Overview

We are developing a new Child and Adolescent Mental Health Service (CAMHS) for Barnsley and during August and September we have been inviting views and comments on our proposals for the service.

Nationally, we know that children and young people are waiting a long time to be seen by Child and Adolescent Mental Health Service, or CAMHS, and this has also been the case in Barnsley.  Our aim is to to develop a new approach to providing care for children and young people’s mental health and emotional wellbeing, which offers a more joined up approach, so they can get the right support at the right time.

We have been listening to feedback from the children, young people and families who have used the range of mental health and wellbeing services available across Barnsley.

In 2019 we also heard from the NHS England’s Intensive Support Team who carried out an independent review of CAMHS and the separate MindSpace service, which runs in secondary schools. This review helped identify what was working well, and what could work better, to improve outcomes for children and young people experiencing mental health and emotional wellbeing issues. The independent review took place in April 2019 and one of the recommendations was to do an urgent review of service specifications.

We are responding to this recommendation by developing a new service, which is based on all the feedback we have received so far. We plan for the new joined up services to be start in April 2020.

The model currently in place to provide mental health services for children and young people within the borough is as follows:

• 0-18 years old specialist Children and Young People’s Mental Health Services (CAMHS), including crisis care, provided by South West Yorkshire Partnership NHS Foundation Trust (SWYPFT);
• Lower-level emotional health and wellbeing support which is provided by a number of voluntary and community providers.
• Specialist Autism Spectrum Disorder (ASD) services are provided by Barnsley Hospital NHS Foundation Trust (BHNFT).

Initial engagement 

So far we have looked at national best practice and spoken to local health professionals about what they think. From recent engagement work undertaken by OASIS the Barnsley young commissioners, Chilypep, HealthWatch Barnsley and local MPs amongst others, we have a rich picture of what children, young people, their parents/carers, and professionals expect from a CAMHS service.

We have also been working closely with OASIS, to develop the specification.

The new service we are proposing is a joined up offer which ranges from low level support to specialist medical support. A key aim of the new service is that children and young people receive support and treatment quickly as we know this is important for getting the best outcomes.

Based on best practice and feedback, we are proposing the following four key elements for the new service which are:

• Provide timely support and offer children and young people robust, ongoing support while they are waiting to be seen.
• A joined up offer of more low-level support as well as specialised medical support.
• The service will support people up to the age of 25 (this would be a gradual change).
• The service will see children and young people outside of school/college hours wherever possible so that they do not have to miss lessons to get support.

Additional feedback identified through engagement to date which we will be incorporating into the new specification covers the following areas:

• Children and young people want to be more involved in their treatment and care planning
• Parents and carers would like more support when their child/young person is being seen by CAMHS
• The treatment environment should be child friendly e.g. comfortable furniture and calming décor
• The service should provide technologically-based support tools such as online self-help and apps Increase awareness and training with regard to what support is available
• Offer more support outside of normal hours (not just crisis support)
• Re-model the Single Point of Access (SPA) to make sure people are seen quickly

What people told us about our proposals for the new service model for Child and Adolescent Mental Health Services?

During August and September 2019, we asked people to feedback their views and comments on our proposals for the development of a new service model for CAMHS and any recommendations for changes. People fed back on the proposals, provided direct feedback on their own experiences or posed questions for consideration. People also fed back on the overall vision, which will help inform future plans.

Over the course of the past few weeks we have heard from 142 people who have fed back to us either in person at one of the meetings that we have attended, via one of the two surveys that we have hosted online and provided paper copies of or via email or telephone call directly to the CCG.

The emerging themes from the conversations and feedback that we have received as part of this brief engagement period has helped to reinforce our direction of travel in relation to our proposals for the new service model for CAMHS and to further inform the service specification. 

This will at a later date also help to shape the development of the new service and we hope to continue the dialogue that we have previously established with OASIS and that we have newly established with the Barnsley Youth Council and the CAMHS Parent and Carer Support Group as part of this process.  

Overall the general viewpoint was that this is the right thing for us to do in Barnsley and it is important for us to stop talking hypothetically and move towards taking some action for the benefit of local children and young people and the people that work in the associated services.  

Conversations at the face to face sessions quickly moved on to how we can we make this happen and questions and ideas for us to respond to and take into consideration as part of the service development phase.

An engagement report has been compiled to support the development of the service specification. Following submission to the Barnsley CCG Governing Body on 12 September 2019, further involvement activity will take place as part of the procurement and mobilisation phases during 2019/20.

A copy of this report and an update on decisions taken by the Governing Body will be sent to everyone who has requested it and provided us with their direct contact details. Updates will also be published here on the CCG website.

Update regarding the development of a new Children and Young People’s Mental Health Service (CYPMHS) for Barnsley - August 2020 

Following the engagement process highlighted above and confirmation of the service specification, we started on a process of trying to find a provider of the new service through what is known as a procurement process where potential providers of the service put forward a bid by a set deadline of how they would deliver the service if they were to be the successful bidder.  Their responses need to be based on the information set out as part of the agreed service specification and within the budget set.  Importantly they need to provide answers in relation to the questions that are set by the panel of people who will score the bids.  These questions are normally based around a number of different criteria such as quality, patient experience and satisfaction and finance for example.    

 When we started on this process in late 2019, we invited representation on the panel of people who mark the bids (where the organisation who scores the highest in line with the above process is the successful bidder and is invited to provide the new service) from the Barnsley Youth Council along with other people drawn from a range of other services and organisations working within Mental Health in Barnsley .  However, before representation was confirmed on the panel we were informed that the procurement would be delayed.   We had hoped that this would be restarted in early 2020 but due to the Covid-19 pandemic this was unfortunately not possible. 

In March due to the changing environment caused by COVID-19 and the resulting pressure caused by this on local health services, Barnsley CCG took the decision to suspend this procurement process with immediate effect to ensure that healthcare staff were free to devote maximum effort to helping with the local response across Barnsley. It was agreed that this would be reviewed in June/July 2020 in line with national guidance. 

Following this and due to the ongoing pandemic, the CCG Governing Body (which is led by local GPs from Barnsley along with NHS Managers) met on 18 June 2020.  At this meeting it was agreed to cancel the current procurement as a result of the ongoing COVID-19 pandemic and the resulting changes in how the local CYPMH service is delivered, particularly in relation to more services being available and provided digitally, which was an ambition of the new co-produced CAMHS service specification 

Where we are now

The contract with the current NHS provider of Children and Young People’s Mental Health Services (South West Yorkshire Partnership NHS Foundation Trust) has therefore been extended to 31 March 2021 with a view to working together during the next few months to develop the future service model from 1 April 2021. 

We want to build on the developments that have been made over the past few months that includes improvements in access for local children and young people to online consultations and to ensure that support and changes in working practices, which improve services for our children and young people, remain in place and are developed further where this is required.  

The current NHS provider is working in partnership with key services and organisations such as MindSpace and Chilypep as well as the 0 - 19 Public Health Nursing service and key services delivered and supported by Barnsley Metropolitan Borough Council towards delivering​ the iThrive CYPMHS system model which moves away from the traditional tiered medical system towards a much needed social model of providing emotional health and wellbeing support at the earliest possible time within a child / young person's life journey.

For further information relating to this work please call: Lucy Hinchliffe, Contract and Commissioning Support Manager, NHS Barnsley CCG on 01226 433738 or email barnccg.comms@nhs.net with the subject header, CYPMHS

We would like to take this opportunity to thank all of the individuals and organisations who have taken the time to share their views and also get involved in the promotion of this work.