Presentation to the Heads of Service on Future Challenges for Child Mental Health Services from a Clinical Psychology Perspective

1. Child and Adolescent Mental Health Simon Lalonde Head of Department Birmingham Children’s Hospital

2. Key Drivers Policy drivers NSF, NWW, CAMHS Review, Aiming High, New Horizons Performance Targets 18 week to treatment, Public Service Agreements + National Indicators (Learning Disabilities, 24/7, early intervention) Finance and resources ‘health recession’ (Negative growth), public finance, savings (Tier 3.5) Risk management Reduce risk, evidence learning, improve accountability, Safeguarding People Expectations, relationships, politics, Local Authority

3. Implications Improving outcomes Emphasis on evidence e.g. Brighter Futures, SDQs Greater efficiency / better value Less waiting, shorter interventions, cheaper service Fewer headlines / crises Safeguarding, death, cleanliness More diverse workforce Fewer profession based jobs – jobs based on skills and competencies

4. Service and Professional Challenges Mental health services are part of a system – efficacy depends on others (implications of CAF) Frustrations of working in multi-disciplinary systems – no-one wants to give up power or take responsibility Expectations are unclear - managing the voices Delivering services is getting harder – greater demands – but less flexibility for staff

5. Key things to work on Promote accurate and robust information – using audit, research etc. Ensure staff develop core clinical skills and competencies Address grading and skill mix issues Improve + maintain standards – responding to poor or out of date practise Embrace wider responsibilities and encourage other senior staff to take on multi-disciplinary leadership