Agenda and Papers for Public Board Meeting June 2013

CAMHS TIER 4 RECONFIGURATION
Business Case
3. CA SE F O R CH A NGE
Whilst overall, the Trust is acknowledged to deliver high quality CAMHS services, there are a
number of issues and key drivers underpinning the case for developing a single Tier 4
inpatient unit, with an increased provision of single bedroom accommodation as outlined
below:
3.1 F ut ur e S t r at e gy & S e rvi ce De v el op m en t s
The CAMHS strategy for the future is predicated on continued delivery of high quality and
effective patient care, which is both fit for purpose and provides value for money.
Opportunities for potential new activity and learning from experience are key to the
development of both inpatient and community services. New models of provision have been
successfully piloted - such as the intensive Home Treatment and specialised inpatient Eating
Disorder Multi-Family Therapy - and are being delivered across both community and
inpatient services, and will be built upon over the coming months and years. This may
include a range of services such as specific outreach and day patient care in order to develop
services and expertise to meet the changes in demand and patient need. In addition
development of models of care will be in line with the delivery of services closer to home for
children and young people where appropriate.
Whilst the business case only creates an additional five physical beds on top of the current
39 bedded clinic it will provide the service with significant opportunities for redesigning and
creating an innovative clinical model for the provision of CAMHS services. This will negate
the need for any further beds, despite demographic trends and increasing service demand,
through increased productivity and innovative service delivery which will enable increased
activity to be managed within the available capacity using the most appropriate clinical
model.
On average there are around 120 children and young people from the West Midlands in
psychiatric inpatient care around the Country at any one time. This is an increase which has
taken place over the last 3-5 years. However, the delivery of this kind of care for children's
and young people with highly complex and specialised needs does not always have to take
place within an inpatient unit where appropriate and clinically viable other options can be
utilised. This is illustrated within by the home treatment model.
Our Birmingham City-wide community service has successfully developed an alternative and
complimentary model of care with the Intensive Home Treatment Team and we are now the
approved provider for that service, following the implementation of a successful two year
pilot. We have seen this have a significant impact in terms of the percentage reduction in
occupied bed days and reductions in lengths of stay for Birmingham young people - despite
the context of an overall growing demand across the region. This is an appropriate delivery
model and enables BCH to provide a broad range of services utilising the Home Treatment
Team model and inpatient facility as part of the overall CAMHS strategy. Importantly this
also helps to address some of the concerns flagged by our commissioners regarding the
current length of stay, which is seen as a key priority amongst the commissioners of the
current CAMHS services. This is important as length of stay, innovative treatment models
and the quality of facility being provided for patients requiring inpatient management are all
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