Agenda item

The Health and Social Care Sub-Committee is asked to consider this presentation and accompany report which provides an overview of Mental Health provision in Croydon borough including:-

•        what is available,

•        the current level of performance,

•        the impact of the pandemic

•        the future vision.

The Sub-Committee considered a report, set out on pages 25 to 58 of the agenda, which provided an overview of mental health services in the borough. The report was introduced by representatives from the various service providers in the borough, including the South West London Clinical Commissioning Group (CCG), South London & Maudsley NHS Foundation Trust (SLaM), Child and Adolescent mental Health Service (CAMS) and the Council’s Adult Social Care team.  A copy of presentation delivered can be found on the following link: -

Overview of Mental Health Provision in the Borough

Following the presentation, the Sub-Committee had the opportunity to ask questions about the information provided. It was noted that the waiting times for Child and Adolescent Mental Health Services (CAMHS) seemed to be high in Croydon and it was questioned whether there was a similar issue in other SLaM localities. In response, it was highlighted that Croydon was the only borough with an Autism Spectrum Disorder (ASD) pathway provided by SLaM and it was this pathway that had a significant waiting time. The numbers waiting for the ASD service had grown throughout the pandemic and work was underway to address the backlog with 100 appointments expected to be completed by April 2022 and a tender for further 450 appointments in 2022-23.

It was confirmed that the current waiting time for the ASD pathway was on average 52 weeks, which was not acceptable and the reason why tackling the backlog to manage demand against capacity was a priority. The Sub-Committee accepted that the backlog was being addressed but agreed that further scrutiny was needed at a later date to be reassured that the plans being developed were being effective. It was agreed that the Children & Young People Sub-Committee would be asked to keep the performance of CAMHS under review as part of its work programme in the forthcoming year.

It was noted from the information provided that staffing seemed to be an issue for mental health services and the partners were asked for their assessment of their key strengths and weaknesses. Partnership working was highlighted as a strength with recognition that no one service could address all the mental health need in the borough. There was a committed workforce in Croydon with skilled staff, who tended to be loyal to the borough with staff development being a strength, however recruiting new staff was challenging.

It was recognised that the crisis pathway was an area for development, which was currently being addressed. It could also be challenging to move complex cases on from the Accident and Emergency department to other services.  While early intervention in schools and child wellbeing practitioners was a strength that needed to be developed further.

An update was requested on the work to improve access to talking therapies through GPs surgeries. It was confirmed that patient access to talking therapies had been targeted for improvement as evidence indicated that once people arrived in the service their recovery rate was quicker. SLaM was working closely with colleagues across primary care as this was the most common source of referral and the introduction of primary care mental health practitioners would help to improve access to these services. There was also work underway to engage with the Asian community more effectively, including having more ethnic counselling options available.

As it was confirmed that the Public Health team had commissioned a new provider of drug and alcohol services, which would be interconnected with mental health services, it was questioned whether there would be sufficient outreach work to provide support to the street homeless in the borough, including those from Eastern Europe who may not have access to services. It was advised that there would be an expectation on a recourse to public funds approach, which was a challenge in Croydon given it was a location for the Home Office. The resource available for outreach work had doubled since 2019 and was already on the way to meeting national guidance. The service had been commissioned as it was recognised that there needed to be a service at the front door of the Council to support people with substance abuse issues.

At the conclusion of the meeting, the Chair thanked the representatives from the various services who had given up their time to attend the meeting and engage with the Sub-Committee on the issue of mental health support in Croydon.

Conclusions

Following its discussion of this item, the Health and Social Care Sub-Committee reached the following conclusions: -

1.     The information provided on the work of the partners involved in delivering mental health services in the borough was encouraging, although to make a more definitive judgement on the level of support available would require the provision of comparative data with other areas.

2.     The Children & Young People Sub-Committee would be asked to follow-up on the work to reduce the waiting times for autism spectrum disorder assessments with the Child and Adolescent Mental Health Service.

3.     A follow-up on the support for rough sleepers, including drug and alcohol services would be scheduled for the Sub-Committee work programme in 2022-23