The way children and young people are helped with mental health issues, such as eating disorders, in Swansea and Neath Port Talbot looks set to change. The current service is run by Swansea Bay University Health Board in tandem with neighbouring Cwm Taf Morgannwg University Health Board - part of a wider network which also comprised Cardiff and Vale University Health Board until it withdrew four years ago.
Now, health leaders at Swansea Bay University Health Board are being recommended to break away from Cwm Taf Morgannwg and run child and adolescent mental health services (CAMHS) , as it is known, on its own. It follows a review which examined different ways of commissioning the service.
CAMHS helps young people aged up to 17 years and nine months by assessing and treating mental health problems and providing support to other professionals who educate and look after them. It has a £5.5m annual budget and provides an out-of-hours crisis response service, early intervention in cases of psychosis, and treatment for eating disorders, among other things.
A health board report said: "Performance has been poor historically but has recently improved with enhanced monitoring and a greater clarity on actions needed to improve performance." Recruiting and retaining staff has been a challenge for CAMHS across Wales, said the report. In February this year, the vacancy rate for Swansea Bay CAMHS was 44%, but has now fallen to 18%. Retention rates have also improved.
The report said GPs still had "major problems" accessing CAMHS, that the service didn't work as well as it could with Swansea and Neath Port Talbot councils, and that there were gaps in areas such as crisis support. "There have been a number of incidents over the course of the year where children are left stranded, but clearly needing support, in inappropriate settings such as accident and emergency and adult mental health wards," it said.
The report also said having two health board IT systems was frustrating for CAMHS staff, who ended up relying on paper-based systems. Demand for the service was also high, and the complexity of referrals has been increasing. This all led to the potential of safeguarding issues, said the report. But it added that the review found several areas of excellent practice, such as a strong new leadership team, dedicated and passionate staff, an early intervention focus, and improving patient satisfaction.
The review considered five options for changing the service, from doing nothing to offering it out to commercial bidders. The preferred option - serving notice on Cwm Taf Morgannwg University Health Board, save for a couple of functions - and running CAMHS in-house from April 1 next year, was felt to be the best way of making improvements. Board members will discuss the report at a meeting on Thursday, September 29.
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