of Children and Young People’s Services, SABP, advised the meeting that there were a range of roles within the mental health in schools teams that were designed to grow skill and expertise for the future in a manner similar to apprenticeships.

·        In reply to questions, the Director of Children and Young People’s Services, SABP, confirmed that the move from primary to senior school was viewed as significant and acknowledged that strengthening support for children and their families at such a transition was a priority.  The Children’s Emotional Health Alliance Programme Director, SABP, stated that information on Mindworks Surrey was updated regularly online and available at www.mindworks-surrey.org.uk. 

·        In response to a query from a Committee member, the Children’s Emotional Health Alliance Programme Director, SABP, confirmed that references to parents and families included all carers and looked after children. 

·        With reference to a question about early years intervention and prevention, the Executive Director for Children’s Community Services, SABP, indicated that she could circulate the Better Start Programme strategy to Committee members.

·        The Executive Director for Children’s Community Services, SABP, outlined efforts in Surrey to aid refugee families and children from Ukraine and elsewhere.

·        In reply to questions, the Director of Children and Young People’s Services, SABP, outlined the processes on the pathway to diagnosis of a neurodevelopmental condition and advised that such a diagnosis would ideally take no more than 6-12 months.  She indicated the need to take away a request for details of the average wait from referral to neurodevelopmental diagnosis.  The Executive Director for Children’s Community Services, SABP, confirmed that support was available along the pathway and diagnosis was not the route to support. 

·        The Committee was informed that cognitive behaviour therapy was one of a range of interventions available to children. 

·        With reference to every district or borough within Surrey having a named primary mental health worker and a community wellbeing lead, the Director of Children and Young People’s Services, SABP, confirmed that the primary mental health worker was a point of contact for every school in the cluster and had a role in upskilling and consultation with those in the school system. 

·        In reply to a question about the transition from children’s to adult’s services, the Children’s Emotional Health Alliance Programme Director, SABP, indicated the measures in place, including governance and other links with adult mental health services, and the transition service team.  The Children’s Emotional Health Alliance Programme Director, SABP, suggested that a future update for the Committee could focus on the 18–25-year-old age group. 

·        In reply to a question, the Director of Children and Young People’s Services, SABP, advised the meeting that progress with the adult eating disorder service was on track and suggested that a future update for the Committee could include neurodevelopmental pathway advances.

·        In reply to a question on the mental health education of schoolchildren, the Director of Children and Young People’s Services, SABP, reminded the meeting of the Amplify participation group and its work, especially on social media.

·        In reply to a question, the meeting was advised by the Director of Children and Young People’s Services, SABP, of professional referral routes and that parents and carers using the contact information on the Mindworks Surrey website would receive a response.  In addition, she informed the meeting that sixty-four percent of requests for support came from GP practices. 

·        In response to a question about information within the presentation submitted to the Committee over video or face-to-face appointments, the Children’s Emotional Health Alliance Programme Director, SABP, indicated that an evaluation of the video and telephone appointments between young people and their child wellbeing practitioners was in progress.  She advised that feedback from Healthwatch Surrey suggested that young people with autism often preferred video meetings.

The Chair thanked the Executive Director for Children’s Community Services, SABP, the Director of Children and Young People’s Services, SABP, the Children’s Emotional Health Alliance Programme Director, SABP, and the Chief Executive, Surrey Wellbeing Partnership, and confirmed that the Committee would welcome a further update in future.