MINUTES OF THE FACULTY OF CHILD AND ADOLESCENT
PSYCHIATRY OF THE ROYAL COLLEGE OF PSYCHIATRISTS
IN WALES
Held at The Lake Country House Hotel,
Llangammarch Wells, Powys
18th April 2008
1.
Present: Dr H Holmes (Chair), Dr C Lamb, Dr R Glaze, Dr H Behi,
Dr P Gore-Rees, Dr E Kapp, Dr C Ball, Dr C Govan, Dr W Barber,
Dr A Hassan, Dr P Duthie, Dr A Dwyer, Dr S Awadalla, Dr W Lloyd,
Dr R Potter, Dr A Ubeysekara, Dr P Roots.
2.
Dr
Dr
Dr
Dr
Apologies: Dr O Sola, Dr S Elsayed, Prof. R Williams, Dr K Lynch,
T Lorenz, Dr U Geethanath, Dr M Hasan, Dr A Sabir, Dr D Williams,
L Eve, Dr S Boyd, Dr P Reddy, Dr G Davies, Dr T Munoz, Dr S Ames,
G Salmon, Dr P Halford, Dr A Darwish, Mr M Griffiths, Dr D Williams,
A Ahuja, Dr H Barton, Dr P Menzies, Dr A Goel, Dr H Hayes.
3.
Minutes of last meeting – 19th October 2007
4.
Matters Arising
FACTS meeting with HCW, Commissioners and Clinicians from North and
South Wales arranged for 24th April in Caerphilly.
Welsh Schools Debate:- No progress as yet, can go ahead re finances.
5.
Chair’s Report
Dr Helen Holmes
a)
Many of you will know that I have changed jobs within the Cardiff
and Vale area recently. I have moved from being the Consultant
covering the East of Cardiff at tier 2/3 level to being Consultant for
the CIT team covering Cardiff and Vale working at tier 4 level. The
move took place on 1st March 2008 having been delayed from 1st
Jan and 1st Feb 2008. The relevance of this to a college report is
that my time and more importantly my attention has been largely
taken up with things other than the Royal College of Psychiatrists
and my role as chair of this group.
Due to my ongoing lack of time to do justice to the requirements of
the role of Chair I have decided to step down as soon as is
practical. My term of office would come to an end in the Summer
of 2009, but I think that it is important to have an active
representative for CAMHS in Wales before then.
The Chair of this group sits on two other college committees.
These are the Executive Committee of the Welsh Division of
Psychiatry and the Executive Committee of the Faculty of Child and
Adolescent Psychiatry.
Discussion within the Faculty of Child and Adolescent Psychiatry has
continued into the issue of the number of CCTs for psychiatry. The
child and adolescent faculty is continuing in its opposition to a
single CCT.
The Welsh Division was involved with the response to the proposed
new Mental Health Act and is part of the Implementation Reference
Group, which continues to work on the Code of Practice for Wales.
The National Assembly for Wales is proposing to take backbench
legislation in the form of a Legislation Competency Order with
regards to the new Act, and the Division hopes to engage in this
process of interpretation and implementation.
The Division has developed a two-way consultative relationship
with the Welsh Assembly Government. The chair of the Division
meets with government officials to discuss issues of priority for
mental health services in Wales.
The Division has contributed to reviews of service developments
including the strategic review of secure mental health services in
Wales and the Burrows Greenwell review of the structure of mental
health services across Wales. Both reviews are due to report in
early 2008.
The Division Biannual General Meeting is on 25th April 2008 in
Swansea. This will be a joint meeting with the Welsh Psychiatric
Society. The two organisations are working with the University
Departments of Psychiatry in Wales to rationalise meeting for
psychiatrists.
b)
Dr Lamb reported from the last Child and Adolescent Faculty
Executive Committee Meeting at the Royal College of Psychiatrists
in London on the 11th March 2008 as Dr Holmes had been unable to
attend.
She reported that the Child and Adolescent Faculty was supporting
with determination the wish to keep a separate CCT in Child and
Adolescent Psychiatry. Greg Richardson, the current chair of the
faculty had written to PRETB, the GMC and the Head of Education
and Training and Development at the DoH to inform them of this.
Copies have gone to the Children’s Commissioner in England, Wales
and Scotland, to Richard Williams as Chair of the Academy of Royal
Medical Colleges in Wales and to Val Anness the chair of the Welsh
Division. A copy of the letter is attached to these minutes.
(Appendix A)
The meeting was informed that the next Child and Adolescent Faculty
Residential Meeting will be from 17th to 19th September 2008 in Liverpool.
The venue of the 2009 meeting has not been confirmed.
6.
Training Issues
Dave Williams unable to be present. Dr Lamb reported that members
of the Faculty Executive have been working on the curriculum for Child
and Adolescent Psychiatry training and that this might in the future
link in with the re-validation process for consultants.
7.
Secretary / Treasurer’s Report
Summary of accounts – 18th April 2008
Balance at 1st October 2007 = £2,269.71
Receipts
£945 in payments for October 2007 meeting
£100 in payments for October 2007 meeting
Payments
£1,175.00 to Lake Hotel for October 2007 meeting
Balance at 25th March 2008 = £2,139.71
8.
Regional Representative’s Report
9.

John Talbot sent his apologies and announced he wished to stand
down as Regional Representative as soon as possible.

He had sent some information via Helen Holmes for feedback.
There were concerns re: workforce and capacity issues in West
Wales that Dr Ann West would address in more detail.

Concern was expressed that the safeguards put in by the Royal
College of Psychiatrists to ensure good training for junior doctors
were being eroded in both NHS Trust and Foundation Trust
Hospitals.
Vacant posts within the Faculty of Child and Adolescent
Psychiatry of the Royal College of Psychiatrists in Wales.
1)
2)
Chair of Child and Adolescent Faculty (Welsh Division)
Regional Representative for the Child and Adolescent Psychiatry in
Wales.
1)
Dr Helen Holmes proposed Dr Lamb as new chair of the CAP faculty
(Welsh Division). This was seconded by Dr Talbot in his absence
and agreed by all present. Dr Clare Lamb was hence duly elected
as Chair. This resulted in the post of secretary becoming free.
A request was made for proposals and seconds for the post of
secretary. There were no willing applicants during the meeting.
Action: Helen Holmes to request nominations by e-mail.
2)
10.
Dr Robert Potter was proposed as new Regional Representative.
This was seconded and supported by all present. Dr Robert Potter
was hence elected as Regional Rep. This will be taken to the next
exec meeting of the Royal College on June 18th 2008.
COMPASS Indicators’ sub-group
Helen Hayes was unable to attend but Clare Ball provided feedback to
the meeting. The sub-group met in November 2007 and a provisional
data sheet has been developed (included for circulation).
(Appendix B)
There was a lack of clarity about whether WAG was planning to
discontinue the COMPASS process. Clare Ball and colleagues planned
to try to ascertain further information on this prior to going further
with the work.
11.
Tier 4 CAMHS in Wales
1)
South Wales: Harvey Jones Unit has now moved to new premises.
Official opening scheduled for May. Emergency beds not yet open.
Financial disputes reported with HCW. Some referrers finding this
difficult as has consequences for HJU to respond to the clinical
need.
2)
North Wales:
Final Business Case now with WAG for “new build”
on Abergele Hospital site. HCW have agreed to fund current Cedar
Court Unit to open 24/7. Successful recruitment of nursing staff
proceeding well. New Staff Grade post soon to be advertised.
12.
Audit of Vacancies
Conwy and Denbighshire 220,000 population
2.4 wte CAMHS. No vacancies.
North Wales Adolescent Service (Tier 4 CAMHS)
1.2 wte. No vacancies
Bangor 186,000 population
0.7 wte and 2 vacancies.
Flintshire 148,000 population
1 wte and 1 vacancy.
Wrexham 150,000 population
0.8 wte and 1.2 vacancy.
Powys 126,000 population
1.4 wte, 1.0 vacancy (0.6 filled by locum).
Ceredigion, Pembrokeshire and Carmarthenshire
362,000 population
2.0 wte and 1.3 vacancy
Swansea, Neath and Port Talbot 400,000 population
3.5 wte and no vacancies
Cardiff and Vale 420,000 population
3.8 Community, 2.0 HJAU and 0.8 locum, 1 vacancy (CITT)
Mid Glamorgan 440,000 population
4.2 wte and 1 vacancy with locum in post, and 1 wte CITT.
Gwent 560,000 population
6.6 wte and no vacancies.
Learning Disability – 1 wte North Wales
Higher Trainees
South Wales
SPR’s – 8 in post – 1 vacancy.
North Wales
1 ST4 post in North Wales.
12.
Any Other Business
1)
Dr Lamb reported that the Vice President of the Royal College of
Psychiatrists, Dr Roger Banks was the lead in the College for
Primary Care. He has requested the input of a Child and
Adolescent Psychiatrist from Wales into the Forum for Mental
Health in Primary Care. Dr Bob Potter expressed an interest and
Dr Lamb will pass his name on to Dr Banks.
2)
ADHD Research. A report was made on behalf of Professor Thapar
for referral of cases to the SAGE study. (Leaflet attached). Please
consider referral of any patients with ADHD. Clinicians present
stated that patients they had referred found the research process a
positive experience. (Apendix C)
3)
Dr Ann West described some difficulties and capacity and workforce
in West Wales since a consultant post vacated by a colleague in
January 2008. The colleague had been off sick for a long period of
time prior to January. She explained that they were left with a
number of difficulties and in addition the Trust and CAMHS
community network were moving towards ADHD being an exclusion
criterion of referral to specialist CAMHS. Dr West expressed
concerns about the impact on services for children in West Wales.
Action: Dr Holmes to write to Val Anness and Dr Gary
Richardson on behalf of the Welsh Group Child Psychiatrists.
She will request whether Val Anness might raise the issue
with the Minister for Wales.
4)
Dr Lamb asked on behalf of Dr Peter Gore-Rees if any members
were aware of any particular drivers/policy re therapeutic foster
care in Wales. Members were not aware of any.
5)
There was an acknowledgement of difficulties with respect to
CAMHS Learning Disability Services across Wales.
6)
Discussion took place about the proposed subjects for the next
meeting. Proposals were put forward for a presentation/discussion
on ‘New Ways of Working’ as applied to CAMHS and/or Bipolar
Disorder in Children and Adolescents.
7)
Thanks were extended to Dr Habib Behi, ST4 in North Wales and
Mr Paul Barber, trainer in Mental Health Law for excellent
presentations/teaching sessions on the Mental Health Act (2007).
Thanks were also extended to Dr Awadalla, SpR, following an
interesting poster presentation of an Audit on the use of
Risperidone in Children.
13.
Dates of next meetings:1)
2)
Friday 17th October 2008
Friday 24th April 2009
To be held at The Lake Country House, Llangammarch Wells, Powys.