Neurodevelopmental Conditions Service (NDC)
Service Developments
We continue to have long waits within the CAMHS NDC pathway for a neurodevelopmental assessment. These are assessments for children who we believe may be autistic or have ADHD. We are discussing this with the people responsible for funding our service and are working with colleagues across Berkshire and Buckinghamshire who have similar high demands.
Due to the number of young people who require follow up and treatment, we have had to reduce the number of assessments we carry out so that we are able to give more time for treatment.
We are working on several different resources to help support families to know what is available for their young person based on their needs rather than a diagnosis so that appropriate strategies and support is accessed when it’s needed. It’s important to remember that an autism and/or ADHD diagnosis is not essential for a lot of the available support, especially in a school setting.
Online Virtual Autism Assessment Tool
The creation and development of our Online Virtual Autism Assessment Tool (OVAAT) during Covid has made an incredible difference, using digital technology to assess and diagnose autism in young people. The tool allows us to understand the young person and the difficulties they are facing and gather the information we need to be able to diagnose autism.
The tool is appropriate for the assessment of children and young people who find it difficult to come to a service in person. This might be because of travel time, health reasons or location. Also, this tool can capture things standard screening can miss.
We are very proud to announce that the OVAAT tool has been nominated for an NHS Parliamentary Award. It is fantastic to see the recognition for all the hard work that has been put into developing this tool.
Pre-Assessment Offer
Over the last year the team has worked hard to offer support to families before they receive an assessment. In collaboration with Autism Oxford and NDC CAMHS we have developed the Living Well with Neurodiversity support service. This service is for young people and families who are known to Oxfordshire CAMHS services where there is a query or diagnosed autism or ADHD.
The offer includes:
An online monthly support space for parents
The “Essentials” course – over 4 sessions participants can learn more about the differences between autism and ADHD.
Opportunities to have one-to-one meetings with a variety of professionals including specialist teachers, occupational therapists and peer support practitioners.
A monthly in person social group for young people, with a separate space for parents to meet.
We would encourage families to take advantage of this amazing resource - Living with Neurodiversity - Autism Oxford UK Ltd
We also have developed a range of videos to help parents understanding 4 key areas that can be challenging for these young people:
Emotional Regulation: NDC Pre-assessment emotional regulation video - YouTube
Self-harm: NDC pre-assessment Self-Harm video - YouTube
Aggression: NDC pre-assessment Aggression video - YouTube
Owl Centre
Due to the demand for autism and ADHD assessments, we do at times use other providers to help us to provide assessments. Some of you will know that we have used Healios in the past for autism assessments and are currently using them for treatment in our Getting Help teams for anxiety and depression.
The Owl Centre also offers assessments for autism and we have been lucky enough to secure some money, so that they can see 400 of our longest waiters when the presentation is relatively straightforward. Initial feedback from the first families who have completed their assessment with the Owl Centre has been positive and we are really excited to be working alongside them and this will help with our service demand. All families that are to be offered these assessments have already been contacted.
You can find out more about the Owl Centre by visiting https://theowltherapycentre.co.uk/
CAMHS Eating Disorders
The Eating Disorders community team have made a real improvement with their waits for the service. In the past year they have reduced the waits for routine referrals to below the national target of 4 weeks. As part of their long-term plan, they have created the new Enhanced Community Pathway (ECP) which sits within the Oxfordshire Child and Adolescent Eating Disorder Service (CAEDS) and is described in more detail below:
Enhanced Community Pathway
The Enhanced Community Pathway has been created to give young people a better chance of their treatment working longer term. Research shows that by creating a positive change in behaviour and weight gain within four weeks, the treatment is much more likely to be successful.
The ECP aims to achieve the following:
Provide a minimum of three weekly contacts tailored to the young person and their families’ needs.
Reduce the referrals for crisis and home treatments.
Prevent admission to paediatric and psychiatric inpatient beds.
Improve treatment outcomes.
Support quicker discharges.
Monitor outcomes and outputs as well as identifying risks and potential benefits of enhanced care.
We have early evidence of the positive impact that the ECP is having on reducing patient admissions and the need for crisis support. In the last five months the average number of young people being supported across the CAED and the crisis team has reduced from ten to two at any one time.
Crisis Resolution and Home Treatment Team
We are due to welcome a Consultant Psychiatrist and Senior Clinical Psychologist from March.
We have seen a steady reduction in young people requiring admission to hospital due to the involvement of the Crisis and Home Treatment team supporting them to stay at home.
Single Point of Access (SPA)/Getting Help (GH)/ Getting More Help (GMH)
We are currently in the process of conducting a large-scale improvement project which will be reviewing the following areas:
What it is our GH / GMH teams offer and how this can be improved
Ways to make our processes slicker so that we have more time to see young people
How our assessment offer can be improved
The package of support offered to young people and their families whilst waiting for assessment / treatment
The purpose of this project is to ensure teams can offer a wider range of support to families whilst they are waiting and to increase the time they have available for both assessment and treatment so that we can reduce our waiting times. Specific work is also being undertaken regarding young people who may be neurodiverse.
Social Prescribers
Social prescribers work with the young person to focus on improving their health and wellbeing. They may help the young person think about social activities, support them to join a gym/other physical activities/think about social groups they could join or support them in looking for work.
We now have two new social prescribers in our Getting Help teams for one year and if the roles prove to be successful, we will then look at this role on a permanent basis.
Outreach Service for Children and Adolescents
The Outreach Service for Children and Adolescents support young people whose level of complexity requires more intensive services than can be offered with the Community Child and Adolescent Mental Health Services (CAMHS) out-patient services. The service aims to meet the needs of those young people who have not benefited through other parts of the service and have found it hard to engage due to the difficulties they are experiencing. Outreach offers intensive treatment packages which are tailored to each individual child and reduces the risk of their condition getting worse.
The team provides:
Wraparound Community Support which offers extra support for targeted treatment, whilst working alongside the young person’s usual CAMHS team.
Assertive Outreach – Working with other services to help the young person gain the support and treatment that they need where other Teams within CAMHS have found it difficult to engage the young person and the professionals supporting them
Dialectical Behaviour Therapy (DBT) treatment, a treatment pathway within Outreach, which is a specific treatment for young people with emerging Emotionally Unstable Personality Disorder (EUPD), or who have emotional dysregulation (they struggle to control or regulate their emotional responses).
Working with our voluntary sector partner Response we have introduced five Community In-reach workers within the team as of 1 February 2023. This is a really exciting development for both teams. These workers will be seeing young people in the community, providing a range of care and support.
Thames Valley Link Programme ‘Supporting children & young people in Complex Situations’
We are currently trialling a new way of working across Buckinghamshire, Oxfordshire and Berkshire. The role of the Thames Valley Link Programme is to provide additional support for the most vulnerable children and young people with complex needs between the ages of 0-18. This team links closely with our existing Outreach team.
We are really passionate about supporting children and young people with complex needs (CYP) in the Thames Valley (TV) to thrive in the community. We want to improve the way we identify and support these children early on, to engage them and their families (incl. carers) in creative ways to access the care they need, working with professionals across settings to ensure the young person receives the best possible care and to make it easier for them to navigate and access support.
The Oxfordshire based team went live on 12 December. The team have received 44 referrals and are offering advice, consultation, assessment and direct treatment.
Mental Health Support Teams (MHST)
MHSTs are teams that work within schools to support young people’s mental health and wellbeing. We are pleased to announce our team is growing and we have two new teams in the South of the county who will join the existing teams in the City and North areas. We recently introduced a youth worker role to the teams. These youth workers will run wellbeing groups as identified by the schools.
MHST youth workers will continue to support schools more broadly in their approach to mental health and well-being and will run well-being groups as identified by schools. When working with a young person, the MHST youth worker may also do some work with parents/ carers to build their confidence and awareness at supporting their child and will also support young people to access services in the community.
Systems Update
Following our IT outage in August last year CAMHS has a new electronic record system (RIO) which has been in place since January. We are now in the process of transferring all of the information from the old system into RIO and we expect this to be complete by September.
Please be assured this does not have any impact on the service we are able to provide you and your family, and our services are running as usual.
Participation
People who use our services are central to everything we do and the theme of involvement runs through every aspect of the trust. Every member of staff is part of a person’s experience of receiving care and treatment. We strive to provide the best possible care and outcomes for the people we work with and believe that involving people who use our services in co-design, co-develop and co-production is simply the right thing to do.
We have recently redecorated parts of Raglan House and as part of our commitment to patient involvement we are working with young people to choose some artwork for the walls. We do currently have vacancies in our participation team, but we will be recruiting for the roles soon. One role will replace Diane Statham as the lead and we are going to be advertising a Social media/website role too which we are really excited about.
The trust is developing a new participation strategy which will be completed soon. If you would like to be a part of our patient involvement team, please contact us at: Getinvolved@oxfordhealth.nhs.uk
Vicky Norman
Head of Service
Oxfordshire CAMHS
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