The Health and Wellbeing Board met on 22 January 2024 to discuss children's mental wellbeing and the Complex Care Programme. The Board noted and discussed the system's response to increased demand for mental health services for children and young people, and agreed to explore opportunities for collaboration 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 Healthwatch Sutton report concerning the mental wellbeing of children and young people. The report highlighted that the COVID-19 pandemic had a significant impact on the mental wellbeing of 9-11 year olds in Sutton, with factors including missed social events, reduced physical contact, and parental employment and mental health issues contributing to this decline. The findings indicated a particular increase in negative issues for girls, such as school pressure and online bullying.

Attendees discussed current service provision and identified gaps, including a referral process that can be cumbersome and off-putting for young people and families. There was a consensus that greater knowledge and information about available services are needed for both young people and professionals. The importance of including parents and families in the support process was also emphasised, alongside the need for strategies to manage conflict, emotions, and relationship building. The discussion also highlighted the significance of early intervention, advocating for low-level support to be accessible to all, not just the most vulnerable, and stressed the need for flexibility in services to ensure young people can access support now and at the right time. Mentoring was suggested as a valuable form of regular contact, and social prescribing for young people was also considered. The pressure on teachers who provide support without being mental health professionals was also noted.

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.

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 programme addresses the joint responsibility of the NHS and Local Authorities, including Sutton Council, to arrange and fund aftercare for individuals discharged from hospital under Section 117 of the Mental Health Act 1983.

The report highlighted that people with complex mental health needs often experience lifelong mental ill health, potentially alongside other challenges like autism spectrum disorder or substance misuse. These individuals may require lengthy hospital admissions and ongoing intensive health and social care support to live in the community. Historically, such support has often been provided through expensive, variable-quality private sector placements, sometimes far from home.

The Complex Care Programme (CCP) aims to improve the quality and cost-effectiveness of these services. Phase One of the programme focused on 100% NHS-funded cases, leading to joint reviews that resulted in Sutton Council taking on some funding responsibilities for eight individuals, costing approximately £279,240 annually. The programme has also invested in community rehabilitation units, which are fully funded by the SLP and are expected to benefit 54 people annually across South London, generating significant efficiencies.

Phase Two of the programme, which began in April 2023, includes existing jointly funded Section 117 aftercare placements. In Sutton, there are currently 68 such cases, with a total weekly cost of £108,848, largely funded on a 50/50 basis. A significant majority of these individuals (76.4%) are placed outside of the borough. The SLP and Sutton Adult Social Care are developing a programme of joint reviews for these cases to ensure consistent best practice and effective resource utilisation. The report also outlined four priorities for joint working: increasing access to settled accommodation, improving collaboration between clinical and social care teams, developing a consistent approach to commissioning and contracting, and exploring specialist provision for priority cohorts.

The Board resolved to note the NHS and Council's responsibility under Section 117 of the Mental Health Act, acknowledge the work undertaken between Sutton Council's People Services and the SLP in managing complex care mental health placements, and agree to Sutton People Services exploring opportunities to collaborate with the SLP on jointly arranged support for Sutton residents with complex mental health needs.