Agenda item

To provide an update on the newly designed and commissioned emotional wellbeing and mental health support offer for children and young people in Brent.

Sarah Nyandoro (Head of Place, Mental Health & Wellbeing (All Age), Brent ICP) introduced the report, which provided an update on specialist CAMHS arrangements, and plans for a neurodiversity profiling tool, a children and young people’s crisis safe hub, and a newly designed and commissioned emotional wellbeing and mental health support offer for Brent’s children and young people known as the Local Young People Resources and Advice Service (LYRA). In presenting the update, she highlighted the following key points:

·       She asked the Board to note the increase in demand for mental health services in Brent and the work being done to reduce the neurodiversity assessment waiting list as well as the work to develop a neurodiversity profiling tool. She highlighted the new crisis safe hub being developed in Brent and the pilot for children and young people focused on early intervention and prevention.

·       In relation to specialist CAMHS, she confirmed that services continued to see an increase in the number of children being referred for support and treatment. The CAMHS caseloads in Brent had increased by 22% in only the last 12 months, making up 1/3 of the overall CAMHS caseload of the 5 CNWL boroughs. Around 13 referrals a day were being received and, in the last 4 months, 1,096 new referrals to specialist CAMHS had been received, with a projected continued increase in caseload in the coming years.

·       In addressing the CAMHS demand, there had been some non-recurrent funding allocated in 2025-26 to Brent CAMHS to support in clearing the backlog of children and young people waiting, but she highlighted the challenge in receiving funding at the end of March that was required to be used by the end of March. As a result, it was unlikely that the non-recurrent uplift would decrease demand to an equal level with other CNWL boroughs, as the demand within Brent for specialist CAMHS was unsustainable.

·       She had previously signalled to the Board that there were also backlogs in the neurodiversity assessment waiting list. NWL ICB had provided non-recurrent funding to support clearing the assessment waiting list, in terms of numbers and length of wait time. This had helped reduce the assessment waiting list from 900 in December 2025 to 199 in March 2026, and reduced the waiting times from 34 months in December 2025 to 12 months in March 2026. She highlighted that 12 months was still a long time to wait for children and young people, and she had not been advised of any plans at an ICB level to provide additional resources to manage that level of demand for neurodiversity assessments.

·       In Brent, a neurodiversity profiling tool was being designed which would be a needs-based tool that could be used whilst children and young people waited for a diagnosis. This did not remove the need for a diagnosis for children and young people but helped identify need at an early stage prior to assessment, allowing schools and health providers to make adjustments and put in place care and education packages of support ranging from Speech and Language Therapy to specialist mental health support. The tool would typically assess speech and language, attention, sensory processing and emotional regulation. She hoped this would provide parents with help managing children and young people while they waited. In order to progress this, funding had been identified by CNWL and NWL ICB, but the ICP was still looking for additional funding to pilot the tool across Brent and Ealing.

·       Work was also underway on a Brent Crisis Safe Hub, offering an alternative space for children and young people to go. Currently, the largest numbers of children attending A&E in mental health crises were from Brent, presenting with suicide ideation, self-harm and emotional distress. The ICP was looking to develop this safe hub to act as a crisis intervention service for children and young people in Brent to receive clinical and non-clinical support, which would be based in the community. The hub would be open to children, young people, and their parents, who could self-define what the crisis was for them with no need to meet a particular criteria to attend the space. The ICB had worked with parents, carers, children and young people to develop a service specification for the safe hub and were now looking to go out to tender, with a view to bring in a provider by late summer 2026. A similar hub had been developed in Ealing which officers had been learning from.

·       Members were also given details of the new Local Young People Resources and Advice Service (LYRA), which had been developed in consultation with children and young people. The purpose of the service was to provide early intervention and prevention for children and young people, responding to the increased mental health needs of the young population in Brent. The new service was in line with the THRIVE model of care, focused on ensuring advice, advocacy and support was provided, a ‘get help’ offer was available, a ‘get more help’ offer was available, and that help was being provided for children and young people presenting with risk. LYRA would have a partnership approach with 4 providers working in collaboration with each other and a single front door, so all referrals went through the same single point of access within CNWL.

The Chair thanked Sarah Nyandoro for the introduction and invited contributions from those present, with the following points raised:

• Dr Rammya Mathew expressed that she hoped LYRA would be transformational for children and young people. The service had been presented across primary care forums and well received by GPs who saw the service as a good way to provide support to those who did not meet the criteria for specialist CAMHS.
• The Board was pleased that the neurodiversity waiting times had reduced dramatically over the past few months from 24 months to 12 months, which they felt was clear had been achieved by the non-recurrent uplift in funding received to reduce those waiting lists. They expressed the need to be able to deliver the transformational changes required to reduce waiting lists and deliver care without being reliant upon uplifts each time. Sarah Nyandoro confirmed that there would be no additional investments into the neurodiversity waiting list, but the ICB was working with a provider, Helios, to provide online assessments to clear the backlog where possible and maintain the shorter waiting times. Some children and young people required a face-to-face assessment which Helios would not be able to provide. Tom Shakespeare highlighted that the assessment waiting times were a national challenge and lobbying was taking place at a national level to ensure consideration of the challenges and different ways services could be delivering in this space. Whilst that ongoing national work took place, he felt that the prevention space that was being developed would be essential to maintain a ‘waiting well’ approach and help navigate children away from the need for specialist CAMHS.
• Further considering the one-off funding provided to reduce waiting lists, the Board asked how long that funding would last and whether it was expected demand would rise quickly once that had been used. Tom Shakespeare responded that it was expected demand would start to increase again, but he hoped that the preventative interventions being developed, as outlined in the report and presentation, would start to have an impact on the level of that increase. He expressed hope that the new West and North London ICB would recognise the challenges and put additional investment in to prioritise CAMHS and neurodiversity. The one-off funding was allocated for the previous financial year, so CAMHS was working through the case list of those who had already been on the waiting list before the end of March 2025.
• Simon Crawford (Deputy CEO, LNWH) advised of the recent comments by Dr Nick Broughton (National Director for Mental Health, NHSE) at the National Health Conference regarding the rise in demand for children’s mental health services and the need for greater investment. As such, Simon Crawford emphasised that the demand being seen across services for children’s mental health support was not unique to Brent, although it was particularly acute in the borough. From an acute hospital perspective, he welcomed the crisis hub and LYRA as potential avoidance of attendance at A&E, which was not the appropriate environment for children and young people in crises. He asked how LYRA would link with A&E services. Sarah Nyandoro advised that LYRA would be part of the acute pathway for mental health, which would ensure those children were being redirected from A&E towards the appropriate services. Tom Shakespeare added that the neighbourhood model approach and work within the Family Wellbeing Centres would also be essential to ensure a coherent mental health offer was provided to reduce the number of paediatric admissions. This would require combined efforts across the Council, primary care, CAMHS, the voluntary sector and community services.
• The Board asked what other local areas were doing in this space and whether best practice was being shared across areas. Sarah Nyandoro highlighted that the work Brent was doing was broadly in line with what other outside boroughs were doing to develop alternative ways to support children and young people.
• In response to queries about how children and young people would access the front door, Sarah Nyandoro explained there would be a single point of access through CNWL, which GPs had direct access to. Work was underway to give parents the same direct access to the front door rather than going through GPs.
• In relation to the neurodiversity profiling tool, the Board asked what data would be collected through that to show its impact. Sarah Nyandoro explained that this was being tested as a pilot in Brent and Ealing for up to 18 months, with the impact evaluated after that to enable the new North and West London ICB to make a decision on future investment into the tool.
• Nigel Chapman (Corporate Director Children, Young People and Community Development, Brent Council) signalled the recently published government white paper on SEND, with an expectation for local areas to produce a plan around preventative approaches to SEND and additional learning needs and return that to the DfE by June 2026. The new expectations came with funding attached and an ‘experts at hand’ offer to be developed by each local area to support schools more effectively. He would provide updates on this to the Board as the work progressed.

As no further issues were raised, the Board thanked officers for their presentation and commended the work done to reduce the neurodiversity waiting list and times over a 4-month period. The Board looked forward to receiving an update on sustainable resourcing for service models in the future.