Agenda item

Caroline Kelly has been invited to present two reports on the topic of Children’s Emotional Wellbeing and Mental Health.

PLEASE NOTE: There are two reports attached to this item:

1.    A report providing an update on the Children’s Emotional Wellbeing and Mental Health Strategy and CAMHS Services.

2.    A report providing an update on School Health Nurses in Oxfordshire.

The Committee is invited to consider these reports, raise any questions and AGREE any recommendations arising it may wish to make.

Oxfordshire County Council Officers and NHS partners were invited to present two reports on the topic of Children’s Emotional Wellbeing and Mental Health; one on the Emotional Wellbeing and Mental Health Strategy and CAMHS, and another on school Health Nurses. The following were invited to present the reports to the Committee and answer the Committee’s questions:

• Cllr Sean Gaul, Cabinet Member for Children and Young People
• Ansaf Azhar, Director of Public Health & Communities
• Lisa Lyons, Director of Children’s Services
• Caroline Kelly, Head of Integrated Commissioning - Start Well
• Dan Leveson, BOB ICB Director of Place and Communities
• Jannette Smith, Public Health Principal
• Mark Chambers, Head of Children’s Community Services
• Mattew Tait, BOB ICB Chief Delivery Officer
• Dr Rob Bale, Interim Chief Operating Officer for Mental Health and Learning Disability
• Sue Butt, Oxford Health NHSFT?Transformation Director
• Vicky Norman, Head of Oxfordshire Children & Adolescent Mental Health Services (CAMHS)

The Committee received a presentation on Children’s Emotional Wellbeing and Mental Health. The Head of Children’s Community Services outlined recent developments, including the expansion of school health nursing to all secondary schools and colleges, with a particular focus on mental health support. The TellMi app had been successfully launched, showing strong uptake among LGBTQ+ youth. Family learning and support programmes were under review, and a new service for primary schools was due to launch. Progress was being monitored through data dashboards.

The Head of Oxfordshire CAMHS described several initiatives: the supportive steps model for parents, the SHaRoN online support platform, and increased neurodevelopmental assessments via external providers. AI tools were being used to triage referrals, and the Andy Clinic provided support for anxiety and depression. The Thames Valley Link programme engaged hard-to-reach young people. Work continued on transitions to adult services and collaborative projects with children’s social care.

The Cabinet Member was asked about the priority given to children’s mental health and the requirements for effective, sustainable delivery of the emotional wellbeing and mental health strategy. He confirmed that children’s mental health remained a top priority, though sustainable funding was challenging due to ongoing pressures. He reaffirmed his commitment to the strategy, pledged to act on the Committee recommendations, and highlighted opportunities for better service integration through family hubs and neighbourhood working.

Questions were raised regarding the tracking of progress against the strategy, the main challenges in implementation, and the factors behind rising mental health concerns. Officers explained that progress was monitored bimonthly via board meetings, action plans, and highlight reports, using both quantitative and qualitative data, including feedback from children and families. Challenges included increased demand and resource limitations.

Concerns were expressed by the Committee about the lack of lived experiences of young people in the report and the involvement and resilience of the voluntary sector. Officers responded that lived experience was increasingly being integrated through youth forums, peer support workers, and co-production with young people and parents, though better coordination was needed. The voluntary sector’s role was recognised as vital, especially in early support and outreach, with ongoing work to strengthen partnerships and ensure sustainability.

Barriers to achieving collaborative, integrated pathways for children’s emotional wellbeing and mental health were discussed. Officers identified time and capacity constraints, the pressures of multiple reforms, and differing priorities and timescales between health and education sectors as key obstacles. Building relationships and trust across organisations, aligning priorities, and moving away from short-term approaches were considered essential. Workforce constraints and the need for better coordination remained ongoing challenges.

The Cabinet member left the meeting at this stage.

The influence of the school environment on children’s mental health, the effectiveness of mental health training for school staff, and the measurement of workforce outcomes were considered. Officers stated that schools played a critical role, and hundreds of staff had received mental health training to empower them to support students and identify when to refer to clinical services. Efforts were ongoing to collect feedback and data on staff confidence and ability to support children’s needs.

The effectiveness of the TellMi app was questioned. Officers explained that the app provided a moderated platform for peer support and early intervention, aiming to prevent crises and identify young people in need. The app had been positively evaluated by external organisations, and local contract monitoring and user feedback were ongoing.

Plans for an early review of the TellMi app and its evaluation were discussed. Officers confirmed that contract monitoring was in place, with regular reports on user engagement and resource access. User feedback was being collected, including surveys and input from youth forums. The app had already undergone scientific evaluation by external organisations such as UCL, with positive results.

Gaps in parenting support provision and the role of the family hub programme were explored. Officers identified gaps in support for parents of neurodivergent children, especially those with sensory needs and Attention Deficit Hyperactivity Disorder (ADHD). Previous pilots had been successful, and long-term resources were being developed. Feedback indicated parents preferred “support programmes” rather than “courses” and wanted clearer information. Family hubs aimed to deliver these programmes locally and improve access for all carers, including fathers and kinship carers, with further work planned to address inequalities.

The nature of the new children’s family hubs and provision for rural communities were discussed. Officers explained that the hubs would resemble children’s centres but with a broader age range and a mix of universal and targeted services, including support for older young people. Existing public buildings and pop-up locations would be used to ensure accessibility, with agile and mobile support for rural areas.

Concerns about high numbers of mental health referrals from certain rural schools were raised. Officers confirmed that data on school referrals had been collected and analysed, showing variation in referral rates and support levels. Some schools were more proactive in supporting mental health and addressing issues like bullying. Further information would be shared to celebrate engaged schools and expand participation.

Evidence supporting the impact of mental health support teams and the whole school approach was requested. Officers replied that mental health support teams had reached 6,500 children in the previous year, though specific outcome data would be provided later. The programme was part of a national directive, with a target for 100% coverage. Additional strategies included new services for primary schools and collaboration with schools commissioning their own support.

Barriers to school engagement with mental health support initiatives were discussed. Officers noted that engagement could be harder for very small rural schools due to capacity. Larger schools or those in multi-academy trusts often commissioned their own services, affecting referral patterns. Mapping and aligning programmes was considered important to ensure a core offer for schools, and future legislation might encourage greater cooperation.

Current referral waiting times for children’s mental health services and support for those on waiting lists were considered. Neurodevelopmental assessment waiting times were a national issue, but local referrals had recently decreased. The longest-waiting families were being sent to a private provider, and webinars were offered for support. Some children were already being seen by nurses, and many improved or were signposted elsewhere during the wait. The eating disorder service met national targets, and crisis teams provided urgent support.

Mechanisms to prevent confusion or errors for vulnerable groups, such as care leavers, were discussed. Care leavers received a health passport and alerts were set up, though national problems with adult ADHD and autism assessment waiting lists persisted. Young people approaching 18 were prioritised, and access to children’s social care records helped monitor and prevent issues.

Workforce challenges in Oxfordshire, particularly differences between qualified and unqualified staff, and recruitment and retention issues, were raised. Most staff were professionally qualified, with only a few youth workers and psychology trainees. Retention rates were below the trust average, though recruitment had improved. The Trust focused on apprenticeships and local training, with recruitment priorities based on clinical need.

Staffing in the intensive care unit and the potential impact of recent immigration law changes were discussed. Staffing had improved since the unit’s opening, with ongoing monitoring and support. The unit served a wide region and dealt mainly with emotionally dysregulated young people. The impact of new immigration laws was not yet clear, though the issue was being monitored.

The strategy’s use of studies, surveys, and data sources such as the Joint Strategic Needs Assessment (JSNA) was explained. The JSNA and large-scale surveys like the Oxwell survey informed the strategy, leading to actions such as training all teachers. Qualitative data from community profiles and family stories also contributed to informing the strategy.

Access to sexual health services for young people in rural areas and efforts to improve equity were outlined. An integrated sexual health service was commissioned, with a needs assessment underway. School health nursing provided over 2,300 one-to-one sessions in the last academic year, with enhanced training for nurses. Preventative education was delivered through the “protected behaviours” programme.

Communication with parents and families regarding the school health nursing service was described. Multiple channels were used, including a chat health service, termly newsletters, and a bulk messaging system. The service ensured a presence in every secondary school at least once a week and sent introduction letters to families of electively home-educated children.

The Committee AGREED to issue the following recommendations, subject to any necessary minor amendments offline:

1. To ensure that clear mechanisms are in place to evaluate the deliverability of the Emotional Wellbeing and Mental Health strategy (including the use of digital platforms/apps), as well as the efficacy of Children’s EWMH services more broadly.?

2. To continue to explore and secure sustainable sources of funding for the delivery of the aims and objectives of the EWMH strategy.?

3. To provide clear and structured support for families awaiting diagnosis and treatment. It is recommended that there is a scaleup of “Supportive Steps” and similar programmes countywide, ensuring proactive communication and signposting to interim support.

4. To improve communication and transparency on Children’s EWMH services. It is recommended that a unified navigation hub is developed which links Tellmi, SHaRON, and local resources and services, with clear guidance for parents and professionals. ?

5. To embed the Whole School Approach across all Oxfordshire schools, and to strongly encourage all schools to have a trained senior mental health lead and for schools to report annually on WSA implementation and impact. 

6. To maintain and enhance sexual health provision in schools, particularly in rural areas, through continued investment in advanced training for nurses and monitoring service uptake.?

7. To work toward integration of Family Hubs with the Whole System Approach to Children’s Emotional Wellbeing and Mental Health.

The Committee adjourned for lunch at 12:32, and reconvened at 13:24