Central Manchester University Hospitals Foundation Trust (CMFT) provides child and adolescent mental health services for Manchester and Salford. They believe using the needs based approach of the THRIVE Framework for system change (Wolpert et al., 2019), along with the i-THRIVE Approach to Implementation will help them to deliver on the aims set out in Future in Mind including increasing access to services for children and young people. For them, a major advantage of using the THRIVE Framework to guide their transformation is that it will foster a shared understanding across the system about the services available to meet the needs of children and young people ‘Getting Advice and Signposting’, ‘Getting Help’, ‘Getting More Help’ and ‘Getting Risk Support’.
The arrival of the first ‘THRIVE’ practitioners was in spring 2017, employed by a third sector organisation and sitting within the early help offer bases of Children’s Services. Specialist CAMHS offer duty/on call support to the team and one-day input from a Consultant Psychiatrist.
CMFT used i-THRIVE’s suggested evidence-based approach to implementation by first establishing an in depth understanding of their current system, including what young people and staff from all agencies think about how it is working now. They started by engaging with staff across their system in pathway design, defining the services and teams that will provide care for the children and young people in each of the THRIVE Framework needs based groupings.
The engagement of the wider system is led by local commissioners and the Greater Manchester Collaboration so as to increase ownership of wellbeing responsibilities of all providers rather than a continued reliance on specialist services, enhancing a culture of celebrating being able to ‘thrive’. Specialist CAMHS are visible and have a greater presence within the Children’s Services operational meetings, such as Early Help Hubs and At Risk of Care, so that advice is more timely and appropriate referrals are picked up earlier.
A key success for Manchester and Salford to date has been the development of its integrated access and care pathways which were designed to improve the smoothness of care for children, young people and their families. They now operate a self-referral system for any age. A case study on the development of these pathways is available to read here. Manchester and Salford staff from CAMHS, Early Help Hubs and third sector attended the i-THRIVE Academy modules.
CMFT CAMHS is developing its school and college offer. This will be built on the success of the CAMHS school pilot in Salford, training school leads in effective referrals to CAMHS and utilising the HEE-funded CYP Health and Well Being Practitioner training (three posts) to review and support the college offer, with matched funding from Education and Health.
As the THRIVE Framework continues to be worked through, there is a greater sense of true multi-agency working and an increased awareness and understanding across all agencies of their roles and responsibilities, with a shared plan in place.
If you would like further information on Manchester and Salford’s work with i-THRIVE, please contact Paul Wallis, Director of Psychological Services, Royal Manchester Children’s Hospital, paul.wallis@mft.nhs.uk.
The Manchester and Salford accelerator site is now part of the Greater Manchester i-THRIVE Programme.
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