Agenda item

To receive an update on the Covid-19 response.

(Presentation to follow)

The Head of Commissioning and Procurement introduced the item and advised that the presentation would be taken in three sections by the guests invited to the meeting to represent organisations that provided well-being services to vulnerable young people in the borough.

The Director of Off the Record presented her organisations response and the following was highlighted:

• Initially all face to face contact was suspended during lockdown and following reconfiguration, services were had resumed using remote means of  access
• There had been an initial decrease in self referrals which had now increased with referrals for online counselling services doubling.
• Young carer’s services had been prioritised during the pandemic due to distinct vulnerabilities of this group.
• Regular telephone contact was maintained with young refugees.
• The service was redesigned as staying in touch was important for young people. Looking ahead the service would retain some of the online service as it had been vital in maintaining contact with young people

The Director of Croydon Drop-in presented and the following was noted:

• All intervention services had moved online with staff and young people adapting well which meant resources were being utilised effectively.
• Clinical supervision of staff remained the same and a staff self-care group had been set up on WhatsApp for regular contact.
• Due to the use of online resources the service had been able to maintain more contact with parents and guardians
• Ongoing counselling support has been maintained

The Service Director of CAMHS, SLAM NHS presented and the following was highlighted:

• The service continued to maintain some face to face interactions, including crisis care and in-patient services. In response to the pandemic and lockdown, the crisis telephone line was expanded.
• There had been a decrease in the number of referrals received in the initial stages of the lockdown, this had been steadily increasing following the lifting of restrictions.
• The service experienced an increase in in-patient admissions and crisis calls
• Reset strategy in place and set within national context with remote working continuing to be the standard way of working where possible.

Following the presentations, the sub-committee was able to ask officers questions.

A Member asked how the Croydon Drop-in was prepared for future ways of working. The officer responded that they would continue to utilise and invest in technology. Staff had undertaken additional training which had increased skills among the workforce. They would offer face to face contact where possible, but the reality was that an increased level of remote contact would continue to take place.

It was further asked if any children had lost out on support as a result of restrictions and what checks were being undertaken to identify children that had been disadvantaged. Officers acknowledged that in the beginning of lockdown there has been a decrease in referral, with colleagues asked to be cautious of referring. In particular there had been a decrease in referrals for autism assessments through CAMHS due to the face to face interaction required for assessments which would not be undertaken. Referrals are now open to be received as normal and priority would be given to face to face assessments where necessary. Referrers had been tasked with taking the lead to identify children and young people that had been adversely disadvantaged. Good communication had been maintained with schools who were being proactive in identifying any gaps in provision.

Additional questions were raised on issues that may have transpired within GP services and officers responded that they had met regularly with clinical leads and provided regular communication. In terms of referrals and access to support, the SPOC played a vital role in multiagency co-ordination and response.

Officers were challenged on how they ensured equalities of access to services and how confident they were that no particular group had been disadvantaged. They acknowledged that improvements could have been made in equality of access, in particular there was an under representation of BME groups accessing services during the height of lockdown. Additionally Looked After Children (LAC) services also needed increased focus and priority. One of the areas that was being utilised going forward was the emphasis on digital connectivity and understanding the impact that it could have on improving access for all.

A Member asked whether the review of Autistic Spectrum Disorder (ASD) assessment would include engagement with stakeholders, including the Autism Partnership Board. Officers said that as part of the review of ASD and pathways to assessment and support, consideration was being given to the ongoing work that cuts across all partnerships. They would also like to engage with appropriate community forums and would like to discuss this in detail after the meeting to ensure they were liaising with the right people.

A further question was raised on how parents could fast track consultation with specialists in respect of medication issues to ensure that substantial delays in medication review could be highlighted. Officers said that all children receiving medication have had regular check- ins during the pandemic with prescribing doctors and nurses being proactive in ensuring medication was sent by post under the national special agreement on distribution of medication. There may have been delays for children that had not had appointments and assessments to determine if medication was an option as part of their treatment. Regular telephone reviews had been taking place but there had been difficulties experienced due to the inability to meet face to face. There was a duty line in place and parents were being encourages to use the line to discuss any concerns or issues.

A member commented that it was important that services used the opportunity presented to explore new ways to deliver and improve long term practice and asked how the roles of schools in accessing support for children and young people has changed and what lessons had been learnt.

Officers said that contact with schools had improved, with increased links between therapists and schools. The education support teams and practitioners had been integral to the provision of virtual programmes and as a result there was the ability to offer workshops over the summer holidays for year six children due to concerns about their transition.

The head teacher of All Saints School said that they had been working with officers and had been provided with increased support and communication during the period. It was important that foundation work at a primary school level in accessing services in particular through virtual means continued.

The Chair thanked officers and guests for their attendance and engagement with the sub-committee and commented on the emerging positive consequences of the pandemic. The importance of building on Scrutiny interaction with CAMHS and voluntary services was re-confirmed, with reference made to a future joint meeting to be held between this sub-committee and the Scrutiny Health and Social Care committee to delve further into mental health service provision for children and young people.

In reaching its recommendations, the sub-committee came to the following CONCLUSIONS:

1. The continued dedication and commitment to supporting, improving and promoting the wellbeing of children and young people during these unprecedented times was commendable.
2. It was clear that there remained distinct issues with Autism diagnoses and that a focus towards addressing these issues must remain a priority
3. The commitment by the Head of Croydon’s Children’s Commissioning and Procurement service to involving stakeholders in the review of Autism diagnosis and support pathways was welcomed
4. The Voluntary Community Services were to be commended for their ability to be innovative and adapt their digital services through the provision of online services to enable young people to access services. The discussion on the potential extension of this innovative and positive way of service delivery was welcomed.
5. The recognition of the need for building foundational services for early years and primary school age children to provide support for mental health and emotional wellbeing was commended.
6. The importance of partnership working to deliver transformation and effect change was essential and must be supported.
7. The provision and availability of easy contact to the emergency duty team for parents and families was encouraging.
8. The opportunity for Members to conduct visits and support services in any capacity was welcomed.

The sub-committee RESOLVED to recommend:

1. That more work be done on equality and diversity of access to services and the commitment made by the Head of Commissioning and Procurement be endorsed.
2. That the Sub-Committee be kept updated on the progress of reviews, including the conclusions and outcomes as well as lessons learnt.
3. That the Voluntary Community Services (VCS) continue to explore ways of using social media and technology to improve their service and be a champion in this area in order that other organisations can learn from its practices.