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Portsmouth: a needs-led city for children and young people

Portsmouth has developed a Social Emotional Mental Health (SEMH) Strategy for Children and Young People 0-25 for 2020-2023, as part of a set of strategies which make up the Children's Trust Plan.

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Portsmouth has developed a Social Emotional Mental Health (SEMH) Strategy for Children and Young People 0-25 for 2020-2023, as part of a set of strategies which make up the Children's Trust Plan adopted by a Partnership bringing together the council, the police, the CCG, schools (including academies), the voluntary sector and representatives of parents of young people. The newest versions of the Strategy have been amended given the impact of the COVID-19 pandemic, ensuring necessary services are put in place before there is a peak in demand that could result in unmet needs in young people’s mental health. Below we present one of the services procured as part of the Strategy, Kooth, which has been particularly successful within the context of the ongoing COVID-19 pandemic.

The challenge

The SEMH Strategy for 2020-2023 is based on a needs-led model, which aims to implement a whole system approach in developing and transforming existing services for children and young people’s mental health and wellbeing. The Strategy also sets out the aims to provide access to the right help at the right time ensuring children, young people and families have access to a range of early help and prevention that will prevent difficulties escalating and requiring specialist mental health services. In light of COVID-19, the impact that the pandemic is going to have more broadly on the population’s mental health has been also considered, and partners are currently preparing to meet an anticipated increase in children’s and young people’s need for mental health support.

The solution

Stuart McDowell explains: ‘For the last few years we’ve been moving towards being a needs-led city rather than focusing on diagnosis and treatment and we have been using the THRIVE framework to structure commissioning, delivery and pathways. The approach used is trauma informed and relational based which is why we developed the idea of social – emotional mental health and coproduced ways of working.’

One of the services procured as part of the Strategy is Kooth - an online platform for emotional wellbeing support for children. Launched in January 2021, is available to young people aged 11-18 years old in Portsmouth, or up to the age of 25 for care leavers and those with an Education, Health and Care Plan (EHCP). It has been introduced in order to meet the Strategy’s intended outcome that children and young people in Portsmouth will have access to a range of early help support options effectively addressing their emotional wellbeing and mental health needs, and as a result preventing the escalation of symptoms and avoiding the need for specialist mental health services later on.

Kooth was decided to be one of the services implemented already before the onset of the COVID-19 pandemic, but the potential of providing young people the opportunity to be able to access services remotely while in lockdown was crucial and sped up the urgency to put the service in place.

The impact

The SEMH partnership approach (including Kooth) and working together collaboratively through the Strategy has been a great success. ‘And having no artificial barriers but instead shared posts between the CCG and the Council. I'm part of an Integrated Children's Commissioning Team and we commission children's services on behalf of NHS Portsmouth Clinical Commissioning Group and Portsmouth City Council. This has meant that as a team we have a better, more rounded understanding of the issues that face children, young people and families, and we can design and commission better services and support that meet their needs', explains Stuart McDowell.

Being an online service, Kooth is available around the clock. It provides young people with a free, safe and anonymous way to access support from qualified counsellors as well as a range of self-help resources addressing mild to moderate mental health issues, such as anxiety, loneliness, stress and body image. ‘Young people can go from accessing self-help to being supported by a qualified counsellor in a seamless way rather than needing a referral. This makes for a smoother transition of support’, explains Stuart McDowell.

It doesn’t really help to differentiate between the Local Authority and the CCG, they work as a single team"

– Stuart McDowell (NHS Portsmouth CCG and Portsmouth City Council)

How is the new approach being sustained?

Aligning the principles of the SEMH Strategy with those of the Children's Trust as well as using the THRIVE framework as a guide has ensured partners can work better together. The services developed by the SEMH Strategy have been linked to the services offered in schools and colleges to better reach out to young people. The integrated approach in Portsmouth has allowed the partners to build effective pathways between and across primary, community and acute care, as well as early years settings, schools and children’s social care.

As a delivery mechanism of the strategy, Kooth enables a transition of services that attends to service users’ needs and which they do not have to attempt by themselves. The platform support staff are provided with all necessary information about local support services, where young people can be directed if they are experiencing complex issues and there are concerns about them. ‘So, this is a well-recognised national platform, but very localised at the same time’, says Stuart McDowell.

Lessons learned

Portsmouth has also been very active and open to sharing lessons from their innovative approaches – which as mentioned earlier is not limited to Kooth – with interested parties. Stuart McDowell gives us the following example: ‘A lot of work has been done over the last year with the community to develop a Neurodevelopmental Profiling Tool which will help non-clinicians to understand neurodiversity and difference, and identify how families’ needs can be met. There has been significant interest in this work both regionally and nationally which led to us holding an online webinar recently where we shared progress and lessons learnt.’


Stuart McDowell - [email protected]

Commissioning Project Manager, Integrated Children's Commissioning Team, NHS Portsmouth Clinical Commissioning Group (CCG) and Portsmouth City Council