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NHS Guildford and Waverley CCGDominion HouseWoodbridge RoadGuildfordSurrey, GU1 4PUTel:
What are we doing now?
Redesigning the service
Informationfor the market
Help and support
Surrey County Council and the Clinical Commissioning Groups (CCGs) in Surrey are committed to supporting children and young people to have the best start in life. A fundamental element of having this best start is their emotional wellbeing and mental health (EWMH).
Both nationally and in Surrey, there is a consensus that we need to change the way we think about and deliver Emotional Wellbeing and Mental Health (EWMH) services for children.
The independent review in October 2018 highlighted that there is a universal commitment to delivering high quality CAMHS services to children and young people in Surrey. The Mindsight model is innovative, with a number of high performing services and clinical interventions are perceived as high quality. However, the vision for Mindsight is not being wholly delivered, nor is it deliverable in the current context. Challenges which are currently facing the service include: multi-agency relationships are not working to provide early help to children and young people (especially schools and GPs), the commissioning structure provides a complex landscape for CAMHS and crucially, demand on the service has been 53% higher than predicted, although this number is only marginally higher than the national average.
Why did we hold engagement workshops in January 2019?
Throughout 2018, we became increasingly aware that people were not happy with services. We were told about long waits and delays for services, difficulty understanding referral routes and pathways, not enough appropriate support for people with complex and enduring needs, a perceived lack of listening and professional respect, inequality accessing services for people who are more vulnerable or from disadvantaged groups and poorly managed transfers between children’s and adult services.
This is not right and we recognised that many children and young people are not getting the emotional wellbeing and mental health support they need to make the best start in life and fulfil their potential.
In January 2019 we held a series of engagement events about EWMH where children, young people, families, teachers, GPs, social workers, care professionals, voluntary sector organisations and other interested people told us what matters most to them.
Launch event presentation slides [pdf, 1.8Mb] that took place at HG Wells Centre in Woking on Thursday 10 January 2019.
EWMH Workshop Leaflet [pdf, 600Kb]
Five themes emerged from these workshops which we now know reflect the aspects of services most important to everybody who took part:
We understand that immediate and longer-term action is necessary to put these matters right and we are committed to transforming services for the better so that children and young people in Surrey flourish, along with those who care for them.
Comprehensive information about what people said during the engagement and the resulting analysis and conclusions are contained in the report which provides evidence to support the five themes, what they mean and how they impact children and young people who need to use services and their families. It also includes recommendations for Surrey County Council and the Surrey CCGs to act upon. Examples of recommendations are:
Following engagement we understand there is more to learn about pathways, challenges, system interdependencies and alternative service solutions. Commissioners are committed to delivering the aspirations contained in the EWMH strategy and to improving the experience and outcomes for our children and young people as soon as possible.
Given the complexity of the system, commissioners will bring together key stakeholders to test new approaches. Partners have agreed that to effectively transform the emotional wellbeing and mental health system of support for children, young people and their families we need to much more effectively involve and include the voluntary, community and faith sectors, social care, early help, schools, GP practices and broader NHS services.
Public Engagement Summary Report [pdf, 700kb]
We have a vision
“To develop a culture of emotional wellbeing and mental health support for children and families that is based on strengthening early intervention and prevention and building resilience. We will listen to and work in partnership with our community to give children and young people the best start in life.”
We have produced a Emotional Wellbeing and Mental Health Strategy for Children and Young People which represents our collective ambition for focused improvement across services. A child friendly version of the strategy, authored by members of the Surrey County Council Rights and Participation Team for CAMHS (Child and Adolescent Mental Health Services) and SEND (Special Educational Needs and Disability) is also available.
Emotional Wellbeing and Mental Health Strategy for Children and Young People
Emotional Wellbeing and Mental Health Strategy for Children and Young Peopleeasy read version
What we are doing now
Surrey County Council and the Surrey CCGs have now embarked on the next steps towards improving services.
Following engagement with children and young people, their parents, professionals, voluntary organisations and community groups we know that we need to focus change on the following areas:
Our Transformation Programme is looking at how health and care partner organisations can collaboratively make a change. Children and young people’s emotional wellbeing and mental health needs cannot be met by a single agency alone. The programme sets out to achieve successful solutions to issues and challenges that have been identified.
We need to work with everybody across health, care and education to make sure they understand the new ways we want to work together to care for and support children and young people. To achieve this in Surrey we need to act and work differently. We are in the process of creating a culture and environment in which we will be jointly responsible for using our resources to provide better results for children and young people.
The Transformation Programme timeline
There are five themes to our transformation work:
Access and support to services (single point of access, joint front door)
Why we need to change
How we intend to change
Access workstream - project mandate summary [pdf, 1Mb]
CAMHS SPA Improvement and Development – Quarterly Bulletins are available via the SABP website. Bulletins for June 2019 and September 2019 have been published to date.
How we intend to change
Early intervention workstream – project mandate summary [pdf, 200kb]
Finalised Accelerator School Sites in Surrey [pdf, 100kb]
How we intend to change
Vulnerable groups workstream – project mandate summary [pdf, 200kb]
Social and Emotional Mental Health (SEMH/BEN)
Social & Emotional Mental Health workstream – project mandate summary [pdf, 200kb]
Crisis workstream – project mandate summary [pdf, 700kb]
Commissioners have undertaken a process of self-assessment to identify how much change is required and what actions need to be taken to move services, systems and cultures closer to our aspirational position. We have worked with key partners to develop plans to deliver improvements. We will begin to trial some new approaches to improve support for children and young people’s emotional wellbeing and mental health in the near future. These new approaches will be evaluated so that we can understand whether they are making a difference for children and young people and their families.
How are we redesigning services?
Commissioners are investigating the use of a model called THRIVE to support the way in which services are redesigned. This model was developed by the Tavistock & Portman NHS Foundation Trust and the Anna Freud Centre for Children and Families, in consultation with children, families and service providers.
The model balances the needs to provide good quality early intervention and resilience-building to tackle issues early, with the need for some children and young people to access more specialist or medicalised care. The THRIVE model is recommended in the NHS Long Term Plan which has just been published.
The key features of the model are that it:
Our THRIVE Framework
The figure below shows how to apply THRIVE segments to meet the needs of children and young people in Surrey.
Figure: THRIVE Model for service redesign
Depending on the age of the child or young person, this will mean providing access to early intervention and prevention through schools, colleges and children's centres, health visitors, school nurses, GPs, helplines and websites for support.
We will provide early support to referrers in schools and general practice.
The support and services to children and young people will be provided through community counselling, hospices and bereavement services, counselling or mentoring in schools, education psychologists, education support centres, targeted youth support teams, family support and support to referrers.
Getting Risk Support
The support and services will include specialised crisis support and day and inpatient units, where children and young people with more severe mental health problems can be assessed and treated.
Getting More Help
The support and services will be provided to children and young people including multi-disciplinary working in a community setting to meet the needs of more severe, complex and enduring mental health needs. They will also include an eating disorder service.
Children's EWMH Transformation Programme Advisory Board Meetings
Children's EWMH Transformation Programme Highlight Reports
The NHS and County Council in Surrey are planning what children and young people’s emotional wellbeing and mental health services should be available in the future. Surrey CCGs and Surrey County Council are planning to issue a combined Invitation to Tender (ITT) for these services. On 28 January 2020 commissioners hosted a second engagement event (the first was held on 15 October 2019) to provide detail on the draft Overarching Service Specification and seek answers to questions in relation to the service. Please see below the information shared, feedback received and attendees for both events.
Supporting documents for Market Engagement event held on 29 January 2020:
Market Engagement event presentation slides [pdf, 400kb]
Draft Overarching Service Specification [pdf, 1Mb]
Service Specification Questions [pdf, 500kb]
Draft Contract Schedule 4 – Quality Requirements [pdf, 700kb]
Market Engagement event questions and feedback [pdf, 300kb]
Market Engagement event attendees [pdf, 100kb]
Supporting documents for Market Engagement event held on 15 October 2019:
Market Engagement event presentation slides [pdf, 1Mb]
Market Engagement event notes [pdf, 500kb] - record of questions discussed with the market and queries posed to commissioners
Market Engagement event attendees [pdf, 100kb] - list of attendees providing permission for their details to be published
Commissioners are happy to provide an opportunity for organisations attending these events to describe the nature of their offer and the benefits they bring to children and young people. Information about those who have taken up this chance can be found below. Contact details can be obtained from the Attendee List above or from the document below.
Voluntary Sector Organisations offering EWMH Support [pdf, 100kb]
The document below describes Surrey County Council’s technical requirements for IT system(s) to support the Children & Young People Emotional Wellbeing Service being commissioned in partnership with the NHS in Surrey.
Technical Solution Requirements Specification* [pdf, 600kb]
* this document is draft, comments are welcome
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