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Cornwall and the Isles of Scilly
Turning the Tide, the transformation plan for the emotional wellbeing and mental health of children in Cornwall and the Isles of Scilly, outlines plans to move away from a tiered system towards the THRIVE framework. “THRIVE puts the needs of the child at the front of any decision making about support and treatment, and encourages a truly collaborative approach between agencies, including health, social care, education and the voluntary sector.” One of the ultimate goals of their transformation is to have a system without thresholds for children and young people who are ‘Getting Advice’ or ‘Getting Help’. They want to use the THRIVE framework to bring together their existing resources across health, social care, education and the voluntary sector in order to deliver “the right help, at the right time in the right way.” They have held preparatory engagement events involving all agencies about adopting THRIVE. Aligned with THRIVE, they have widened the leadership of their transformation beyond the health sector. ‘Getting Advice’ is led by public health consultants, ‘Getting Help’ is led by CAMHS, ‘Getting More Help’ is led by specialist CAMHS provision, ‘Getting Risk Support’ is led by the CCG, nurses for looked after children and local authority representatives and ‘Thriving’ is led by GPs.
Warrington CCG and Halton CCG held a system-wide engagement event in September 2016 which was attended by over 100 people and included representation from the local authority, schools, health and the third sector. The event introduced people to THRIVE and resulted in a system-wide sign up to making changes in line with the THRIVE framework. This followed engagement with young people about their experiences of support for mental health in Warrington. The themes drawn from their stories were validated at a wider engagement event in July 2016. At this event, everyone was invited to add their experiences to five posters hanging up on the walls, one for each of the THRIVE needs-based groups. A further session explored how THRIVE would look in Warrington. Their views were pooled to create the poster you see below which has received really positive feedback from young people and may form the basis of a rebranding for Warrington CAMHS. Warrington have task and finish groups for outcomes and performance management, ‘Getting Risk Support’ and ‘Getting Advice’. Claire Hammill, Commissioning Manager at Warrington CCG, says that one of the key contributions of using the THRIVE framework so far has been the shared language it provides for stakeholders from across the different sectors supporting children and young people.
After hearing about THRIVE at a talk by Miranda Wolpert, Stephen Turberville, Child and Adolescent Psychiatrist in Bournemouth CAMHS, took the framework back to Dorset to have conversations about implementing it. They recognised the need highlighted in THRIVE to have closer relationships between CAMHS and the other agencies in the system for young people’s mental health and emotional wellbeing. Dorset is taking part in the national Children and Young People’s Mental Health Currency Development Project which is helping to embed the use of the current view tool and discussion of care pathways. Dorset has developed new clinical pathways which are aligned to THRIVE. The ‘Getting Advice’ needs-based group will be a particular focus for Dorset in the future, helping local teams to recognise when they are delivering ‘Getting Advice’ and encouraging more signposting. Dorset are also planning a day’s conference next year (2018) to bring together health, social care and other agency partners to develop their local response to ‘Getting Risk Support’.
Leicestershire Partnership NHS Trust (LPT) held a CAMHS redesign week in June 2017 where the THRIVE framework was introduced to CAMHS staff. There was a positive response from attendees and a further multi-agency engagement event to include local authority, schools, social care and third sector in the transformation is planned for autumn 2017. One focus for LPT is on improving their routine outcome monitoring and use of outcome measures. Using outcome measures to inform clinical practice is one of the principles of the THRIVE framework. Assistant psychologists have been employed to assist with the analysis of outcomes and feeding this back to clinicians. A second focus for Leicester in relation to THRIVE is in recognising the limits of what CAMHS can offer and clinicians becoming more comfortable with “endings”. Dr Amanda Keenan, Lead Child and Adolescent Psychotherapist says that one of the things she likes about the THRIVE framework is the recognition that there will always be a minority of children and young people who will need long term intervention.
If you are part of the i-THRIVE Community of Practice and would like to be featured on this page, please contact Bethan Morris at firstname.lastname@example.org.