To consider the submitted report on the above.

The Director of Women and Children’s Improvement NHS Devon - Su Smart presented the submitted report on One Devon’s Children’s Strategic Approach and Action Plan and responded to questions.  The key themes from the report were:

·                A focus on six strategic initiatives including Special Educational Needs and Disabilities (SEND), safeguarding, mental health access, neurodiversity, early identification, prevention, and multi?agency working.

·                An emphasis on reducing waiting times for mental health and ADHD/ neurodiversity assessments.

·                Shift to digital technologies, community?based care and reducing hospital reliance.

·                Target improvements in neighbourhood teams, exploring co?location possibilities with schools and Family Hubs.

·                Challenges managing children with complex needs in the community without funding following them.

Members heard first hand from a young person who shared their experiences highlighting stigma, lack of early recognition in schools and challenges explaining mental health.

The following questions were raised:

·                The Strategy was very high-level, what exactly was changing on the ground to make it happen?

·                How would results be shared across health providers and schools, and how would ADHD assessments be completed more quickly?

·                How “integrated” would the system be?  Would this model reflect the Adults’ integrated system (GPs, hospitals, community teams)?

·                What happens during transition from Children’s Services to Adults’ Services, e.g. for young people with epilepsy but without SEND?

·                What was meant by an Integrated Board, and how was this different from Adults’ Services?

·                How would funding and team organisation work?

·                What would co?location of neighbourhood teams look like?  Where would this be based?  How would joint working between social care, police, and health be implemented?

·                How many children were waiting for ADHD/Neurodiversity assessments, and how were they prioritised?

·                How does shifting traditional acute care into communities work in practice for short-term, high?intensity needs?

·                Why was there no place for those “suffering silently” with complex mental illness?

·                Why do schools fail to recognise autism or anxiety early enough?

·                How could culture change so young people were better understood?

·                How do we overcome parental distrust of a new system and improve access?

Members received the following responses:

·                Multiple internal and partnership work programmes underpin the Strategy.

·                Additional investment had been put in place for ADHD and Neurodiversity assessments to increase capacity.  A recovery programme was increasing assessment throughput and there was support for families on waiting lists.

·                Information Governance and IT programmes (including EPIC hospital system) aim to improve secure information sharing with schools and community services.

·                The Children’s model would not fully mirror the Adults' integration model.  The Integrated Care Board (ICB) was the funder, while the ICO (Integrated Care Organisation) was reviewing its operating model for delivery of adult social care.

·                Children’s Services were structured differently from Adults’ Services, with future locality-based multi?agency teams planned.

·                Planning for transition starts age 14–16, working with Adults’ Services and NHS providers.  Gaps may still occur due to team capacity limitations.

·                Health services were currently provided from the John Parks Unit at Torbay Hospital.

·                Co?location may include Schools (e.g. speech and language therapists working inside schools), Family Hubs and community spaces rather than traditional office settings.

·                ADHD and Neurodiversity assessment prioritisation was based on clinical need, medical urgency, or for safeguarding concerns.  All referrals undergo clinician triage and could be escalated if new risks emerge.

·                Community?based acute care supports children earlier to avoid hospital admission.  Short?term high?intensity needs could be managed by community teams to reduce inappropriate hospital stays.

·                The system acknowledges trauma caused by late recognition and welcomed the feedback from the young person.  There were plans for more mental health support in schools, staff training to improve awareness and multi?agency commissioning changes based on feedback from young people.

·                Building parental trust would require a culture shift, more transparency and consistent relationships with families.  Digital tools and multi?agency hubs aim to make access easier.

Resolved (unanimously):

That an annual update on the implementation of the One Devon’s Children’s Strategic Approach and Action Plan be added to the Work Programme for the Children and Young People’s Overview and Scrutiny Sub-Board.