Healthwatch Hillingdon: bridging the gap

The challenge

Our role is to be an independent champion for people, making sure that those running services, put people at the heart.  During a local authority review of child and adolescent mental health services, it seemed that there was a lack of engagement with children and young people.

During the summer of 2014, we listened to children and young people and their families with experience of services in Hillingdon. Parents reported that they felt that their children were being badly let down and that they were not being engaged.

This work and subsequent interim report, ‘Listen to Me’ published in collaboration with Hillingdon Mind, highlighted the struggles of children and young people with mental health problems in Hillingdon. It presented a selection of evidence and summarised the challenges that needed to be explored further. They also outlined how uncertain funding, a lack of early intervention and fragmented services were compounding issues; and called for a joint approach, from all stakeholders, to improve services.

The solution

The interim report ‘Listen to Me’ inspired a renewed commitment to improve services for children experiencing mental health problems, and led to Hillingdon Clinical Commissioning Group and the London Borough of Hillingdon forming a new Children and Young People’s Mental Health and Wellbeing Group. This group would oversee improvements to services and the development of a Joint Social Emotional Wellbeing and Mental Health Strategy. This strategy incorporated a number of the recommendations made in their publication.

Nationally, Healthwatch England used the report to directly influence the Government’s Children and Young People’s Mental Health Taskforce, which at the time was undertaking a major review of children’s mental health.

In March 2015, we began a wider process of listening.  As well as continuing the conversation with service users, they worked closely with the voluntary sector, schools, colleges, GPs and other front-line professionals, practitioners and local bodies to explore barriers. This five-month intensive programme of engagement with children, young people, their families and care professionals focused on gaining a better understanding of services. We wanted to produce a comprehensive report, which not only gave a rich evidence base of the lived experience of children, young people, parents and carers; but ensured that these experiences influenced and shaped future plans.

During its work, we took every opportunity to bring focus to children’s mental health, including:

• Influencing the expansion of the membership of the Children and Young People’s Mental Health Group to include schools and the voluntary sector
• Continuing to challenge the Clinical Commissioning Group (CCG), it’s governing body and the Health and Wellbeing Board, which led to the CCG requesting a Children’s Mental Health Needs Assessment and funding to:
  
  • Reduce the waiting list for the Tier 3 services
  • Establish a learning disability service
  • Establish an out-of-hours and intervention service at Hillingdon’s A&E Department
  • Establish perinatal mental health services.

In March 2015, the Children and Young People’s Mental Health Taskforce completed its review and published a report called ‘Future in Mind’; which echoed much of our research.

In July 2015, we published our second report, ‘Seen & Heard – Why not now?’.The report featured some uncomfortable hard hitting stories. It gave real insight into Hillingdon’s mental health and wellbeing services from a user’s perspective.

The impact

The engagement work undertaken by us influenced local and national responses to improving children’s mental health services.

Progress has been made on the implementation of the plan since its sign off, including:

• New services focusing on eating disorders, self-harm, crisis and intensive support and challenging behaviour
• A reduction in waiting times for accessing Tier 3 services; however until the implementation of initiatives to offer early help and prevention, system pressures will remain
• Engaging children and young people in the redesign of services
• Producing a ‘blueprint’ for commissioners to provide better support and services in Hillingdon.

Demonstrating local leadership and accountability

We have had a pivotal role in the formulation of Hillingdon’s Children and Young People’s Mental Health and Wellbeing Transformation Plan. The insight provided by their engagement framed much of its contents, and as a consequence were asked to countersign the plan with the Health and Wellbeing Board, Clinical Commissioning Group and the council, before it was submitted to NHS England for approval.

As a critical friend, and member of the Health and Wellbeing Board, Healthwatch Hillingdon continues to work with and challenge partners on the delivery of the transformation plan, ensuring services are being appropriately planned, and that children and their families/carers are involved in the process.