Download New CAMHS model letter April 2016

Dear Colleague
I am writing to inform you about exciting changes happening within Lincolnshire Community
CAMHS from April 2016.
Following a review of the service, involving over 55 stakeholder groups, a new delivery
model has been developed and commissioners have been successful in securing an
additional £1.4 million through transformation funds to deliver the new model from 4 April
2016.
The New Model
CAMHS will continue to provide community mental health services for all children and young
people, from birth up to the age of 18 years registered with a GP in the county of
Lincolnshire (or 25 years of age for care leavers).
In the new model, access to services has been reduced from 12 weeks to 6 weeks, with
shorter waiting times for certain vulnerable groups.
The remodelled service will operate according to Children and Young People Improving
access to Psychological Therapies (IAPT) principles and will no longer deliver services
according to tiers or in discrete teams which can lead to silo working.
This means that teams like the CAMHS Primary Mental Health or ‘Looked after Children’
Workers will no longer be in place and instead services will be offered through:
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A Single Point of Access (SPA).
Support to universal services, known as Targeted Early Access to Mental Health Support
(TEAMHS), to include:
o a Professional Advice Line,
o consultation clinics,
o a full programme of training for staff working in universal services,
o the development of self-help psychosocial education materials,
o the development of a directory of the local CAMH Services and other potential
services that may be beneficial to the young person.
An integrated CAMHS provision delivering evidenced based pathways and focused on
outcomes; this will be known as Core CAMHS.
Access to Crisis Intervention and Home Treatment 24 hours a day, 7 days a week.
A community based Eating Disorder Service known as CAMHS EDS.
Support to vulnerable groups including young people with a learning disability.
Care and support through transition.
This means that Looked after Children and those receiving support from the Youth Offending
Services will be able to access services in an equitable and non-stigmatising way; however
in recognition of the particular vulnerabilities of these young people a number of additional
supportive measures have been put in place and waiting times for services will be reduced
to:
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Looked after Children: face to face within 4 weeks.
Young people under the care of YOS: face to face within 3 weeks.
Service delivery will take place through the provision of a Hub and Spoke model, across
Lincolnshire.
Service hubs will be provided in Boston, Grantham, Lincoln and Louth in LPFT premises.
Spoke or ‘satellite’ clinics will be delivered to enable choice and care close to home, if
required. These will be in a variety of settings; for example: health clinics, community
centres, children’s centres, schools and hospitals to give the best chance of identifying a
mutually agreeable setting for appointments.
CAMHS will operate core hours of 9am until 5pm, Monday to Friday, with hubs open
between 8.30am and 5pm. However to ensure flexibility of access, the service will operate
later opening hours until 8pm each evening at one of the hubs, Monday to Thursday and, as
described above, crisis services will now be available 24 hours a day, 7 days a week.
Some key elements of the new service:
The Professional Advice Line
This will operate Monday to Friday between 9am and 4.45pm. It will be delivered by
experienced and qualified CAMHS staff and will provide:
 Consultation and advice to universal services.
 Criteria for referral and advice whether a referral should be made.
 A gateway to CAMHS for all professionals other than GPs, paediatricians and social
workers (other referrers such as school nurses, health visitors and YOT etc. will need to
demonstrate they have consulted the Professional Advice Line before a referral will be
progressed).
 Signposting to appropriate alternative services.
 Psycho-education.
 Anonymised advice about young people.
 Early prevention strategies.
Please note the Professional Advice Line will commence on the 11 April 2016.
The number to call is: 01522 309120
Core CAMHS
Core CAMHS will deliver care through a number of evidenced based pathways, these will
be:
 depression
 general anxiety
 social anxiety
 anxiety OCD/BDD
 PTSD and trauma
 self-harm
 harmful sexualised behaviour
 psychosis
 behaviour (the CAMHS element of the ‘Collaborative Lincolnshire Behaviour Pathway’)
 attachment disorder
 learning disabilities
o depression
o anxiety
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challenging behaviours/self-harm
There will be a wider range of interventions offered and this will include access to self-help
and a greater number of groups.
CAMHS Crisis & Home Treatment Services (C&HTS)
The function of the C&HTS will be:
 Admission avoidance.
 To facilitate early discharge from inpatient services.
 Providing crisis response and crisis support.
 Intensive home treatment.
 Assertive Outreach (support to Core CAMHS and CAMHS EDS with urgent concerns.)
 Support to CAMHS EDS home care.
 To undertake a gatekeeping function for admission to inpatient services.
The service will be available 7 days a week, between 8.45am until 7pm, 365 days per year.
Outside of these hours, cover will be provided for advice, crisis intervention and
emergencies by on call staff.
To ensure good wraparound care, the C&HTS will be based in the CAMHS hubs at Lincoln
and Boston.
In terms of young people in a crisis the C&HTS will operate two levels of response:
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For emergencies: a 4 hour telephone response and 13 hour face-to-face response. This
is for young people actively displaying suicidal ideation or suicidal attempts, severe
symptoms of depression with suicidal ideation, life threatening harm to self, harm to
others as a result of a mental health concern, acute psychotic symptoms or presentation
of anorexia with severe physical symptoms.
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For urgent: a face to face appointment within 72 hours. This is where children or young
people present as a risk to themselves or others but are currently safe and contained, to
include:
o Severe symptoms of depression.
o Symptoms of anorexia with BMI below 18 or above but with low physical
observations.
o Serious incident of self-harm that is not life threatening.
o Severe, unexplained deterioration in emotional state and behaviour at home and
school, not thought to be due to substance or alcohol misuse or physical illness.
o Symptoms suggestive of emerging psychosis.
o Follow-up after assessment for self-harm at A&E.
Young people’s Eating Disorder Service
As part of its new delivery model, future CAMHS provision will include a young people's
Eating Disorder Service (EDS), which will implement a NICE Guidance eating disorder
pathway to include anorexia nervosa, bulimia, binge eating and atypical eating disorders.
24 hour delivery of care will be provided with:
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The team operating Monday to Friday, core clinic hours 9am until 5pm, with home
support being in place 7 days a week until 7pm.
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Crisis support and home treatment out of these hours will be provided by the CAMHS
Crisis & Home Treatment Service.
To ensure the service is available in a flexible way, staff within the team will offer some
appointments at the CAMHS Hubs on the evenings they open until 8pm.
We are very excited about the changes and believe they will deliver improved services to
children and young people in Lincolnshire.
If you have any questions about the new service or would welcome further discussions;
please contact Sharon King, Deputy Director of Operations at LPFT on
[email protected] or 01522 577108.
In the meantime, please find enclosed a copy of the service’s referral guidance and a referral
form. Further copies of these can be obtained by contacting the Professional Advice Line on:
01522 309120.
Yours sincerely
Sally Savage
Assistant Director for Children's Services
Chief Commissioning Officer for Women and Children
Lincolnshire County Council
The new CAMHS model is commissioned by:
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Lincolnshire County Council
South West Lincolnshire Clinical Commissioning Group
Lincolnshire West Clinical Commissioning Group
Lincolnshire East Clinical Commissioning Group
South Lincolnshire Clinical Commissioning Group
The service is provided by: Lincolnshire Partnership NHS Foundation Trust (LPFT)