Bedfordshire CAMHS Crisis Service – East London NHS Foundation Trust

In 2017 Bedfordshire CAMHS developed a targeted CAMHS crisis service in partnership with both local authorities, both acute hospitals, stakeholders (young people and families / carers) and BCCG. This targeted team operating 7 days / week with extended out of hours service will offer a rapid same day response to young people presenting in mental health crisis, diverting young people away from inappropriate accident and emergency depts, and / or paediatric wards by ensuring they access the right support, at the right time in a location that suits their needs.

Joint Winners - National CYPMH Awards 2019

Co-Production

  • From start: Yes
  • During process: Yes
  • In evaluation: Yes

Evaluation

  • Peer: Yes
  • Academic: No
  • PP Collaborative: Yes

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What We Did

In 2017 Bedfordshire CAMHS developed a targeted CAMHS crisis service in partnership with both local authorities, both acute hospitals, stakeholders (young people and families / carers) and BCCG. This targeted team operating 7 days / week with extended out of hours service will offer a rapid same day response to young people presenting in mental health crisis, diverting young people away from inappropriate accident and emergency depts, and / or paediatric wards by ensuring they access the right support, at the right time in a location that suits their needs. The team provide comprehensive specialist assessments with bespoke intensive community treatment packages to support the young person and family within their home environment.

 

Wider Active Support

The service works in partnership with our local GPs and has developed an urgent care pathway for young people who may present at local surgeries in mental health crisis by offering a same day assessment at a location of their choice, this pathway has diverted pressure on local A&E depts. Working closely with external partners (including the street triage programme and local A&E depts.) the team has developed pathways to improve rapid access to young people presenting in mental health crisis and co-ordinated / delivered training to services promoting mental health management thus enabling practitioners to have a greater awareness and more confidence in managing young people’s emotional and behavioural needs.This training programme is co-produced with our young people to form part of the PanBeds LSCB training programme and has been shared via webinars for other professionals to access. The team lead chairs the countywide crisis task and finish group with key stakeholders including representations from young people, local authorities, police, acute care and adult partners to ensure clear pathways are in place throughout the crisis journey, this includes the recent development of escalation process for young people awaiting social care / tier 4 input – an increasing pressure within Bedfordshire due to the lack of tier 4 provisions.

 

Co-Production

Beds CAMHS have a strong vocal people participation programme led by a dedicated People Participation Worker, which has been recognised by The Anna Freud Centre for commitment to services. The group consists of a variety of young people who are both accessing or have accessed services and are key to all areas of service developments, attend all recruitment panels and co-deliver training to external partners. Moving forward we are currently looking to appoint a parent governor to join our Senior Management Meetings.

 

Looking Back/Challenges Faced

Lack of tier 4 provision locally – especially helpful for brief acute assessment, this work is now being explored via the New models of Care Difficulty accommodating young people with social care needs due to lack of availability within the county – addressed with the escalation process now in place. IT systems – working on different IT systems across the system has led to communication being duplicated on each system.

 

Sustainability

Clear pathways in place Robust training programmes Development of podcasts to promote pathways and training packages

 

Evaluation (Peer or Academic)

Peer evaluation including young people, most recent inspection in January 2019 highlighted good areas of practice especially within this team and the training programme delivered – we are working closely with adult service and street triage to ensure the out of hours services are extended.

 

Outcomes

Reduced lengths of stay in tier 4 provisions / acute beds Reduced waiting time for assessment Admission avoidance into A&E / acute provisions The team use a variety of Routine outcome measures including goal based outcomes to monitor clinical outcomes. The team also use the chi-esq feedback routinely to demonstrate qualitative feedback, the recent feedback was received today: “What can we say! Thank you really doesn’t feel enough for what you have done to help us all as a family. This past year has certainly been a huge challenge for us all emotionally and physically. We are not sure where we would be now with our daughter without your huge input. You never gave up on her, whatever she threw at you. You were patient but also honest and open. You are an amazing person.”

 

Sharing

Routinely report via quality reports submitted to commissioners each quarter. Attending regional networking events Strong following on Twitter Quarterly stakeholder events Recent Radio broadcasting National TV short film nomination

 

Is there any other information you would like to add?

The team are incredibly service user focused, passionate about engagement and providing high standards of care when young people and their families most need it. The team work exceptionally well as a group of multi-agency professionals working with increased demand and potentially high stressful situations managing risk on a daily basis whilst ensuring they support and look after themselves as a whole team. The energy and creativity demonstrated within the team is commendable – this is evidenced via their team wellbeing activities, team away days and their Twitter following!

 

Can you please tell us who your service is commissioned by and provided by?

Bedfordshire Clinical Commissioning Group and ELFT

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