Child and Adolescent Mental
Health Services – Tier 3 Service
Specification
Lisa Wells
Commissioning and Redesign Lead – Women and Children’s Services
Shropshire Clinical Commissioning Group
Lisa.wells@shropshireccg.nhs.uk
Structure of CAMHS in Shropshire
 Shropshire CCG commissions:
 ‘Core’ CAMHS Tier 3 Service
 CAMHS Learning Disability Service
 Reaching Out Service
 One provider across Shropshire and Telford and Wrekin – Shropshire NHS
Community Trust
Background
 A review was commissioned by Shropshire PCT and Shropshire County
Council in 2011 to consider comprehensive CAMHS provision in Shropshire
(not just Specialist Tier 3 CAMHS)
 The two key findings from the Review:
 the lack of a robust commissioning strategy for a Comprehensive CAMHS
in Shropshire
 secondly specialist Tier 3 CAMHS is seen as a service that works in
isolation to the broader primary care services, education and social care
Areas for development
 A number of areas for improvement were identified:
 Data collection and needs assessment
 Understanding of pathways
 Understanding of criteria/threshold for the service
 Long waiting times
 Urgent referrals are not seen soon enough
 Issues with transition to adult mental health services
 Links to other services
Achievements to date
 Revised service specification for Tier 3 CAMHS and Reaching Out Service
(ROS) across Shropshire and Telford
 Single point of access for referrals to CAMHS - via Compass
 Service Development and Improvement Plan
 Joint CQUIN for transition for 2014/2015 between CAMHS and Adult Mental
Health Services (provided by SSSFT)
 Clear timescales for referrals
 Improved data collection and reporting to commissioners including weekly
updates on waiting times
Next steps
 Development of Compass including electronic referral form
 Development and communication of a range of clear pathways for
diagnosis and management of conditions
 A scoping exercise exploring the demand for extending hours provision
 Improvements to the 24 hour on-call arrangements, including scoping and
reviewing the current provision
 Development of joint working protocols to support the discharge of
patients from acute settings who require Tier 3 CAMHS
 Scoping the service requirements identified as a result of Special
Educational Needs and Disabilities (SEND) Reforms