Children and young people

The Children’s Commissioning Team in West Sussex have published a five-year plan for improving children and young people’s mental health and wellbeing services across the county.

The plan was developed during 2015 in partnership with children and young people (CYP), parents, carers and key stakeholders.

It was approved by NHS England in December 2015 and NHS England awarded local commissioners an additional £8.3m funding over the next five years to support the implementation of the plan.

Download the plan [refreshed in October 2018] or read a summary of the plan below.

Redesign strategy

The local transformation plan builds upon the five-year redesign strategy for CYP mental wellbeing services in West Sussex.

The three clinical commissioning groups (CCGs) and the county council in West Sussex are committed to giving mental health and wellbeing for CYP the priority it deserves.

They are taking a collaborative, integrated and evidence-based approach to ensure services and pathways are best suited to local needs.

A comprehensive needs assessment and mapping of local services was published in June 2014. It identified many strengths and a number of gaps.

Commissioners developed a five-year programme of service redesign to address these issues which involved extensive consultation with a wide range of key partners, CYP and their parents and carers.

It set out seven key recommendations:

  1. Local single point of access for early intervention and targeted services to provide a streamlined process and ensure an appropriate and timely response.
  2. Early intervention and prevention a priority to support professionals to identify mental health problems at an early stage and respond accordingly.
  3. More capacity and greater choice of preventative and early intervention support, including more web-based services.
  4. Making co-production with users a given to ensure planning and evaluations are based on the needs of CYP.
  5. A focus on outcomes and the levers to achieve them, with a new performance framework to demonstrate outcomes for CYP and encourage a seamless service.
  6. A focus on improved transition between children’s and adults’ services to ensure that young people receive the right help when they need it.
  7. A new commissioning approach with a single integrated approach to commissioning and contracting between the council and CCGs to streamline transactions and ensure clear provider accountability.

Local transformation plan

The five-year redesign strategy underpins the local transformation plan (LTP). In addition, the LTP also reflects the recommendations made in Future in Mind, a 2015 report from the Department of Health and NHS England on how children’s mental wellbeing can be best supported.

The LTP complements and supports the implementation of the West Sussex Health and Wellbeing Strategy and has been endorsed by the Health and Wellbeing Board.

Local priorities: The LTP sets out a series of priorities that aim to both increase capacity and address gaps in services and to also increase the ability of the workforce to help CYP and their families develop their own resilience and coping strategies:

  • Community eating disorder service – Enhance the current service offer in order to support more CYP in the community, reduce the need for inpatient admissions and reduce the number of CYP who need to travel outside the county for specialist care (as set out in the guidance around access and waiting times for CYP with an eating disorder)
  • Development and extension of IAPT – Roll out and extend the IAPT approach to make it available to younger age groups, with training for the CYP workforce on evidence-based interventions, pathways and tools
  • Perinatal mental health – Ensure young mothers under the age of 18 have appropriate specialist support and provide increased mental health training for health visitors and midwives with a specialist perinatal mental health clinician at every birthing unit
  • Crisis care and A&E psychiatric liaison – Ensure that all young people attending A&E with a mental health related presentation are offered an appropriate and timely service. This includes developing an A&E psychiatric liaison service and temporary overnight provision for young people at risk. This work links to the current West Sussex A&E psychiatric liaison pilot funded by NHS England in 2014/15
  • Vulnerable children – Develop an enhanced therapeutic offer dedicated to vulnerable children (especially looked after children, children with complex disabilities and those with harmful sexual behaviour) to ensure they have access to more integrated services and support
  • Self-harm – Reduce rates of self-harm by developing community information resources, continued training for the wider CYP workforce and increasing the availability of early intervention and self-help programme.
  • Working with schools – Build whole school approaches to foster resilience and link into care pathways, supported by specific school self-help resources, enhanced training for the school workforce and a named CYP emotional wellbeing lead within each school
  • Child sexual exploitation – Urgent work underway to scope and commission a service to address this current service gap in order to ensure CYP have access to appropriate therapeutic support
  • Early help and intervention – Continued development of early intervention services to ensure that CYP have choice, through a single point of access, from a suite of services to help them recover and build resilience
  • Youth offending mental health support – Work is underway to scope and commission a service based on need to develop an emotional wellbeing service for those CYP at risk of offending or offending

Evaluation: An outcomes framework has been developed in consultation with key stakeholders and CYP and their families. A robust methodology is being established to capture and demonstrate both the clinical and economic costs and benefits of the programme.

Implementation and governance: A five-year implementation plan has been developed. The Children’s Commissioning Team is working on behalf on the three CCGs and West Sussex County Council and are responsible for day-to-day implementation and delivery.

The LTP will be reported and monitored through the Health and Wellbeing Board at a strategic outcomes level. A multi-agency Emotional Wellbeing and Mental Health CYP Partnership board supports the delivery of the plan and the ‘Free Your Mind’ group provides oversight and quality assurance from a CYP perspective.

Workforce: The changes needed across the wider health and care system to underpin greater mental wellbeing support for CYP will require significant changes in the numbers and skill mix of staff. Commissioners are in discussions with providers, partners and Health Education Kent Surrey and Sussex about the implications for workforce planning.

Finance: The CCGs in West Sussex have agreed to commission CYP emotional wellbeing and mental health services with a county-wide approach to ensure equitable coverage across the county. The LTP will result in an additional investment of £8.3million in CPY emotional wellbeing and mental health services over the next five years.

For more information

For more information, download the full local transformation plan or contact the Children’s Commissioning Team at: CYPEmotionalWellbeingMentalHealthCommissioning@westsussex.gov.uk