Minutes for Children & Young People Scrutiny Commission meeting, Jan 5 2009, 7.00PM official page

1.   

2.1.  Urgent Items
There were no urgent items

2.2.  Order of Business
The order of business was as per the agenda, although it was decided to take items 6 and 7 together.

3.1.  There were none.

4.1.  A number of errors were noted resulting from the way in which Modern.gov, the system which automates much of the committee papers process, presents data.  These included:

§  the omission of apologies from Commissioners who are not elected Members, notably Mrs Ludlow and Mr Bergman

§  the designation of Cllr Icoz as Chair of the Committee, in addition to being “in the Chair” at the beginning of the meeting.

4.2.  Ms Neidich highlighted an error on p.13 of the minutes, under the heading “Socio-economic mix”.  The second sentence of the fourth paragraph should read “Although they were small in number and did not present a great need, they were there and should be offered an appropriate service”.  The purpose of this statement was to highlight the use of crèche facilities while parents attend classes.

RESOLVED

That the minutes of the Children and Young People’s Scrutiny Commission meeting on 1^st December 2008 be agreed as a true and accurate record.

4.3.  Matters arising

Cllr Taylor drew Members’ attention to the two responses given to the matters arising.  These were in relation to the Health in Hackney Scrutiny Commission’s review of Childhood Obesity and the use of Information, Advice and Guidance services.

5.1.  There were no updates from Members of other Scrutiny Commissions.

6.1.  Cllr Taylor introduced Carl Blakey (Head of Commissioning, Children and Young People’s Services, LBH and CHtPCT), Pat Howley (Joint Commissioning Manager, LBH and CHtPCT), and Sarah Wilson (Director of Specialist Services, ELFT).  Mr Blakey and Mr Howley were invited to make an opening presentation.

6.2.  Mr Blakey began by highlighting to Members the common abbreviation “CAMHS”, which stands for “Child and Adolescent Mental Health Services” and is likely to be used often throughout this review.  The Head of Commissioning then delivered a presentation which covered the following major points:

6.2.1.  The definition of positive mental health, including the importance of good parenting in building resilience and mental health.

6.2.2.  The main types of mental ill health referrals (i.e. conduct disorder) and their prevalence in the borough.  Those covered by the term “other” (15%) encompass more than one type.  It was added that psychotic disorders are very rare in CAMHS and, if they do occur, are more likely to do so in later life.

6.2.3.  The focus on vulnerable children and young people.  Members were informed that it is important to make sure that the children most at risk get the right service as their needs can often be hidden.  This might be due to their status, cultural background or immediate family circumstances such as: being a refugee, cultural interpretations of mental health, mental ill health being overlooked due to other disabilities, abuse or neglect.  Sometimes the combination of problems can be so large that mental health can be overlooked.

6.2.4.  The approach to commissioning CAMHS in Hackney – most of which is done through the PCT.  Investment in the services comes largely through the PCT and the Council.  The premise of Commissioning is that it is based on need, with an emphasis on prevention and targeted work in the Borough.

6.2.5.  The model of four tiers which is the basis of Hackney’s approach to commissioning CAMHS:

§  services at Tier 1 are those provided in universal settings to promote positive mental health

§  Tier 2 has services provided by specialists working in community settings

§  Tier 3 comprises specialist services from multi-disciplinary teams for complex problems; and

§  Tier 4 deals with inpatient or day patient services.

6.2.6.  The range of authorities and agencies working in the Borough with responsibility for delivering CAMHS.

6.2.7.  The investment and expenditure of each authority with notable changes in the last year highlighted.  The vast majority of funding and expenditure comes from the PCT with an increase in Government grants in the current year.  It was emphasised that the figures made available to Members should not be taken as entirely accurate but represented the allocations at a high level.

6.2.8.  The location of services: where they are actually delivered.

6.2.9.  The new Hackney CAMHS Plan for 2008-11.  Mr Blakey explained the main objectives of the plan which included: earlier intervention; the need for an evidence-based approach to intervention; improving access; and improving efficiency and value for money.

6.2.10.  The Plan also presents a  ...  view the full minutes text for item 6.

A copy of the Executive Summary is provided for Members to discuss within the context of the Commission’s review of CAMHS.

This item was considered in conjunction with ITEM  6 above.

This review report was published in February 2007, and is available here to provide context for Member’s discussion of their current review of CAMHS.

8.1.  Cllr Taylor drew Members’ attention to this report on CAMHS which was produced by the Health in Hackney Scrutiny Commission in 2003. 

8.2.  The Chair advised Members that it would be important to bear its contents in mind during this current review and consider the extent to which what was said then has been taken into account since.

9.1.  The Chair asked Members if they had any comments to add to the proposed terms of reference.  None were received but Cllr Taylor reminded Members that they could raise the matter at any point in the future.

10.1.  Cllr Taylor advised Members that a summary of the Audit Commission’s report “Are We There Yet?”, regarding the improvement of governance and resource management in Children’s Trusts, were tabled at the beginning of the meeting.

10.2.  Cllr Siddiqui commented that the Commission had formerly received copies of the Council’s Forward Plan of Key Decisions.  This gave Members an opportunity to consider in advance any issues which they might like to ask questions about at a future meeting.

10.3.  Cllr Taylor reflected that consideration of the Forward Plan is a role undertaken by the Overview and Scrutiny Board.  The Chair also commented that the Plan is a public document and any Member would be welcome to bring issues raised within it to the attention of the Commission.

10.4.  Cllr Taylor asked the Overview and Scrutiny Officer to explore the possibility of extracting relevant items from the Forward Plan so that they might be considered on the Commission’s agenda in future.

ACTION

That the Overview and Scrutiny Officer report to the Children and Young People’s Scrutiny Commission on the options available regarding including the Forward Plan on future agendas.