The creation of the Young Commissioners programme enabled 14 Young Commissioners to be equal partners in leading service and culture change for children and young people’s mental health services in Newcastle and Gateshead.
Long waiting lists meant that children and young people were waiting weeks to be seen by mental health services. Partners recognised that the current system was not meeting their needs, and services needed to be more responsive.
Therefore in late 2015, Newcastle Gateshead Clinical Commissioning Group, along with Newcastle and Gateshead Councils applied for, and were successful in, a collaborative commissioning project bid to NHS England, to support work to review mental health services for children and young people.
The aim of this work was to design and commission a radically different ‘whole system, whole family’ response to the psychological and emotional needs of children and young people in Newcastle and Gateshead. Any radical review must be inclusive to ensure that transformation meets the challenges of mental health services and leads to an improvement in children’s mental health. The involvement of young people was seen to be absolutely essential to the review and the development of mental health services for children and young people.
Using a co-production approach, which allowed young people to be involved at every stage of the commissioning processes, was key. In order to work with young people in a meaningful way, funding was identified to develop a service to recruit and train young people to be Young Commissioners. These would work alongside staff from the Clinical Commissioning Group and the two councils, with the overarching vision being that the Young Commissioners would be an equal partner to the work now and in the future.
Following a tendering process, Youth Focus North East was awarded the contract to work closely with children and young people. They:
- recruited a core group of 14 young people from across Newcastle and Gateshead, to work alongside mental health service leads to transform services and outcomes
- led extensive engagement and consultation, involving professionals, service users and parents and carers
- supported the Young Commissioners to meet and get to know council and clinical commissioning group staff, and commissioning processes.
Since their recruitment, the Young Commissioners have had a real opportunity to shape future service provision, and in addition, they have gained skills, insight and confidence as a result of being involved in the programme. In particular the Young Commissioners have:
- ensured that the voice of the service user is heard at meetings, including board meetings, after they received training to help them understand what is meant by commissioning, the legal framework, jargon busting and local processes
- provided a local perspective in the review of the National Service Specification for Tier Two and Three mental health services, leading to their involvement in the tendering process for counselling provision, including having input in making the decision on which organisations would be awarded the contract
- played a valuable ongoing role, attending regular meetings with key staff to share findings and to allow the Young Commissioners to discuss and contribute actively to those findings
- encouraged commitment from all partners to improve children and young people’s emotional health and wellbeing by being involved in a ‘Pledge Event’; with good involvement from young people and professionals
- identified need and led on areas of work including the design of a future website and information hub for mental health services
- been involved in planning, organising and leading a young people’s event, which included a short play by a local drama group, called ‘My Mind, My Life’, to raise awareness of young people’s mental health and to signpost young people to local services.
I came across the Young Commissioners programme when looking for some voluntary opportunities for young people... I was worried that we wouldn’t be taken seriously, but we have had such fantastic feedback from everyone. The local CCG and city council really listen, and actually want to listen, to what we have to say…The programme has been a fantastic opportunity to speak at events with important people, influence decision making and just be part of the wider conversation.
Sarah, Young Commissioner
Demonstrating local leadership and accountability
Director level ownership of this work was one of the key drivers to its success; with senior staff driving the work forward, and being accountable for the progress and involvement of young people.
From the very start, commitment was made to young people, with professionals being willing to change ways of working to meet the needs of young people, ensuring true participation and co-production.
Ultimately oversight for this work sits with the Joint Newcastle and Gateshead Mental Health Programme Board. On a local level; the work is accountable to the Programme Board for the Children and Young People's Mental Health Review, known as the Expanding Minds, Improving Lives Board; which is chaired by the Executive Director of Nursing, Patient Quality and Safety.
The Young Commissioners themselves actively monitor and challenge partners for how they respond and improve services.
Whilst the initial review and transformation of services using Young Commissioners was enhanced by additional funding sought from NHS England, all organisations involved have recognised that improving the emotional health and wellbeing of children and young people is a priority, and there is a commitment from all partners for this work to continue. As the commissioners of mental health services, the Clinical Commissioning Group is fully committed to fund this work in the future.
Senior Specialist Public Health, Newcastle City Council
Executive Director, Newcastle and Gateshead CCG
This case study, written by Su Turner of Insight to Impact Consulting Ltd, is taken from the forthcoming LGA publication ‘Lessons in local leadership and accountability for children’s mental health services’.
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