Children's Service Mapping

Provided by
Durham University Mapping Unit

CAMHS partnership profile for SAM

Herefordshire

Introduction

This profile is designed to provide information which will be helpful to the Partnership in completing the CAMHS Self Assessment Matrix (SAM).

It takes the data which has been entered in the annual Children's Services Mapping (CSM) exercise and sets this in the context of the questions asked in the SAM. We hope that this will be helpful. It will enable you to see and consider the data which has been entered and also provide objective information to assist discussion of your responses to the SAM in your Partnership.

How to use this briefing

Print off both this briefing and your latest response to the SAM. The idea behind the SAM is that it be discussed and agreed by the whole CAMHS Partnership. After discussion the SAM can be filled in online.

The section headings (i.e. 'Commissioning', 'Strategy') and the small roman numerals correspond to the question headings and references in the SAM. Not all the questions have data, which is why the references here are discontinuous.

The benefit of filling in online is that the data is safe until you next need it and that RDWs and the NCSS can use the scores to demonstrate progress in the implementation of the national CAMHS agenda.

None of the comments you make in the SAM nor your action plan are used for comparative purposes, only the aggregated scores.

This briefing is structured in the same way as the SAM (i.e. major headings on Partnership, Strategy, Commissioning, Workforce and so on).

If your Local Authority has not entered wider Children's Services information on Children's Services Mapping, please encourage them to do so - it will make briefings such as this more informative and useful to you.

1 Partnership working

Many of the questions on Partnership working are a matter of local record.

Prompts are set out in the SAM.

The reported position in respect of budgets is shown below. Points to consider are:

  • Are both major agencies making appropriate contributions?
  • Is financial data accurate?
  • Are decisions being taken jointly about the indicative CAMHS allocation within the ABG?

LA and PCT percentage contribution to CAMHS budget

Commissioner Total Spend 2008/091 Total Budget 2009/101 Population 0-172
Herefordshire PCT 1,484,887 2,006,200 0.372
Herefordshire, County of LA 0 0 0.000
Total
1,484,887 2,006,200 0.372
  1. Excluding individual care / spot purchasing
  2. ONS Mid-year estimates 2005 in 100ks Could not restrict by Service Type.

Mental Health Grant (MHG) notional allocation in Area Based Grant (ABG)

MHG 2005 177,000
MHG 2006 180,000
MHG 2007 184,000
MHG 2008 208,000
MHG 2009 434,000

2 Strategy

2.1 CAMHS SAM Profile Strategy CYPP

Children and Young People's Plan (Strategy Qi)

The status of the CYPP for the Children's Trust was as follows at February 2008

CYPP agreed and signed off by the Children's Trust Yes
CYPP published on the following websites LA.
CYPP deposited in local libraries Yes
Child friendly version of CYPP available Yes
Outline of actions to improve the outcomes for Children and young people with Special Educational Needs (SEN). Children and young people with disabilities. Children and young people looked after by the local authority.
CYPP sets out arrangements made by Board partners for cooperation on A workforce strategy to deliver priorities. Early intervention and preventative action. Safeguarding and promoting the welfare of children and young people. Improving the behaviour of children and young persons and attendance of pupils at school. Achieving education, early years, LAA and safeguarding targets (when available).
Children, young people, parents and carers were consulted during the preparation of CYPP Yes
Does your PCT have a CAMHS strategy? Yes updated in last 3 years
Is this strategy part of the Children and Young People's Plan (CYPP)? Yes
Does your PCT have a specific Service Level Agreement (SLA) for specialist tier 2-3 CAMHS? Yes
Is intensive home treatment and crisis management commissioned within tier 3 services? No

Points to consider:

  • Does each agency providing children's services make an appropriate contribution to comprehensive CAMHS? This will not just be financial but can include staffing, premises and other resources

  • How does the spend on Tier 2/3 services compare with statistical neighbours - are investment levels appropriate in relation to assessment of need?

Total spend per head on CAMHS services by the partnerships in your region

In this and the following graph only finance associated with a specific CAMHS team or CAMHS team type is included. Where finance data has been aggregated up to the level of all CAMHS services, this data has been excluded as it does not provide a useful basis for comparison within the services listed under the partnership.

Total spend per head on CAMHS tier 2/3 services by the partnerships in your region

2.2 Vulnerable Groups

Caseload from vulnerable groups

This table shows the number of cases from the partnership area that were identified within one or more of the vulnerable group categories of learning disability, looked after child or young person who has offended. The table shows the total CAMHS team caseload in the sample period as well to give an indication of the size of the overall CAMHS caseload identified with the following characteristics.

Cases: A case is a child, or a young person, or a child/young person and their family, for which a referral has been received and with whom CAMHS staff have actively been working. Where separate referrals were received for one or more siblings in a family, each sibling was counted as a separate case.

Sample caseload: The sample caseload is a count of the total number of cases worked with in the data collection period. This is collected at the team level only. If a number of staff within a team work with the same case it should be counted once. The team caseload is effectively a head count of those active cases that have been worked with in the sample period.

Service Learning Disability Cases LAC cases1 YO cases2 Sample caseload3
LD CAMHS Kite Team 53 3 0 53
Linden Team 59 12 1 216
Total
112 15 1 269
  1. Looked After Children
  2. Young Offender
  3. Total number of cases worked with in the sample period

3 Commissioning

Does joint commissioning make use of pooled budgets and Health Act Flexibilities? (Commissioning, Q.ii)

CAMHS None
Complex and continuing care None
Disability None
Youth offending None
Looked After Children None

Do commissioning arrangements:

  • Reflect developments in School cluster and Practice based commissioning?
  • Meet the requirements for World Class Commissioning?
  • Encourage collaborative commissioning across age, geographical and care group boundaries?

Have arrangements been made to mainstream fixed term funding initiatives where these meet strategic objectives?

4 Multi-agency provision of universal services

i Education interface programmes: number of teams which provide consultations to schools weekly, broken down by the type of school.

Service Primary schools1 Secondary schools1 Special schools1 Extended schools1
LD CAMHS Kite Team 0 0 1 0
Linden Team 1 1 1 1
Total
1 1 2 1
  1. Number of teams carrying out this function weekly

v Access to community based mental health services

Service Primary Mental Health Workers (FTE) fte in post1 Universal2
Linden Team 1.800 1
Total
1.800 1
  1. Includes Primary Mental Health Workers (FTE)
  2. Number of teams carrying out this function weekly

This information is also relevant to the Workforce statement: 'Teams have the capacity to provide support, consultation and face-to-face work in primary care settings'

5 Multi-agency provision of targeted services

Targeted CAMHS teams

Service No. Targeted Teams Target group for CAMHS team Total staff in post WTE Total staff in post WTE
LD CAMHS Kite Team 1 Specialist Mental Health Services for children with a moderate/severe learning disability including Down's syndrome 5.590 5.590
Linden Team 0 Eating disorder 0.000 0.000
Total
1 5.590 5.590

Individual care spend

Commissioner Total1 Spend 2008/09 Individual care1
Herefordshire PCT 621,995 621,995
Herefordshire, County of LA 0 0
Total
621,995 621,995
  1. Could not restrict by Service Type.

According to Children's Mapping you have the following facilities in your area:

Secure children's home No
Secure training centre No
Young Offenders Institution No

6 Multi-agency provision of specialist services

Much of this section is concerned with the establishment of care pathways and use of NICE Guidelines. Guidance on these is given in the CAMHS SAM questionnaire itself.

Use of the term care pathways is not intended to imply solely 'health' pathways - they should reflect the wider pathway towards appropriate assessment and intervention, whether that be social, health or both.

VS12-04 Score

Specialist provision for children and young people in crisis:

VS04: Full range of early intervention services 4

7 Workforce

Service Type Nurses In Post (WTE) Doctors In Post (WTE) Clinical Psychologists In Post (WTE) Educational Psychologists In Post (WTE) Social Workers In Post (WTE) Psychotherapists CAF In Post (WTE)1 OT In Post (WTE) Family Therapists In Post (WTE) Other Qual Therapist In Post (WTE) Other Qualified In Post (WTE) Other Unqual In Post (WTE) PMHW In Post (WTE) Managers In Post (WTE) Admin In Post (WTE)
Multidisciplinary generic CAMHS team 2.000 3.100 3.400 0.000 1.000 1.800 0.000 1.400 0.000 0.000 0.000 1.800 1.000 4.800
Targeted CAMHS team 2.400 0.390 1.000 0.000 0.000 0.000 0.000 0.000 0.600 0.000 0.000 0.000 0.000 0.600
Total
4.400 3.490 4.400 0.000 1.000 1.800 0.000 1.400 0.600 0.000 0.000 1.800 1.000 5.400
  1. Child, adolescent and family psychotherapists with the formal qualification and employed within this staff group.

The profile of staff in post and vacancies is shown. The total staff column shows the total FTE of staff working in teams that work within the partnership. The staff total apportioned column shows the estimated FTE staff working within the partnership i.e. excluding the proportion of staff that work in teams that cover this partnership as well as other partnerships. If the team works only within the partnership then the apportioned total should be equal to the staff in post.

Service Type Total staff in post WTE Total funded vacancies fte Total establishment fte1 Vacancy rate2 Staff total apportioned
Multidisciplinary generic CAMHS team 21.100 5.100 26.200 19.5% 21.100
Targeted CAMHS team 5.590 1.000 6.590 15.2% 5.590
Total
26.690 6.100 32.790 18.6% 26.690
  1. Staff in post plus funded vacancies
  2. Funded vacancies divided by establishment

Staff (apportioned) per 100k population

The recommendation from A Comprehensive CAMHS is that there should be 15 CAMHS staff per 100,000 population. The graph shows staff per 100k (all age population) for partnerships in the region. Where services cover more than one partnership the staff are apportioned between the partnerships.

8 Specialist CAMHS infrastructure

Admin staff per clinician

The RCPsych recommended guideline is 0.3 admin/ support staff per clinician. This graph shows the ratio of admin staff to clinicians across the region. Where services cover more than one partnership the staff are apportioned between the partnerships.

9 Accessibility

iii Are waiting times within Government targets?

Service Type Cases waiting less than 18 weeks New cases in sample period1 Proportion of cases waiting less than 18 weeks
Multidisciplinary generic CAMHS team 12 35 34.3%
Total
12 35 34.3%
  1. The number of cases that were new (seen for first time) to the CAMHS team caseload in the sample period

VS12-02 Score

Are young people aged 16 and 17 are able to receive a full service?

VS02: Appropriate services for age 16/17 4

10 Appropriateness and acceptability

Is routine evaluation in place and evidence used to inform service development?

None reported