Spotlight Session 2

A Whole System Response to Improving Children’s Emotional Wellbeing by Building Capacity in Families, Communities and Systems 

Speakers:

Kate Rocks – Head of Public Protection and Children’s Services/Chief Officer, East Renfrewshire Health and Social Partnership

Mary Glasgow – CEO, Children 1st 

East Renfrewshire Health and Social Care Partnership identified a significant challenge in supporting the high number of children and young people presenting emotional distress and poor mental health across their children’s planning partnership. 

Families were focused on diagnosis and clinical intervention from Child and Adolescent Mental Health Services (CAMHS) which led to professionals across the whole system becoming reactive and overwhelmed. 

The session will share the experience and process of reframing the problem from clinical/medical to social/ecological and embedding the principles of Getting it Right for Every Child (GIRFEC).

By building an authentic partnership with the third sector, primary care and children’s services, a new model of early help at the point of first presentation to GP’s has been developed. 

The session will share the challenges, and successes that evidence improved outcomes for children and families over the past two years. 

After this session, delegates will have a better understanding of:

  • Co-production.
  • Ecological/whole family models of response.
  • The impact of adversity and childhood trauma on family relationships.
  • Effective components of relationship-based approaches from design, delivery and commissioning. 
  • The role of leadership and partnership working across the system.
  • Child-centred, family minded practice. 

Working Together to Improve Access to Child and Adolescent Mental Health Services (CAMHS) While need and Demand Increase

Speakers:

Scott Wilson – Senior Information Analyst, NHS Greater Glasgow and Clyde

In recent years, public awareness and scrutiny of Child and Adolescent Mental Health Services (CAMHS) has grown considerably. Furthermore, in 2018, the Scottish Government commissioned audits across the Children and Young People’s Mental Health (C&YPMH) system and subsequently established the C&YPMH Taskforce. 

This drive to improve CAMHS sits alongside evidence of increasing prevalence of poor mental health, with a recent study finding that 12.8 per cent of children and young people have a mental health disorder (NHS Digital, 2018). As mental health awareness and need both rise, services must adapt and deliver accessible and efficient services to improve mental health outcomes for children and young people.

This session will highlight local improvements designed to support more children and young people to receive a quicker and high quality experience in NHS Greater Glasgow and Clyde. 

To achieve this, NHS Greater Glasgow and Clyde CAMHS has developed its service model as part of an intensive quality improvement programme involving a range of CAMHS clinicians and multi-agency partners. This programme is informed by local and national policies, and is designed to improve accessibility of services for children, whilst ensuring an evidence-based and high quality service.

Achievements to date include:

  • Reducing rejected referrals from 30 per cent to under 10 per cent.
  • Helping patients attend appointments using SMS Text reminders.
  • Reducing the Did Not Attend (DNA) rate from 18 per cent to 10 per cent.
  • Planning services in an efficient manner with the aim of reducing the longest wait from 18 weeks to 12 weeks from referral to treatment.
  • Incorporating a focus on health inequalities and using epidemiological methods to ensure the needs of those who reside in more deprived areas are considered.

While the number of children and young people accessing CAMHS has increased substantially, the quality improvement programme is continuing to ensure these children are seen and treated quickly.

During this sessions delegates will learn about, the change process from planning to implementation and how management and clinicians working together can improve accessibility. Delegates will also hear highlights from smaller projects that have supported the programme including on-going work with young people from Glasgow City to make CAMHS a more engaging and friendly service.

Psychology Adding Value: Epilepsy Screening (PAVES)

Speakers:

Dr Catriona George – Clinical Psychologist, NHS Lothian

Dr Kirsten Verity – Paediatric Neuropsychologist, NHS Lothian

Children and young people with epilepsy are at an increased risk of developing social, emotional, behavioural and learning difficulties. If not identified or addressed at an early stage, these problems can lead to increased morbidity, and impact adversely on quality of life, treatment outcomes and educational attainment. In order to address this issue, NHS Lothian set up a pilot project, Psychology Adding Value: Epilepsy Screening (PAVES) at the Royal Hospital for Sick Children in Edinburgh. The project is funded by the Edinburgh Children’s Hospital Charity, and on behalf of the Scottish Paediatric Epilepsy Network .

This session describes the development and implementation of the PAVES approach, which includes an innovative mental health screening methodology administered within routine neurology appointments. This is linked to an early intervention pathway, which maximises use of existing third sector and NHS resources, while also delivering new evidence-based interventions. 

Through partnership working between local and national NHS bodies and third sector partners, the PAVES project has been developed from the identification of an issue into an improvement project. Initially at local level, this is now being developed for national application. 

So far, 155 Children and young people with epilepsy have completed the screening process at least once, with around 75 receiving some form of mental health intervention from the PAVES stepped care intervention pathway. Feedback from families and clinicians has been positive so far and evaluation is ongoing. 

Following a successful bid for Scottish Government Realistic Medicine funding, the next steps are to develop the PAVES approach to, allow mental health screening to be carried out electronically in routine epilepsy clinics, thereby increasing accessibility and to develop capacity across Scotland to identify ‘at risk’ Children and young people with epilepsy. Along with this the approach will also develop and deliver effective and locally sustainable intervention pathways and support materials to meet their needs.

Providing a similar stepped care approach across the country would improve equity of care, reduce waste, and provide an efficient way to identify and manage risk, in line with the aims of ‘Realistic Medicine’.