The Wales Audit Office have today published a report on Child and Adolescent Mental Health Services in Wales(CAMHS), which to those of us that work in the field of Children's Social Care do not find particularly surprising. Many of us as Lead Members in the field have long complained of inadequate funding from the NHS Trusts/LHB's in Wales towards children's continuing healthcare. Many children in Wales are having to be cared for away from home in expensive private placements because local authorities do not have the therapeutic services to deal with their complex needs in house or in county. The WAO Press Release is reproduced below:
Mental health services in Wales are still failing many children and young people, despite some improvement in recent years. That is the conclusion of a report published jointly today by Healthcare Inspectorate Wales, the Wales Audit Office, Estyn, and Care and Social Services Inspectorate Wales.
The report acknowledges the recent improvements that have been made. These include new funding streams to develop parenting and family intervention services, expanding school based counselling and the introduction of primary mental health workers who support professionals, such as GPs and school nurses, working with children and young people.
However, it highlights the barriers that are currently preventing further improvement – such as the way services are planned and provided, and issues around workforce development, staff training and performance management. The report makes 16 recommendations to the Assembly Government, health boards and local authorities in Wales.
The report highlights that there is too much variation across Wales in the availability and quality services. For example:
1. Unlike other parts of the UK there are no specialist mental health services in the community for children under five;
2. In parts of Wales some groups of young people do not have access to the specialist mental health services that are in place ;
3. Specialist community services, including services for young people with eating disorders are too variable;
4. Transition arrangements for the transfer of young people to adult services when they get older are not good enough;
5. Services are often not child friendly and many children and young people are not involved enough in planning their care;
6. The access to care and support for young people varies substantially across localities in Wales;
7. A number of practices are putting children at risk including placing significant numbers of children inappropriately, on paediatric or adult mental health wards.
The report also states that it is unclear how policy should be implemented, with only limited support and guidance provided by the Assembly Government to organisations arranging and providing services locally. The overall approach to planning and providing services is one of assessing whether a child or young person’s needs meet a service’s criteria, rather than building services around the specific needs of the individual. And joint working between the health, local authority and voluntary sectors is very variable, resulting in some children and young people receiving services that are poorly co-ordinated.
The report’s recommendations call for:
a. The Assembly Government to develop an action plan within six months of the report being published to address the issues identified around the availability and quality of services.
b. Health Boards and Local authorities to develop local multi agency plans for implementing the priorities and targets in the national action plan.
c. The Assembly Government to commission the development of information for children, young people and their parents on their rights relating to child and adolescent mental health services and what they should expect from these services.
d. The Assembly Government and other public bodies to introduce effective arrangements for managing and scrutinising performance, ensuring results are widely available
I just wonder whether the WAG Action Plan when produced will follow the usual route of passing the buck onto Local Authorities to implement without the resources to go with the costs of implementation.
Ministerial Statement by Edwina Hart
This report makes some important points and, during the time period it covers, identified a number of areas where improvement was necessary. In comparison with many reports, however, a lengthy period has now elapsed since the field work was conducted and the final text produced. As a result, the key recommendations contained within it have already formed the basis of government policy in this area for some time. This written statement therefore concentrates on the actions already taken, and the changed position which has resulted, since the position outlined in the report.
The mapping of Child and adolescent mental health services (CAMHS) by Durham University in late 2008 and 2009 shows that, waiting times for specialist CAMHS have fallen by 9% since November 2007. Of new cases seen, 90% were seen within the 16 week target for treatment. Total staffing rose by 10% and the number of specialist CAMHS nurses has increased by 15% and clinical psychology has increased by 56%.
The number of doctors has increased by 8%. Total numbers of Primary Mental Health Workers rose from 27.3 whole time equivalents to 40.08 whole time equivalents, an increase of 47%. Training courses have been provided for front line services by Primary Mental Health Workers in Wales.
This year, I launched our National Action Plan to Reduce Suicide and Self Harm in Wales called Talk to Me. The National Action Plan outlines the challenges and priorities and how organisations, working together, will deal