Issue - meetings

Purpose of the item:

1.    The Adult and Health Select Committee have asked for evidence and information on the system wide response to support the needs of Children and Young People (CYP) who may have Autism (ASD) or Attention Deficit Hyperactivity Disorder (ADHD), including details of the Neurodevelopmental (ND) diagnostic pathway provided by Mindworks.

2.    Mindworks is an alliance of emotional wellbeing and mental health providers that includes Surrey and Borders NHS Partnership (SABP) as the NHS Trust, Tavistock and Portman leading on system change (i-Thrive in Surrey model described in Appendix 1) and 13 Voluntary and Community Sector (VCS) partners coming together under Surrey Wellbeing Partnership (SWP), of which three VCS partners also provide specific support in the ND pathway. SABP and third sector partners provide support and assessment for ASD and ADHD as part of the ND Pathway for children over six years of age.

3.    This report provides an overview of the status of provision and performance. It acknowledges that providers of support are challenged in their ability to provide a comprehensive response as are schools and families, and that change is required within the context of; increased needs and demand, pressure on staff (including those in schools) and families and diminished financial resources across health, local government, and schools. 

4.    The proposed cultural shift, described in the report, to a social model of support, requires action across the system and continued recognition that there remains considerable work still to be done in meeting the needs of CYP with Autism Spectrum Disorder (ASD) or ADHD. The work detailed within the ND Transformation Plan builds on that of the All-Age Autism Strategy, helping to provide a focus on specific areas for improvement through a needs-led ND pathway.

Witnesses:

Sinead Mooney, Cabinet Member for Adult Social Care

Clare Curran, Cabinet Member for Children and Families, Lifelong Learning

Rachael Wardell, Executive Director – (CFLL)

Suzanne Smith, Director of Commissioning for Transformation (CFLL)

Trudy Pyatt, Assistant Director- Inclusion and Additional Needs (SCC)

Kerry Clarke, Head of Emotional, Mental Health & Wellbeing Commissioning- Surrey Heartlands Health and Care Partnership (ICS)

Harriet Derrett-Smith, Associate Director, Integrated Children’s Commissioning- Surrey Heartlands Health and Care Partnership (ICS)

Graham Wareham, Chief Executive (SaBP)

Professor Helen Rostill, Deputy Chief Executive and Director of Therapies Surrey and Borders Partnership Trust (SaBP)

Justine Leonard, Director of Children and Young People’s (CYP) Services (SaBP)

Ann Kenney, Independent Chair at Surrey Wellbeing Partnership

Emma Ellis, Service Manager, National Autistic Society (NAS)

Kerry Oakly, Head Teacher at Carrington School

Alison Simister, SENCo

Children, Families, Lifelong Learning and Culture Select Committee (CFLLC) Members:

*Fiona Davidson

*Jeremy Webster

*Liz Townsend

*Fiona White

*Jonathan Essex

rChris Townsend

Key points raised during the discussion:

1. The Chairman of the Adults and Health Select Committee (AHSC) introduced the Mindworks item and highlighted it was a joint scrutiny item in conjunction with Members of the Children, Families, Lifelong Learning and Culture Select Committee (CFLLC). The Associate Director for Integrated Children’s Commissioning introduced the Mindworks report.

2. The Chairman of AHSC invited the Head Teacher of Carrington School to speak. The Head Teacher outlined that the school had a share of young people facing neurodevelopmental conditions, presenting with the need for Mindworks referrals. These children had difficulties accessing aspects of the curriculum and the social aspects of the school day. There was an increasing sensory need, such as requiring ear defenders and an amended timetable. Quieter spaces for young people also had to be found and as a new build school, this was not considered as part of the Department for Education (DfE) programme. The biggest challenge was getting Mindworks’ referrals through quickly to people that could provide the support, as schools did not necessarily have the skills to manage young people with neurodevelopmental need. Process changes to Mindworks was a challenge, with long lead times such as for consultations. The pausal of Mindworks referrals resulted in school backlogs and an increasing number of non-attenders, whose complex needs were not being managed. It was acknowledged this was now changing, with some referrals now coming through. The working hours of Mindworks’ telephone service was between 9am and 12pm which was during teaching hours, making it difficult to contact Mindworks. Parent’s felt frustrated with the system, which led to schools being looked upon to provide young people with the help needed, which impacted on the relationship between schools and parents. Staff felt challenged despite work undertaken with NurtureUK and using trauma-based approaches with young people. The Mindworks process was time consuming, which took time away from the young people.

3. The Head Teacher of Carrington School wanted to see a greater ability to cope with the young people going through the Mindworks service. Mindworks’ work hours outside of the school day was a suggested  ...  view the full minutes text for item 14