Why children's mental health services need joint planning

Covid has cost our children dearly. The increased prevalence of mental health problems and rising demand for services may be temporary, but we all know that prior to Covid we needed greater resourcing from prevention through to complex case management in the NHS, education and social care. Now is the time for investment, for co-production, joint planning, and above all transparency to tackle inequity.    

In 2015, Future in Mind set out a consensus built on the experience of austerity and cuts. It committed to joint agency cooperation, prevention, early intervention, evidence based, outcome-informed delivery with the authentic participation of young services users and those who care for them. Across England, each local system worked with children and young people and families to agree and publish how this vision would be delivered. Up to the pandemic, CYPMH Local Transformation Plans were refreshed and republished annually, involving local populations, setting out the contribution by all partners to improved outcomes with action plans and timelines.  

When it comes to assessing progress in services for children with emotional or mental health needs, we focus on the NHS deliverables, because we can monitor them nationally in a way that is not possible in other agencies. Over the last five years, as NHS funded services have expanded, delivered or exceeded almost all its commitments made following the publication of Future in Mind, against a backdrop of rising referrals and prevalence, we must also celebrate and recognise the way in which other agencies have worked hard to deliver change and invest where they can.

This is clearly illustrated by the Feeling Heard summary of six joint targeted area inspections by Ofsted, the Care Quality Commission, and the police and probation inspectorates. As well as restructuring CYPMH - some 60 per cent of the country is now moving away from the old tiered model - Feeling Heard notes improved quality of service across statutory, voluntary and community sector partners. However, the report also shows that improvements are not universal, and how far there is to go to improve prevention, risk management and access for children and young people wherever they present.

It is no accident that the NHS Long Term Plan Implementation Framework commits Integrated Care Systems to go further in creating joined up plans for children and young people across physical and mental health, with specific deliverables which build on previous programmes. Increased allocations for CYPMH set out in the NHS Long Term Plan and this year’s Spending Review should drive further improvements. But unless we plan together, and if other agencies are cut again, we risk stalling progress or even going backwards. Mental Health Support Teams for example are designed to build on, not replace, existing services in education, whether school nursing, pastoral care, or organisations such as Place2Be.

This requires constructive debate and at times, hard decisions. These should be made with our communities as equals, ensuring everyone has a seat at the table.  

• Kathryn Pugh is former deputy head of mental health, NHS England - children and young people's mental health programme