Agenda item

A presentation on Croydon’s Covid response and offer to support emotional wellbeing and mental health of children and young people.

The Head of Commissioning and Procurement introduced the item, with invited guests outlining details in a Presentation.

Following the presentations, Members’ had the opportunity to raise questions.

In response to a question on when services would resume face to face contact with children and young people, Members were informed that services were slowly increasing the amount of face to face contact. All contact was completed under strict Covid guidelines using correct PPE. It had emerged that some young people preferred online contact and this was still being offered. The Single Point of Contact service continued to receive referrals throughout the pandemic although there was a significant reduction in the early stages, referrals were now increasing to pre pandemic levels.

It was further asked what the figures of children contacted weekly by services were and Members were informed that services were back up to 60% face to face contact. Many young people preferred the alternative means of contact as some did not want to travel to offices in central Croydon at this time. Both Croydon Drop In and Off the Record have always worked on a self-referral basis and this had not changed.

In relation to contact with younger children, Members were advised that at least 50% of children worked with were between the ages of 10-13. The advantage of other means of contact such as telephone was that therapist were able to engage with parents of carers which may not have been the case previously.

A Member questioned what consideration if any was being given to extend the trailblazer funding that had 30 schools involved in the project to the rest of the schools in the Borough. Members were advised that the numbers of schools involved in Trailblazers came from commissioners, most of the work to date was in primary schools and was done in conjunction with parents. It had been difficult to get secondary schools involved although they were being encouraged to participate. There was another Trailblazer project running across South West London for colleges and post 16. It was important to note that there wasn’t a school in the Borough demanding to be involved that was not yet involved.

In response to a question on what mechanisms were in place to capture hidden harm and what support there was available for children and families, officers said that there were several routes for young people to contact and seek support.  Partners were working to streamline pathways in order to ensure they were clear and accessible. Investigations were taking place at national level to capture what was happening through surveys which gave insight to what was occurring. One of the lessons learnt was for agencies not to make assumptions  and that whilst there had been an increase in hidden harm, this was not actually in the cohort of children that were previously know or were accessing services. Those deeply affected by events of the pandemic were children that had not previously accessed services.

It was asked if there were children who had not returned to school and what actions had been taken. An invited Guest commented that at his school, attendance was higher that it had been pre pandemic. The school had been able to foster good connection with families who had not engaged on the past. Throughout the pandemic, engagement by students online was closely monitored with home visits conducted where appropriate. Staff were vigilant in spotting changes in behaviours.

Further information would be sought on missing numbers of children from schools as well as data on SEN children who may have been disproportionally impacted by events of Covid-19 and the details on specific outcomes for that group.

A Member asked what were the wait times for detailed intervention and assessment for young people from mental health services. Officers said that following initial assessment there was a wait time of between seven to ten weeks for ongoing regular counselling. During the wait period contact was maintained and there was an offer of short term intervention where necessary.

In Child Adolescence Mental Health Services, different pathways had differing wait times. Eating disorders had wait times of between one to four weeks, Crisis and follow up was up to one week. The average wait time for other services was 13 weeks. In the Autism Pathway, there were approximate wait times of over 52 weeks for assessment. One of the drivers for the long wait times was the pathway which was different to others in the rest of the country and as a result the services was being redesigned.

It was challenged that the level of wait times was unacceptable in a number of areas of service and in light of the Councils restructure to reduce spend, it was asked how the budget would impact on post pandemic recovery. Officers said that the majority of funding for CAMHS and mental health was from the Clinical Commissioning Group. There were some joint contracts which resulted in some funding from the Council and there were no mass cuts planned as parts of the Councils reconfiguration. There were several streams that contribution to the situation of the service such as badly planned pathways, workforce issues, which was a national and well as local issue and the level of complex needs.

It was commented that if substantial reconfiguration of the service was being undertaken, this would require further Scrutiny by the Health and Social Care Sub-Committee and a conversation would need to take place with officers to facilitate a meeting.

The Chair thanked officers and invited guests for their contribution to the meeting.

In reaching its recommendations, the Sub-Committee came to the following conclusions

1. The support being provided to families by schools and the voluntary service was commendable
2. It was important that services explore ways to capture and monitor issues that manifest over time, especially those where issues may be manifesting differently due to the unique challenges of the pandemic.
3. The monitoring on different challenges in contact with families in order to track emerging issues was crucial.
4. It was evident that there was now increased need for services and understanding and monitoring of need was essential.
5. There were serious concerns regarding the waiting times for some services in CAHMS and it was welcomed that a substantial reform of its services was being undertaken.
6. It was important to understand the effects and responses from services of lockdown on children and young people with severe learning difficulties and profound multiple learning difficulties.

The Sub-Committee recommended that

1. That the CAHMS service provide a report to the Health and Social Care sub-committee on the reconfiguration of its services and how this will impact or improve the unacceptable levels of waiting times for assessment in some areas of its service.
2. That the CAHMS service report back to the Children and Young People sub-committee on targets for waiting times and monitoring framework.
3. That services explore ways and options of being more systematic about hidden harm.

Request for info:

• Data on children who accessed the service on a regular basis pre pandemic who had not been back in contact.
• A short briefing on the specific response by services on the effects of lockdown on children with severe learning difficulties and profound and multiple learning difficulties and how outcomes were being measured.

The Chair thanked officers and invited guests for their attendance and engagement with the sub-committee.