Agenda item

To provide the Health and Wellbeing Board with an update of the Brent Children’s Trust (BCT) work programme, covering the period April 2022 to October 2022.

Councillor Gwen Grahl (Cabinet Member for Children, Young People and Schools, Brent Council) introduced the update on the activities and priorities of the Brent Children’s Trust (BCT). In introducing the item, she highlighted the following key points.

·         She highlighted the critical role of different agencies outside of the Council, particularly the voluntary sector and healthcare, in the lives of children and young people, which she felt would become more important with the rising cost of living and resource pressures in the Council. She felt that BCT was vital in bringing all those various organisations together into one place to co-ordinate support for children, young people and families.

·         The report detailed the work being done by the BCT on the implementation of the SEND green paper. She relayed the experience of one parent who had disclosed that her daughter was not speaking when she was 2 years old and had entered reception still unable to speak. The parent tried to access support from her GP, Council and schools but was told her daughter was shy. When the parent’s daughter was 7, she began self-harming, and was no longer able to remain in mainstream education, moving in and out of various schools for the duration of primary school. The daughter had now been placed in a SEND school and had just finished year 7, which was the first time the daughter had finished a full school year since the age of 7. Councillor Grahl felt this case study highlighted the importance of early help and intervention. She was pleased to see the BCT were looking at a neurodiversity pathway review considering 42% of children with an Education, Health and Care Plan (EHCP) had a diagnosis of autism. She highlighted it was positive that there was a clear plan for this area to address gaps in provision and support families.

·         Nigel Chapman (Corporate Director Children and Young People, Brent Council) added that the focus for the BCT was now working on the 4 joint priority areas – inequalities, mental health and wellbeing, community services, and primary care. He felt that there had been good progress with looking at the details underneath those priority areas in the most recent BCT sessions, but acknowledged there were challenges that would be faced particularly around SEND. The challenges around demand for SEND had been heard at the most recent Community and Wellbeing Scrutiny Committee meeting, including the approaches the children’s services department were taking to deal with the increasing demand.

The Chair thanked Councillor Grahl and Nigel Chapman for their introduction, and invited contributions from those present. The following issues were raised:

• The Board were advised that there was currently no specific Autism Strategy in place for young people, however there was an expectation from the Integrated Care System (ICS) that there would be an Autism Board established in each borough, which Integrated Care Partnerships (ICPs) would have oversight of. The intention would be to jointly develop an Autism Strategy with the local partnership, and Nigel Chapman highlighted that the partnership had been particularly good at identifying the issue of rising autism diagnoses locally and responding through special school provision. He felt more now needed to be done to support children and young people with autism at an early stage through early intervention.
• Considering the high number of children waiting for an ASD or ADHD assessment, the Board queried why that number was high and how long it took once a child was referred to be assessed. Nigel Chapman agreed that the numbers were high and children’s services were ensuring this was dealt with as a priority within the NHS system. He felt the higher numbers were an indication of the greater awareness of ASD and ADHD now, and was another reflection of the huge growth of demand in the system over the past 4-5 years, which had seen an increase in EHCPs by 50%. It was agreed that Nigel Chapman would request the waiting times from referral to assessment from CLCH, who carried out the assessments.
• The Board queried how the BCT linked into the borough-based partnership to bring the NHS and local authority together to plan for the future. Nigel Chapman advised the Board that the ICP and children’s services colleagues had met twice within the last month to discuss priorities first, in order to ensure a shared vision, before looking at governance. It was agreed that something like a Trust needed to remain in the health system going forward to maintain operational focus of children as a priority within the system.
• The Board asked whether there would be any additional work done through the funding for the ‘Troubled Families Programme’. Nigel Chapman confirmed that the programme would be a continuation of existing work rather than additional provision. The Board heard that children’s services relied almost entirely on the Supporting Families Programme to fund intervention work which supported the Family Wellbeing Centres, triage officers, identifying families in need, Citizen’s Advice, and the Council’s own staff who worked with families needing higher levels of intervention.
• The Board heard that the success of the polio vaccination campaign was mixed, but the offer continued to be available at the Brent Civic Centre and there was a small and steady stream of parents bringing children in to be vaccinated. Dr Melanie Smith (Director of Public Health, Brent Council) encouraged anyone with a child aged between 1-9 years old to bring them in to the Civic Centre to get their polio vaccination.
• Simon Crawford (Deputy Chief Executive, LNWUHT) highlighted that Northwick Park were seeing increasing numbers of young people presenting through A&E with mental health issues and spending a long time in the hospital. He asked what the relationship was between the BCT and CNWL, who commissioned CAMHS, and whether there was focus on this within the BCT. Nigel Chapman confirmed this was a priority area under the mental health and wellbeing priority. The focus was on a ‘Thrive’ model, looking to deal with issues at a Tier 2 level opposed to Tier 3. In the past year, there had been focus on dealing with the waiting times for CAMHS, which had improved to around 11-12 weeks compared to double that the previous year. An important part of that work was educating frontline staff on when it was appropriate for a CAMHS referral to be made. Regarding presentation at A & E, the ICS were seeking to find Children’s Home providers that would take children as a step-down immediately from A&E in partnership with health colleagues, as it was unsatisfactory for children with behavioural conditions to be held in A&E for significant lengths of time. The Chair requested that this issue was raised at a borough partnership level to focus in on the approach.

RESOLVED: To note the report.