The Health and Wellbeing Board met on 22 January 2024 to discuss children's mental wellbeing and the Complex Care Programme. The Board noted the system's response to increased demand for mental health services for children and young people, and agreed to explore opportunities to work with the South London Partnership (SLP) on jointly arranged support for individuals with complex mental health needs.

Children's Mental Wellbeing

The Board received an update on the Sutton-wide response to the mental wellbeing of children and young people, following the Healthwatch Sutton report published in September 2023. This report highlighted the impact of the COVID-19 pandemic on 9-11 year olds, noting a decline in overall happiness, increased negative issues, and strained family relationships.

Attendees discussed current service provision and identified several gaps. These included a cumbersome referral process, a lack of awareness among young people and professionals about available support, and the need for better inclusion of parents and families. Suggestions for improvement included incorporating strategies for managing conflict and emotions, emphasising early intervention and low-level support, and offering flexible and accessible services, such as regular check-ins and mentoring. The pressure on teachers who provide support without being mental health professionals was also highlighted.

The Board resolved to note and discuss the system's response and ongoing priorities to address the increased demand on mental health and wellbeing services for children and young people. This aligns with the Council's corporate plan, Ambitious for Sutton, which prioritises high-quality, inclusive health and care services, with a specific focus on the mental wellbeing of children and young people.

Complex Care Programme

The Board was informed about the work being undertaken by the South London Partnership (SLP) across South West London to improve support for individuals with complex mental health needs. This initiative, known as the Complex Care Programme (CCP), aims to address the challenges faced by people with significant and often lifelong mental ill health, who may also experience co-occurring conditions such as autism spectrum disorder or substance misuse.

A key aspect of the discussion revolved around the responsibilities under Section 117 of the Mental Health Act 1983¹, which mandates a joint duty between the NHS and local authorities to arrange and fund aftercare for individuals discharged from hospital under certain sections of the Act. The report highlighted that this support has often been provided through expensive, variable-quality private sector placements, frequently located far from home.

The SLP's CCP has been working to review existing cases and support individuals to move to less restrictive settings closer to home. Phase One of the programme involved reviewing 100% NHS-funded cases, which led to some boroughs, including Sutton, taking on funding responsibilities for individuals where a joint duty existed. This resulted in Sutton Council contributing to the funding of eight cases, creating new costs for the council. The programme has also invested in community rehabilitation units to provide a more cost-effective and locally-based offer.

Phase Two of the CCP, which began in April 2023, now includes existing jointly funded Section 117 aftercare placements. The SLP is now responsible for these cases across South West London. In Sutton, there are currently 68 shared funded cases, with a significant proportion placed outside the borough. The Board agreed to explore opportunities for Sutton's People Services to work with the SLP in managing these jointly arranged support arrangements. The programme aims to improve outcomes, ensure better use of resources, and drive up quality through consistent contracting and performance monitoring.