10.1 Effective commissioning is a multi-agency activity that requires that the commissioners have the requisite skills, knowledge, time and executive responsibility to undertake the task.
10.2 There should be full participation and ownership of the commissioning process by health, social services and education with participation as appropriate by other key partners such as youth justice. In many areas, this participation and ownership will be secured through the Children and Young People's Local Strategic Partnership, or equivalent body.
10.3 The development of a multi-agency CAMHS strategy is essential for effective commissioning and service delivery and is a collaborative process between commissioners and providers.
10.4 The commissioning of appropriate services required for the delivery of the full range of services will be different, depending on the complexity of services and the level of need within a given population size. For highly specialised needs, collaborative commissioning arrangements need to be established.
10.5 The only services currently commissioned at a national level are those for forensic secure inpatient provision and highly specialist inpatient provision for deaf children and young people with mental health disorders. See Standard 3
Primary Care Trusts and Local Authorities ensure that a commissioning strategy (which also covers specialised commissioning) is in place for CAMHS. This is informed by a multiagency assessment of need that is updated regularly. The needs assessment incorporates: - Locally adjusted epidemiological information on the prevalence of children's mental health problems to reflect the diversity of the population and other local demographic circumstances;
- An assessment of the needs of particular groups of children and young people in the locality who are vulnerable or at risk of harm;
- An audit of services currently provided by all agencies that address both directly and indirectly the mental health of children and young people;
- An analysis of current service usage;
- The views of all stakeholders including those of the children, young people and families;
- The available evidence of the efficacy and effectiveness of interventions and service models, and
- Current national and local policy priorities.
Commissioning ensures that the workforce is of sufficient size to have the capability to meet the range of defined needs safely, effectively and efficiently. In order to provide adequate support to universal services and to prevent unnecessary admission to Tier 4 services, particular attention is paid to the capacity of Tier 3 services. See Section 9 Commissioners refer to the outcome of the National Service Mapping Exercise (16) that has provided information on the levels of service provision across the country. This information is useful for benchmarking the levels of staffing currently in place as elements of the desired comprehensive CAMH service. In order to meet the needs of the very small number of children and young people with complex, severe and persistent problems that often consume large amounts of commissioner and provider time and effort, there are pre-emptive risk-sharing agreements on cost shares between local commissioning agencies. Primary Care Trusts work together in consortia to ensure that highly specialised (Tier 4) services are commissioned. Strategic Health Authorities oversee and performance manage collaborative commissioning arrangements. The continuing care needs of children and young people who receive highly specialised services is taken into account in the commissioning process. See Standard 3 |
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