• Pilot project for CAMHS aims to bridge disconnect between community and inpatient care
  • West London project one of two granted devolved commissioning powers to create new care models in the sector
  • Project leaders hope to integrate tier three and four CAMHS services to reduce number of admissions and length of stay in inpatient units

SERVICE DESIGN: A pilot project is aiming to bring greater integration to children’s mental health services and break the “disconnect” between community and inpatient care.

The West London CAMHS pilot is one of two projects in the sector with devolved commissioning powers to create new care models for tertiary mental health services.

The scheme is a partnership between West London Mental Health Trust; Central and North West London Foundation Trust; Priory Group; and the region’s clinical commissioning groups.

West London Mental Health’s director of business and strategy, Chris Hilton, said the pilot project will bring together tier three (community and outpatient services) and tier four (inpatient services) CAMHS to provide more care in the community, reducing admissions and lengths of stay.

Plans for the pilot project include:

  • tier three and four staff creating joint care plans for every child and young person admitted to inpatient beds;
  • community teams to work with tier four staff to work out what care is needed to help discharge a patient as quickly as clinically possible; and
  • working with out of area inpatients and tier four teams to develop plans to bring them back to local services where clinically appropriate.

Dr Hilton said the overarching aim is to strengthen the links between the two tiers, which historically have been “disconnected”.

He said: “One of the aims is trying to remove the disconnect which is perpetuated within the arrangement between the community services in tier three and admitted patients in tier four. That disconnect is not just in payment structures and provider structures, historically it’s in clinical teams and particularly for us in geography.

“By working together, by taking on new care models it is encouraging us to proactively bridge that divide between tier three and four.”

The trust’s CAMHS clinical director, Vijay Parkash, said the eventual aim was to break down the barriers between the tiers, which is recommended in the government’s Future in Mind report into child mental health.

She added: “We need a simpler system, breaking down the barriers which tiers create, looking at some of the innovative practices which are already happening in this country and abroad.”

The partnership will take over responsibility for an estimated budget of £10m in October to provide tier four CAMHS, which has previously been commissioned by NHS England.

Phase one will involve improving links between tier three and four staff to develop better discharge planning from the point of admissions to reduce how long young patients stay in hospital.

Phase two will involve enhancing the community teams to provide more care outside of inpatient units.

The pilot schemes were announced in July as part of NHS England’s response to the mental health taskforce, with more pilots expected to be confirmed by NHS England.

The West London CAHMS pilot will be spearheaded by the clinical leads from both trusts. It will use £150,000 from NHS England to hire a project manager, and pay for time and travel to assess out of area patients and bring them closer to home.