harry golby
TRANSCRIPT
Salford CAMHS Schools Link Pilot
Harry Golby
Head of Service Improvement, Salford CCG
December 2016
Salford Context
• Salford’s population is increasingly rapidly – 242,000 in 2014, expected to reach 284,000 by 2034
– By 2021 increase of 1,500 primary school children
– By 2021 increase of 2,300 secondary school children
• Black & Minority Ethnic population is growing– 5% in 2001 to 14% in 2011
– 23% of children in 2015
• Health outcomes for children are below national averages but (slowly) catching up
Salford Context
• 83% of Salford’s primary school leavers
achieved KS2 Level 4+ in English & Maths
compared to 80% nationally
• 48% of Salford children achieved 5+ GCSEs in
2015 compared to 57% across England
• 8.1% of Salford’s 16-18 year olds are NEET
compared to 4.9% in England
• 27% of Salford’s adult population have no
qualifications compared to 22% in England
• Salford’s business will need 11,000 more
employees qualified to NVQ Level 4 by 2021
• Greater Manchester STP
• Salford Locality Plan
• 0-25s Programme
3 x City Wide Workstreams:
Emotional Health & Well Being
Speech & Language Therapy
Children with Disabilities
2 x Place Based Pilots:
Salford Context
National School / CAMHS Link Pilot
Joint NHS England & Department for Education pilot
Aiming to test;
• How training and subsequent joint working between
schools and CYP mental health services can improve
local knowledge and identification of mental health
issues;
• Improve referrals to specialist (and other) services; and
• Test the concept of a lead contact in schools and
CAMHS
22 pilot sites across the country
Salford CAMHS School Link Pilot
• 32 expressions of interest for schools to take part in the
pilot
• 10 schools (Phase 1):
• 6 Primary Schools, 3 Secondary Schools, 1 PRU
• CCG resources in addition to national funding
• 23 schools (Phase 2):
• 18 Primary School, 5 Secondary Schools
Poor communication between schools and CAMHS:
• Schools often unaware if a case was open to CAMHS or if
discharged
• Teachers had concerns that their views as educators are not always
requested, valued or recorded
• Teachers unable to routinely contribute to the review process
• General lack of information flows
• Teachers feel best placed to be able to identify a child's difficulties at
an early stage, but no mechanisms in place for this to be utilised.
Unclear and complicated referral processes
• Schools reliant on other health professionals to refer to CAMHS or
parents to follow up referrals
• Little or no information on how a referral progresses
Patchy multi-disciplinary approaches
Unclear roles, responsibilities and expectations across the system
Learning - Schools Views of CAMHS
Unrealistic expectations from schools that CAMHS can:
– Provide information without consent, no blanket consent for release of
information
– Provide interventions without clear assessed rational
– Remain involved in cases without engagement and clear purpose.
– Force parents and young people to engage in treatments - not unless a
safeguarding issue
– Advise on classroom management
Dilemmas for CAMHS
– Limited Resources, high volume of referrals, significant DNA rates
– Paid on tariff – not paid for non clinical contact
– No provision for crisis team (CAMHS Transformation Plan addresses)
Learning – CAMHS views of Schools
Phase 1 Progress• Completion of two full day workshops (3rd Dec 2015 and 3rd Feb
2016)
– Opportunity for listening to concerns and acknowledge barriers
– Agreed named schools mental health leads in each of the schools and CAMHS
– Agreed areas for improvement and all being open to change
– Adopted a positive approach to addressing change
• Development and testing of a direct referral framework from phase
1 schools to CAMHS, framework includes:
– All school mental health leads to complete 2 day CAMHS training before they are
able to refer
– All participating schools need to be engaging in Salford Emotional Friendly
Schools Programme
– Implementation of the direct referral process, via school mental health leads to
CAMHS Schools Link practitioner (June 2016 – Dec 2016)
– CAMHS Schools Link Practitioner offers all schools:
• CAMHS point of contact for all participating schools
• Triage facility for all referrals
• Specialist support for participating schools
Phase 2 – Progress & Next Steps
• March 2016 initial engagement and participation sign
up of an additional 23 Salford schools
• Agreed named mental health leads in each school
• Mental health leads to complete 2 Day CAMHS training
between Jan 2017 – March 2017
• April 2017 all phase 2 participating schools who have
completed the 2 day training will start to refer directly to
CAMHS.
• Mental health and emotional wellbeing Salford
Networking Event delivered to all 33 participating
schools on October 2016
Learning so far Schools have reported
– Improved communication and formation of stronger links and relationship with
CAMHS workers
– Specialist support and intensive support packages are improving the holistic
approach to the care of the child
– Schools are In unique position to make timely referrals
– Schools are able now as referrers schools to be central to progress and
information flows regarding the child's progress with CAMHS
– More creative methods of engagement have been developed
– The in depth knowledge schools have regarding the child and family is now being
recognised and utilised effectively and are now able to work in partnership with
CAMHS
CAMHS have reported
– Information received from schools has improved quality of referral information
improving the child’s assessment
– Because of improved relationships and information flow having SENCO’s attend
appointments has provided new insights to the assessment and ongoing
management
– Knowing who to contact in schools via the school mental health leads has proved
very useful
Schools Referrals to CAMHS
• 12 referrals made by Primary schools, with 9 accepted
• 10 referrals made by Secondary schools with 9
accepted
• 3 Referrals not accepted as ‘watch and wait’ and 1
was re-directed to CAMHS Psycho Social Service at
RMCH
• Referrals well completed with accurate information
facilitating triage and appropriate diagnosis, especially
with ADHD
• Majority of pilot work focused on training,
consultation and liaising on a day to day basis
which has helped to establish firm relationships
with SENCO’s
Where are we now• Integrating lessons learnt from the pilot into general CAMHS
process
• Continued consultation and engagement with schools
• Continued delivery of bespoke training for participating schools
improving skills, knowledge, building capacity and capability.
• Roll out of the direct referral framework to phase 2 schools
• Start to plan wider Salford school roll out
• Evaluation with a view to a business case for city-wide rollout and
recurrent resourcing
