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:
- 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.
- 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.
- 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 change along
with a change in the speed of acknowledgement from Mindworks and
triaging, to enable schools to provide reassurance to parents. More
collaboration between Mindworks and schools was also a suggested
change, and a streamlined approach to receive updates and make
referrals, to reduce anxiety on families and school
staff.
- The Chairman of CFLLC
asked how many children the Head Teacher felt required
neurodevelopmental treatment at Carrington school. The Head Teacher
explained that the school had around 1000 pupils, with around 5 and
10 pupils in a year group of 180 to 210 students having signs of
requiring neurodevelopmental (ND) treatment, which was increasing
year on year. In the exam period, the school had over 30 children
not able to sit in the main area to take exams due to Autism
Spectrum Disorder (ASD) traits and mental health issues. This put
extra pressure on school staff.
- The Chairman of CFLLC
asked if there was one thing the Head Teacher could immediately
change what it would be. The Head Teacher stated it would be to
engage in early communication with Mindworks to improve the
likelihood in getting young people through Mindworks’ system
with a known timeline.
- In reference to what
Councillors were told by parents and schools, the Chairman of CFLLC
asked why Mindworks had almost given up providing front line
Neurodiverse (ND) support at the screening and assessment stage,
handing the responsibility over to schools without proper
transition or preparation. The Director of CYP services (SaBP)
explained that the ND Pathway was a partnership that worked with
Surrey Wellbeing, Barnardo’s, the National Autistic Society
(NAS), and Learning Space colleagues, and there was a pathway and
range of offers. SaBP predominately provided the assessment and
diagnosis element of the ND Pathway, including deploying available
expertise to ensure it came alongside the early help, support and
strategies that families, schools and others were trying to
implement to support a child in a school situation. Mindworks, had
received around 4000 referrals in less than 6 months. There was not
the capacity to be present in schools alongside parents, providing
the immediate help and support. Mindworks’ strategy to
respond to the demand was to bring all the ND expertise together
from across the partnership in a front-facing position alongside
schools and families. In parallel, Mindworks was trying to empower
schools to have good access to information, advice, support, and
strategies which is what the guidance from The National Institute
for Health and Care Excellence (NICE) advised for that worked for
children and young people with ND needs. This was done through
several methods including enhancing the website, consultations, and
training. Mindworks’ partners, Barnardo’s, NAS, and
Learning Space provided good pre-diagnostic support.
Mindworks’ consultations with schools could help identify
more vulnerable children. Mindworks was trying to expand their
universal offer, work together with children’s support
networks to increase the ability and confidence in supporting young
people and to ensure that expertise was deployed to identify those
more vulnerable.
- The Chairman of CFLLC
raised that the London Boroughs such as Richmond and Kingston, had
shorter referral lead times, better processes, and got through
treatment pathway’s waiting lists faster. The Chairman of
CFLLC asked if the Mindworks team had benchmarked their
performance, in terms of the referrals and diagnosis treatment
pathway, with other organisations that appeared to be performing
better. The Chief Executive of SaBP explained there had been a
benchmarking process. Mindworks had employed a Commissioning
Support Unit (CSU) to benchmark the Mindworks services. Changes
that could be made were being reviewed to implement. Benchmarking
had not been done against the London Boroughs, but, in terms of the
effectiveness as a clinical model, the benchmarking suggested
Mindworks was in range expected nationally. When Mindworks was set
up a 1% prevalence rate was being worked towards. This prevalence
rate had since increased which meant that demand had also
increased, exceeding capacity meaning Mindworks had to do things
differently. There was a danger that more effort would be put into
diagnosis and not enough being put into support and treatment. The
question Mindworks had was whether it had the right model in terms
of emphasis on diagnosis versus emphasis on support. The underlying
prevalence in London was higher across a range of health
conditions. Shire counties all dealt with a similar set of
problems.
- The Chairman of the
Adults and Health Select Committee (AHSC) introduced the Special
Educational Needs Coordinator (SENCo) to speak on peoples’
experience of Mindworks. The SENCo explained schools felt on the
front-line and that information from Mindworks was limited. Once
information was produced there was a delay with schools seeing the
strategies, ideas, and support coming through. The SENCo presented
a case study on the struggles experienced by a family using the
Mindworks process, and the delays experienced. The parents were
being supported by the primary school as much as it could offer but
were now considering a private assessment for their child. The
SENCo outlined a case study where a young person had been waiting
21 months for an assessment and was told the wait was 36
months.
- In response to the
SENCo’s statement, a CFLLC Member asked for further
clarification on the responsibility of SENCos to find the next
level of support when the support provided by one agency appeared
to stop. The SENCo explained that there was a particular gap
between when children could be referred into the paediatric service
and maybe discharged by the paediatric service. The official
referral age into the paediatric team was 5.5 years old. If
children reached the point of being seen by the paediatric team,
children were more than 5.5 years old when an ND assessment may be
required. There did not always appear to be a consistent response,
with children sometimes directed to Mindworks, and in other cases
the ND assessment was done through paediatrics.
- The Service Manager
for the National Autistic Society (NAS) explained that
NAS sat within a social model, providing support to
families, young people, and schools funded by Mindworks. It was
difficult to get the breadth of the NAS service out to people. NAS
used methods such as school bulletins, talking at SENCo network
meetings and foster carers network meetings to promote the service.
A diagnosis of autism was not required for families to self-refer
into NAS. In 2024, NAS was on target to produce about 450 workshop
events and in NAS’s main programme areas such as social
communication, social interaction, sensory processing and how to
manage distressed behaviour were being reviewed. NAS provided
parents with skills, techniques and tools that could be implemented
at home, and the knowledge could be taken to schools to explain why
a child required adaptations. NAS were predominately in the family
space but provided school training, such as a 2.5-hour training
sessions provided as a whole school approach which covered key
areas such as social interaction, social communication, and sensory
behaviour. 100% of staff and teachers who attended the training
would recommend the service to other schools. NAS did one-to-one
support for parents in complex situations but due to the demand,
NAS asked that parents did the group work first, to gain a
foundation of knowledge. NAS had a support line which was open
outside school hours from 5pm to 11pm, that teachers could use for
specialist advice. This service had Attention Deficit Hyperactivity
Disorder (ADHD) specialists from Barnardo’s and Autism
specialists from NAS.
- A CFLLC Member raised
that the pausing of the school’s neurodevelopmental referral
pathway was six months in without a timescale for the next stage.
The solution of stopping the referrals by pausing the pathway did
not make the issues go away, and it was only when a child or young
person was in crisis that they may be accepted for assessment. The
CFLLC Member asked for a response on this. The Director of CYP
Services (SaBP) explained that there were medical treatments for a
small percentage of children who may had a diagnosis of ADHD.
Nationally, there was a problem with the supply of ADHD medication,
and an update on this could be expected in July 2024. This was not
the same pathway for children with mental health difficulties.
There was confidence that children with mental health difficulties,
waiting for a diagnosis or not, could access pathways and help
without delay. Improvements had been seen with access to assessment
and treatment for children who had routine needs. Regarding the
consultation approach, Mindworks’ focus was on growing the
offer of early help and support, as this made a
difference.
Dennis Booth left virtually at
11.15am.
- The Chief Executive
of SaBP added that a post-diagnostic treatment for autism was
offered by NAS. Why schools felt that post-diagnostic treatment
that was available from Mindworks was not being received, needed to
be thought about. The three treatment pathways included medication
for ADHD, a social model treatment for ADHD and a social model
treatment for autism. Mindworks needed to address the delays with
prescribing ADHD medication, but recognised there was a national
shortage of ADHD medication and issues around how Mindworks
diagnosed and prescribed for ADHD. Mindworks needed to understand
why schools felt there was no front-line support.
- The Interim Assistant
Director for Inclusion and Additional Needs (SCC) added that the Council intended to work with all its
stakeholders and schools to ensure they were not feeling
overwhelmed. The Council had specialist teachers in practice that
worked closely with schools.
- A Member asked how
many children, who would have been referred to the ND pathway since
it closed on 1 September, were still waiting for a referral, and
how the outstanding referrals would be managed. The Member also
asked how many children were currently on a diagnosis or treatment
pathway and how this information was retained. The Director of CYP
Services (SaBP) explained that there was not a wait for
consultations. There were around 7,300 cases on the ND pathway, and
around 3,600 children on the diagnostic pathway. Mindworks was
working through a significant number of children and young people
currently on the pathway, going through the diagnostic process.
Mindworks had increased the capacity to diagnose, such as
commissioning support. There were approximately 900 children
waiting for ADHD medication.
- The Member asked how
Mindworks ensured that children still awaiting referral were not
lost. The Director of CYP Services (SaBP) explained that electronic
patient record was opened when referrals were received and a
business intelligent system enabled Mindworks to know who was
waiting on the ND pathway, and where on the pathway they were. The
Member asked if there was regular communication with people waiting
on the pathway. The Director of CYP Services (SaBP) explained that
at the point of referral it was ensured families had good
information about how to access help and support. Mindworks did not
have the digital infrastructure to inform people how long the wait
on the pathway would be but could say how long children had been
waiting on the pathway. Children were also currently being seen on
a chronological basis on the diagnostic pathway. The Member raised
that Croydon was able to communicate where people were on the
pathway and suggested this should be considered.
- A CFLLC Member raised that, by not
diagnosing everyone, Mindworks were choosing to ration and delay
who got support and when. The Member asked how Mindworks monitored
the outcome of Mindworks change of approach, and the demand for
screening and assessment. The Head of Emotional,
Mental Health & Wellbeing Commissioning explained that
Mindworks was informed by schools, Families, Children and
young people about the want for swift access to direct support from
trusted people, which came from the social model being implemented.
Mindworks had invested in ND advisors and was expanding teams
working directly alongside schools. Schools wanted access to parent
support, which Mindworks’ third sector partner NAS provided
and Mindworks had a recruitment process to expand this support.
Named leads Mindworks at a district and borough level were being
reviewed to allow people to form relationships with partners, to
enable direct support. The consultation process provided answers
straight away and enabled all paperwork to be completed and a
dialogue to be in place. SaBP and The Tavistock and Portman NHS
Foundation Trust were evaluating the consultation process. From an
ICB perspective, NHS Surrey Heartlands had to listen to information
provided by SaBP around children and young people waiting too long
on the pathway. Mindworks was trying to learn the best way to meet
the needs of children and young people by hearing feedback and
implementing change, which would take time as some recruitment was
needed. Regarding pressure on access to services, Mindworks did not
decide the criteria to access its services alone. Mindworks had to
look across the system and view it from a quality and safeguarding
perspective. Mindworks was not prepared to extend waiting lines to
significant levels if it remained within the medical model of
approach. The criteria to access Mindworks’ services was a
collective decision and Mindworks was now in the process of
re-looking at this.
- A CFLLC Member
referred to the decision to notify schools of the paused Mindworks
referrals in September 2023 and asked about the funding and
resource required to get Mindworks to the level it needed to be.
The Associate Director for Integrated Children’s
Commissioning explained that initial communications to the changes
to the ND pathway, was agreed with Council colleagues, the ICB and
SaBP collectively. The resourcing issue was about workforce and
medication availability, some of which was improving, as well as
financial issues. Mindworks had brought in additional funding. For
example, there was £0.5 million for several programmes from
the ICB. Funding could be drawn down through the mental health
investment fund which was a joint funding option across the ICB and
the Council. Trying to get the right balance within the current
resources available continued to be a challenge.
- The Deputy Chief
Executive and Director of Therapies (SaBP) explained there was a plan to step back and look at the
Mindworks model, looking strategically at what was being done. This
was being undertaken in the beginning of May 2024. There would be a
wider workshop with partners to review key areas of transformation
in June 2024. SaBP would articulate what the Transformation
Programme looked like, what the milestones were, when to expect the
delivery of the milestones and the impact of the changes. NHS
England were leading a piece of work on how to tackle some of the
issues faced. It was important to learn from areas of good
practice.
- The Chief Executive
of SaBP explained Mindworks had seen a growth in the presentation
of need. As prevalence grew there was recognition that the medical
model was not the right solution, and a social model was needed.
The Mindworks contract and THRIVE approach was the beginning of
introducing a social model as a way of dealing with the change in
prevalence. There was understanding that support for schools was
not working, and the Mindworks team needed to work out why and
change the services. This was part of the transformation
work.
- In reference to the
CFLLC Member’s point raised around Mindworks rationing
diagnosis, which was effectively rationing the delivery of
treatment, the Chief Executive of SaBP explained that waiting for a
diagnosis within a social model did not delay practical support.
There was a component of diagnosis around ADHD, where medication
was delayed, due to a national shortage. Mindworks had now
emphasised the importance of the social model but where there was
continuing need, the medical model could be used. A diagnosis was
not needed to provide social model solutions. Traits of
neurodiversity could be used to formulate a care plan that
addressed needs. Work was starting around mapping school need and
working with schools to address the dissonance between what support
Mindworks offered schools and what schools were
experiencing.
- The Independent Chair
of Surrey Wellbeing Partnerships explained that Surrey Wellbeing
Partnership represented around thirteen voluntary organisations
that were part of the Mindworks alliance within the early
intervention and prevention space. There was recognition that there
should had been more communication and planning around the changes
to the diagnostic pathway. Mindworks was on a journey of
transformation, and it was a challenge to ensure current needs were
met whilst transforming. Mindworks had a fixed financial envelope,
without a mechanism in the Mindworks contract to increase it, with
recognition that demand had outstripped capacity since the
Mindworks contract began. The voluntary sector recognised the
increased prevalence in ND traits. Across the fourteen voluntary
organisations within Mindworks, it was assured that all
practitioners had been and continued to be trained in how to
support children with ND traits, pre-diagnosis.
- The Independent Chair
of Surrey Wellbeing Partnerships explained that when children and
young people arrived in the Mindworks service, their experience was
good. The experience of people while waiting was also important and
were several deep dives reviewing people’s experiences and
what could be done to improve people’s experience and ensure
people felt supported when waiting for the service. This piece of
work was conducted through audits within Surrey Wellbeing
Partnership and across Mindworks.
- A CFLLC Member asked
for further clarification on how children and young people could be
treated without a diagnosis. The Director of CYP services (SaBP)
explained that children and young people still had the opportunity
to access the assessment and diagnostic pathway, but the difference
was Mindworks was now offering a consultation for children and
young people that were known to need support. Treatment was limited
to children that might benefit from an ADHD diagnosis. The Director
highlighted examples of help and support such as providing
alternative arrangements for children undertaking school exams or
providing help and advice to parents. Through consultation, could
allow Mindworks to understand what a child’s challenges were.
There were several ways children may present with need, that may be
indicative of an ND need and may also be indicative to, for
example, difficulties with sleep, trauma and behavioural concerns.
Instead of queuing children on a waiting list, Mindworks was trying
to engage quickly, educate others, identify what might contribute
to the child’s difficulties and therefore the support that
could immediately be made available. Mindworks had 183% more
referrals than what was contracted in 2023/24, pre-consultation,
with twenty-six staff. If Mindworks could not engage early with
children and young people, in multiple ways, to provide support,
the clinical team would spend time processing referrals without
being able to diagnose.
- The Chairman of CFLLC
expressed concern that the issues raised by schools, in terms of
how parents and schools were feeling was news to the Mindworks
team. It was suggested that if there was more listening to schools
and parents the Mindworks response might be more appropriate. The
Chairman of CFLLC did not feel assured there was a plan that had
timelines, activities, accountability, and funding, designed to
address what schools and parents felt. Parents were not aware of
how to find the tools and techniques available from Mindworks, and
the language Mindworks used was not accessible. The Chairman of
CFLLC raised whether Mindworks was monitoring the effectiveness of
the range of support services available.
A break was called 12.02pm and
the meeting resumed 12.18pm
- The Chairman asked
about the support available for children and families, with
reference to the pressures parents faced. The Service Manager (NAS)
explained that NAS offered parents support through group workshops
and ran family fun days in school holidays, providing an
opportunity for parents and children to meet in person which
received good feedback. The work undertaken by NAS was goal based.
93% of NAS’s clients reported an improvement in all their
goals, against the national average of 20% and a contractual target
of 70%. This figure was 90% across the Midnworks alliance. In terms
of parent support and mental health, NAS ran parent support groups.
A network of parents that understood each other’s experiences
could be validating and supportive. In Surrey, NAS had 4000
Members. NAS provided days out for children, and different events
for children and families to get together. There was an online
moderated forum with around 1000 members where parents could get
support from other parents. NAS supported parents to understand
that a diagnosis was not needed to access special educational needs
and disability (SEND) support, and to understand the adjustments
parents could request at the early stage.
- A CFLLC Member asked
about what further was being done to replace the capacity of
Learning Space, which was not going to be commissioned further,
where there were 28 people in East Surrey and 23 people in West
Surrey currently waiting. The Independent Chair of Surrey Wellbeing
Partnerships explained that work was being done with Learning Space
to see whether the service could continue. There was a period
before Learning Space could exit the Mindworks Partnership. If
Learning Space did exit the partnership there would be a
procurement exercise to ensure continuity of service.
- In relation to autism
activity evenings and day events offered for children and young
people with autism awaiting an adult social care assessment, the
CFLLC Member asked what data was being recorded on how networks of
support were benefitting the children and parents and what the
learning had been. The Service Manager (NAS) explained there was
qualitative but not quantitative data that looked ahead. Feedback
questionnaires were used to design services going forward and
create new events that would meet parent’s needs. It would be
difficult to ask people about personal connections that were made
going forward.
- The Vice-Chairman
asked the Service Manager (NAS) how easy and accessible it was to
access its pre-diagnostic support. The Service Manager (NAS)
explained there was a reliance on practitioners and individuals to
make the support known as NAS’s resources were limited. NAS
tried to attend community events and get information in areas such
as school bulletins. One of NAS’s roles partly involved
attending schools to talk to parents about neurodiversity and
services offered. NAS had a website and attended local events
however, work was limited to people’s availability as there
was no specific marketing or communications role at NAS’s
Surrey Hub. A newsletter went out bi-monthly, however people needed
to join NAS to receive this.
- The Head of
Emotional, Mental Health & Wellbeing Commissioning explained
that Mindworks had secured some investment to increase capacity of
the type of activities undertaken by NAS. £1.2million from the
mental health investment fund went to Surrey Wellbeing Partnership
to support primary school children and their families. Mindworks
was working on a single referral process and Information Governance
(IG) arrangements were being signed off around this. Work was being
undertaken on how to provide this digital solution, as it should
not be the responsibility of families find the support from the
different selection of partners available through
Mindworks.
- The Chairman of CFLLC
asked how the Mindworks team was working with others to achieve the
aims of Mindworks’ Care Leavers Service and what the key
issues were in reducing the risks of long-term mental health needs.
The Chairman of CFLLC also asked what more needed to be done in
this area to improve outcomes. The Director of CYP Services (SaBP)
explained the New Leaf Service supported children who were looked
after and those that had left care. This service included
specialist support, such as support for unaccompanied
asylum-seeking children. The service, from a clinical perspective,
included a multi-disciplinary team that were expert in working with
children that had experienced trauma. The multi-disciplinary teams
networked and engaged with all agencies supporting the child and
worked with families to support the child’s needs.
Mindworks’ Reaching Out Service was aimed at children that
were hard to reach and often challenged with mental health and ND
needs. This service worked with children up to the age of 25. When
a young person needed to transition into adult services for
example, there was a comprehensive offer to ensure this involved
the young person and family, with consideration to their
vulnerabilities. There were different approaches such as transition
check lists and courses available to families and young people
through the Transition Recovery College. Mindworks also aligned a
support worker with a young person at more vulnerable points in
their care journey.
- The Chairman of CFLLC
asked how a care leaver knew how to access the Mindworks support
services. The Director of CYP Services (SaBP) explained that access
to Mindworks’ service may be through Surrey County Council.
The Mindworks screening criteria would highlight vulnerabilities
for review, such as if the child was a care leaver, prioritising
their needs. There would be a direct referral to the New Leaf
Service who would engage, offer support and network with agencies
to support the young person.
- The Chairman of CFLLC
asked whether young people who could not immediately access the
Mindworks service themselves had to be referred by an agency. The
Director of CYP Services (SaBP) explained there was no
self-referral option in the New Leaf Services, but for care leavers
it was usually known that they were in the county and needed
support. There were a range of services that young people could
access through self-referral.
- A Member asked how
people could access signposting to know what services they were
eligible for. The Member also asked whether the Mindwork’s
team felt there was a joined-up approach to ensure a continuity of
service and whether care leavers were made aware of the support
available. The Director of CYP Services (SaBP) explained that the
emphasis in the Mindworks partnership was to increase the presence
of help and support in places where children and young people were,
to enable immediate access to the service and through
Mindworks’ network of partners, build confidence in
understanding the needs of young people, to ensure they could be
directed and supported in the right way. Mindworks had fifteen
mental health support teams, and its third sector and voluntary
partners were present in schools and communities. Mindworks’
Recovery College had a self-referral option and there was good
information on related websites. Mindworks THRIVE approach was
trying to grow competence and understanding of what was available
for children and young people.
- The Member asked if
Mindworks felt confident that the signposting approach was working
and was effective. The Independent Chair for Surrey Wellbeing
Partnership explained that signposting available was put out in all
channels possible. Work was done in communities across multiple
organisations with children and young people. There was a concerted
effort to signpost the services available.
- The Member asked what
procedures were in place to see if signposting was effective and
was ensuring people were not falling through the system. The
Independent Chair for Surrey Wellbeing Partnerships explained that
this related to Mindworks’ focus on vulnerable groups,
through the Reaching Out service. More demand than capacity
indicated people were aware of Mindworks’ support services.
Mindworks had early intervention coordinators that worked with
schools to ensure vulnerable pupils were supported and referred to
the right partners if necessary. The Director of CYP Services
(SaBP) added that Mindworks had a 24/7 mental health crisis support
line. Posters were put in schools and cards were created that
children could carry around. Emerge, a Mindworks partner, were
present in emergency departments. Mindworks had CYP havens and
worked with Amplify, who were young people themselves that
connected with other young people to promote support available.
Goal based outcomes helped Mindworks review how effective the
services were in meeting the needs of children and young people.
Mindworks tended to receive more compliments than complaints, with
complaints related to waiting times for ND need.
- The Member asked if
social media was used. The Director of CYP Services (SaBP)
confirmed it was. Consideration was given to certain times of year
more difficult for young people, such as exam seasons, where
Mindworks promoted access to crisis services and havens. The
Independent Chair of Surrey Wellbeing Partnership explained that
social media was important and was recently reviewed to add other
platforms. Social media was used to promote key messages,
particularly crisis numbers and signposting to the Mindworks
website.
- The Deputy Chief
Executive and Director of Therapies added that SaBP was doing a
piece of research with the McPin Foundation under a National
Institute of Health Research Grant (NIHR) to look and learn from
the experience of young people in transition services, to ensure
needs of young people were met.
- The Chairman of CFLLC
asked what services were currently offered by the Mindworks
Recovery College to young people with neurodevelopmental issues.
The Chairman of CFLLC also asked what proportion of young people
had taken the Recovery College offer, how more take up could be
encouraged and if the Recovery College could be widened to include
more support for parents. The Director of CYP Services (SaBP)
referred to the transition course, which particularly vulnerable
people were encouraged to attend. There were three specific courses
that included an introduction to the autistic spectrum,
understanding adult ADHD and post-diagnostic ASD, and understanding
adult ADHD courses, which were well attended. The Recovery College
had self-referral options and were open to all, including parents
and teachers. The courses had an emphasis on sharing information
about people and their conditions, and it was more difficult to
understand the proportion of attendees that had ND needs. The
Deputy Chief Executive and Director of Therapies explained that a
strategy to increase take up of The Recovery College was to instil
anonymity, to challenge stigma. Reports from The Recovery College
showed that most people did not want to disclose a diagnosis, and
attendees were treated as students rather than as
patients.
- CFLLC Members asked what the Mindworks plan was.
A CFLLC Member also asked about the amount of funding needed and
whether the funding should sit within the Mindworks contract or be
put into other areas that held Mindworks back. The Associate
Director for Integrated Children’s Commissioning explained
that Mindworks needed to listen more to what was heard from
children and families to make changes. In terms of the overarching
plan, there were areas outlined in the report which the Mindworks
team had heard from committee Members that it felt disparate, which
was helpful feedback. A lot of work occurring around the All-Age
Autism Strategy and improvement work around SEND. Mindworks needed
to break down some of the siloes and bring it together. Mindworks
tried to ensure funding from the ICB and needed to understand what
the funding looked like for the year ahead.
- The Deputy Chief
Executive and Director of Therapies (SaBP) added that universal
early year’s provision was critical in supporting families
and young people, recognising the gaps in this provision
nationally. There was a risk that the transformation work would
become siloed, and it was important to ensure it was
well-connected. The plan was to ensure the transformation work was
fed through a broader transformation board, chaired by the Director of Commissioning for
Transformation as part of the Council, so it could connect
into other aspects of work, such as SEND work, to allow for a more
holistic plan. The financial plan would also be reviewed.
Engagement with the right partners needed to be ensured to hear
more from families and schools.
- The Assistant Director for Inclusion and Additional Needs
(SCC) explained that there was still a lot to do in support
of schools and families. The Education and Lifelong Learning
Directorate focus on this. The Ofsted inspection would be responded
to, part of which was about having a cohesive plan to ensure the
Council was working in close partnership. For the Council, mapping
out the support and ensuring available support was clear to schools
would be key. It was suggested that the Council’s offer to
schools, and the training and development for practitioners needed
to be reviewed. Learning from other local authorities facing the
same issues could be beneficial.
- The Chairman of AHSC
raised that society as a whole needed to become more inclusive and
support people with neurodiversity.
- The CFLLC Chairman
asked what the timeframe was for the Transformation Plan. The
Deputy Chief Executive and Director of Therapies (SaBP) explained
that Mindworks had committed to present the Improvement Plan at a
national conference in November, with the expectation of the plan
to be ready over the next few months.
Break was called at 1.10pm and
the meeting resumed at 1.47pm
Rebecca Jennings-Evans left at
1.17pm
Actions:
- Mindworks team to
look at the London Boroughs and benchmark their performance against
them, in terms of the referral process and treatment pathways (and
to share this information with Adults and Health Select Committee
and Children’s Select Committee Members).
|
- Mindworks team to
share the completed Transformation Plan with the Childrens, Family
Lifelong Learning and Culture Select Committee in October
2024.
|
Resolved:
The Adults and Health Select
Committee and the Children, Families, Lifelong Learning and Culture
Select Committee jointly recommended that:
- Mindworks must
demonstrate how it proposes to regain the confidence of parents and
schools, and that it is accepting responsibility for the services
that it is commissioned to provide, by:
·
Publishing the Transformation Plan, with dates,
times, and levels of performance with appropriate Key Performance
Indicators (KPIs)
·
Providing research to identify the size of the
problem.
·
Encouraging the partnership to improve resources for
communicating early help prior to diagnosis from organisations such
as NAS.
·
By scaling up supply to meet the level of demand,
and secure sufficient support from the NHS England, and show how
this is linked to the Transformation Project.
- Recommend that the
response to the Joint Targeted Area Inspection Report (JTAI) is
extended to accommodate a joined up Mindworks / Education, Health
and Care Plan (EHCP) process.
- The Surrey and
Borders Partnership Trust Recovery College needs to be more
accessible to people and encourage more local access, with better
publicity and provision of outreach services. Ensure that the
Recovery College is given more active publicity and has the
capacity to take on extra workload. Establish skills and work
coaches to help coach and support people to enable the transition
with helping people to maintain employment and get into employment,
and critically to help people with regards to the Recovery
College.
- Mindworks must
provide a clear and simple information guide for parents on how to
access services, so that pathways of access are coherent,
accessible, and easily understood ensuring communication is clear,
and consider how it could be further reaching, so that parents and
schools are supported while children are on the waiting
list.