Homelessness projects are today the focus of over £3 million in National Lottery funding, set to increase third sector led provision, helping prevent Scots losing their tenancies and becoming homeless. Continue reading National Lottery delivers funding support to tackle homelessness
Latest waiting time figures highlight need for fundamental shift in focus for child mental health services 
Latest waiting time figures have reinforced the call by a coalition of leading independent and third sector children and young people’s service providers for increased investment in mental health services with a much greater focus on prevention and early intervention.
The call from the Scottish Children’s Services Coalition (SCSC) (see Notes to Editors for members), which campaigns to improve services for vulnerable children and young people, comes as the latest waiting time figures from the Information Services Division, part of NHS National Services Scotland, highlight that thousands of children and young people are failing to be treated within Scottish Government waiting time target.
With an increasing number of children and young people being identified with mental health problems they also highlight a postcode lottery for mental health treatment across the country.
Covering the quarter January to March 2019, the figures highlight that 4,237 children and young people started treatment at specialist child and adolescent mental health services (CAMHS) in this period.
The NHS in Scotland, including ten of the 14 regional health boards, failed to meet the Scottish Government 18-week waiting time target for children and young people to receive treatment from CAMHS. This target should be delivered for at least 90 per cent of patients.
While 73.6 per cent in the NHS in Scotland are being seen within this 18-week waiting time, still in itself far too long, more than a quarter (26.4 per cent) are failing to be seen within this period.
Individual health boards failing to meet this target are: NHS Borders (target achieved for 40.0 per cent), NHS Fife (72.8 per cent), NHS Ayrshire & Arran (81.6 per cent), NHS Grampian (43.3 per cent), NHS Greater Glasgow & Clyde (80.6 per cent), NHS Highland (81.4 per cent), NHS Lanarkshire (76.6 per cent), NHS Lothian (69.1 per cent) and NHS Tayside (57.9 per cent)
The figures also indicate that 118 children and young people in the quarter had been waiting for more than a year prior to being seen for treatment, an increase from 108 in the previous quarter (October to December).
It should be noted that a mere 0.53 per cent of the NHS budget is spent on specialist CAMHS, amounting to £61.074 million. In addition to this, only 6.34 per cent of the overall mental health budget is spent on CAMHS.
These very low figures are despite the fact that mental health services are creaking at the seams due to greatly increasing demand, as evidenced by these waiting time figures. Research indicates that 10 per cent of children and young people (aged five to 16) has a clinically diagnosable mental health problem (around three in every classroom), with 50 per cent of mental health problems established by the age of 14 and 75 per cent by the age of 24.
While acknowledging the great efforts the Scottish Government is making, such as an additional £250 million of funding announced in the Programme for Government, the SCSC has called for the Scottish Government for greatly increased investment in CAMHS and for a more consistent approach to delivering these services across Scotland.
It has also called for a renewed focus on prevention and early intervention for those with mental health problem, reducing the need for referral to under-pressure specialist CAMHS.
This includes embedding mental health within education from an early age in order to strengthen knowledge and awareness of mental health, as well as reducing the stigma associated with mental health.
Emotion and resilience classes should be provided to all students from primary one to teach students how to work through their emotions in a healthy way and there should be a whole-school approach, with training for all staff involved in education and providing counselling support.
A spokesperson for the SCSC said: “These latest waiting time figures highlight that fact we are continuing to fail thousands of children and young people with mental health problems.
“The great efforts the Scottish Government is making, including an additional £250 million for mental health over the next five years announced in its recent Programme for Government, is to be welcomed, but more clearly needs to be done.
“These newly released figures highligh that the NHS in Scotland, including ten of our health boards, are failing to meet what is already a lengthy waiting time. Yet we know that three children in every classroom has a clinically diagnosable mental health problem.
“There must be a radical transformation of our mental health services, with a focus on preventing such problems arising in the first place and intervening early, especially when we know that half of all mental health problems begin before the age of 14. This includes embedding mental health within education from an early age as well as providing training for all staff involved in education.
“With mental health and the issues associated with it representing one of the greatest public health challenges of our time, we must ensure that children and young people are able to get the care and support they need, when they need it. This includes investing in greater community support and support at school, reducing the need for referral to specialist CAMHS.”
The ISD figures released yesterday show that for the latest quarter to March 31st 2019, 85 young people in NHS Lothian waited over a year to be seen out of the 118 of young people waiting over a year across all NHS health boards in Scotland.
The number of young people waiting within the 18 week target in NHS Lothian has increased to a record 540, 69.1%, which is still below the national average of 73.6% seen within the 18 week target for the last quarter.
In NHS Lothian more young people are being seen within the 18 week target, however the 85 young people waiting over a year to be seen still makes up 72% of all young people waiting over a year to be seen in Scotland for the same quarter.
The CAMHS Workforce Report states that “NHS Grampian and NHS Lothian’s child & adolescent populations are projected to increase the most by over 6.0% each” (page 8), which means that NHS Lothian CAMHS will need extra funding to meet future demand.
Scotland’s first Youth Commission on Mental Health produced a report last week that said fundamental change was needed to the way young people with mental health issues were supported. Recommendation included that mental health education be embedded within the school curriculum and for education professionals to be trained in mental health support.
The commission’s also called for waiting times to access child and adolescent mental health services to be reduced to eight weeks.
Scottish Conservative Health Spokesperson, Miles Briggs, said: “This provision of mental health services for young people in Lothian is nowhere near where it needs be.
“Hundreds of young people are waiting over the 18 week target every quarter in NHS Lothian to be seen by a mental health professional.
“There has been a mental health crisis for young people in Lothian for many years now and the complacency of SNP Ministers means that young people are suffering without the access to support that they need.
“The SNP must start taking the necessary actions to improve mental health provision for young people in Lothian immediately.”
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” … right care, at the right time, in the right place” – Cllr Ricky Henderson, Chair of Edinburgh Integration Joint Board.
Edinburgh Residents are being asked to comment on a “bold new vision” for way the city delivers health and social care services. The Edinburgh Integration Joint Board has launched an online consultation as it seeks feedback on its new draft Strategic Plan.
The high-level vision – which intends to rapidly influence the way services are delivered by the NHS and City of Edinburgh Council – proposes the creation of a bespoke ‘Edinburgh Model’ for collaborative health and social care, placing Edinburgh’s communities and citizens at its heart.
Developed in collaboration with patients and their families, voluntary groups and care workers, the draft plan seeks to tackle inequality and concentrate resources at a local community level rather than in hospital settings.
Through a range of measures, the strategy intends to create the right conditions for the EIJB’s existing systems to evolve over the next three years and beyond so that it can provide the city with a “radically more modern, inclusive and sustainable offering”.
Residents are being asked to what extent they agree with the vision and its aspirations which include developing a:
Chair of the Edinburgh Integration Joint Board, Ricky Henderson, said: “At its heart, the strategic plan sets out our desire to support people to be well at home, and in their community, for as long as possible. Providing first class acute hospital care only when medical intervention is needed, and the right care, at the right time, in the right place.
“Age, disability or health conditions should not stop people living a safe and good life and so our approach aims to work with individuals and their carers to see what matters most to them and support them to reach their goals. Everyone also deserves to live as comfortably and independently as they can, and by working towards a ‘home first’ method, we hope to empower people and communities to make these choices where they can.
“To do this, we need input from everyone who is touched by health and social care services in Edinburgh and we need to work collaboratively with our partners to optimise available resources. I urge people to take part in the consultation and have their say.”
| How can I take part in the consultation?
You can take part online through the consultation hub. A number of specific drop in events will also take place with staff, members of the third sector and EIJB stakeholders.
What is a ‘three conversation’ model’? The Three Conversations Model is proving successful as an approach to health and social care and is expanding fast. The conventional approach to care triages people, attempts to divert and connect the level of support required, and then too often makes people wait for an ‘assessment for services’. To move away from the idea that the task is to process people, complete unwieldy documents and presume the need for formal services, the Three Conversations Model offers three clear and precise ways of interacting with people that focus on what matters to them. It is a radically different approach which recognises the power of connecting people to the strengths and assets of community networks, and the necessity to work dynamically with people in crisis. It is focused on improving the experience of people and families needing support, and in so doing, improving the satisfaction, fulfilment and effectiveness of those working in the sector, whether they be health care professionals, volunteers or carers. The Three Conversations Model not only improves the experience of service users but is popular with those working in the sector and can lead to a significant reduction in recurring funded support. What is the Edinburgh Model? Essentially, we believe people are experts in their own lives, so our aim is to work with individuals and their carers to identify what matters most to them and support them to reach their potential. We will introduce the Edinburgh offer to redefine the services and support that we offer to Edinburgh’s people. It will concentrate on supporting and enabling people to be as independent as possible. We will engage our citizens in a more active and collaborative way. People who find themselves needing our support will know how to engage with us and realistically what to expect from that relationship. It will be an explicit statement of our intent and mutual expectations, with greater definition on the kind of contract we wish to have with Edinburgh’s citizens. What is a ‘home first’ approach? Under a Home First approach, Integration Joint Board staff would work closely with colleagues in the community and in social care to plan for a patient to return home from the first day they arrive. Some patients may not need any help when they get home, but for those who do, Home First would make sure the right support is in place. Patients would be seen at home within hours and receive an assessment by a Home First Team, made up of community nurses, therapists and social care professionals. Every patient would have a personal care plan and this may include therapy, goals, support for carers, any equipment they may need and self-help advice. It helps patients to get home quicker and helps them to lead independent lives, with the support they need. |
The length of time people are waiting for care assessments in the Capital has fallen by almost 50% under the Edinburgh Integration Joint Board (EIJB), (writes its Chair, Councillor Ricky Henderson). Continue reading Health and social care: An improving picture but more needs to be done, says EIJB Chair
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