Priority 7: Involve Young People in Commissioning

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Commissioning of services involves children and young people in their design, procurement and evaluation.

We asked young people how best to involve them in the commissioning of services. Here are their ideas:

1. Find out young people’s needs in an area.

  • Start by reviewing what you already know, for example by analysing feedback on existing services from service users, parents and workers. Other sources of information might include existing consultations or plans.
  • Carry out your own research, for example, through distributing questionnaires.

2. Involve young people in the design and commissioning process.

  • Recruit a smaller group of young people and offer specific training relevant to the task.
  • Ensure young people have a direct stake in the process, as well as a wider influence.
  • Ensure money and direct responsibility for some aspects of commissioning is passed directly to young people.
  • Roll out pilots to test ideas, and ensure young people are involved in evaluating their success before rolling out projects.

3. Once services are established, it’s important to keep feedback mechanisms in place to review the project’s effectiveness in meeting identified needs. This might include:

  • Mid-term user feedback
  • Termly service provider feedback
  • Yearly reviews
  • Where the feedback is positive, considering action to increase access to the pilot, for example across the wider area.
  • Where there is bad or constructively critical feedback, this should be acted on, not swept under the carpet.

 

Case Study 8: Hampshire

Hampshire County Council were looking to commission their tier 2 and tier 3 CAMHS service.  They appreciated the value of including young people within the process and sought our support and ideas around how to include service users.

We recruited service users through our VIK panel as well as through connecting with local voluntary organisations that supported young people with mental health needs.  Over a period of six months, the group of young people established the key indicators of what a successful provider should offer, evaluated the bids for the tender though their indicators, made site visits (to sites currently run by each bidding provider) and conducted interviews with each bidder.

The major benefit of this model of involving service users was that the young people themselves were able to develop their own priorities for a service that is aimed at them.  Having had lengthy experience of mental health services the young people certainly knew what to look out for! And they were passionate about ensuring that they made the right decision for the young people of Hampshire.

The process was long and emotionally involving for the young people. It meant a lot of travel and the young people at times felt the burden of having to make such a big decision and therefore needed both training and supprort in their roles. The outcome is that Hampshire now has a service which closely matches the wants and needs of service users and the young people involved felt a real sense of achievement once the process was over.

Top tips:

  • It’s important to give young people time and space to debrief after emotionally involving tasks.
  • Try to make the days fun and allow time and space for them to unwind.

Case Study 9: Hull and East Riding

Michelle Watson, Clinical Service Manager, Hull CAMHS, was tasked by senior management, Humber NHS Foundation Trust, to write a participation strategy for the nine service areas that come under the umbrella of the CAMH Service across Hull and East Riding and she was assisted in this by YoungMinds.

The vision went quickly from simply writing a strategy as a management requirement to pushing for active participation and change through putting in place champions to drive service improvement and develop a programme of inspection involving young people.

The Hull and East Riding Services have now put in place a working group of champions, with representation from each area, to explore how to move participation forward in their teams. The champions meet regularly, receive training, contribute to the strategy so that it is realistic, and agree priorities for action.

The CAMH Service will be one of the sites involved in the VIK Inspector process, drawing on children and young people who have experience of CAMHS locally. This will include having open dialogue between children and young people and CAMHS senior managers about what can be improved and what is achievable in order to make services more responsive to their service users.

For Michelle Watson, the Clinical Services Manager at Hull CAMHS, the value of peer support aswell as advice from outside organisations has been crucial to the success of the project.

 

Case Study 10: Worcestershire

A group of young people from Worcestershire were determined to improve mental health services for young people in the West Midlands and so they formed a group and started to deliver presentations and talk about their personal experiences of mental ill health to a wide range of professionals and services.  Whilst this was mostly a positive experience, the group decided that they needed to speak to key people who could influence change within CAMHS.

To this end they sent a letter to the head of Commissioning and Partnerships in Worcestershire, inviting him to a meeting to talk about the need for young people’s participation within CAMHS service design and delivery.

The timing was right; the comissioning team were in the process of carrying out a needs assessment with a view to re-designing CAMHS services and were using a web based consultation tool to start the initial process of gathering the views of children and young people.

The group pointed out the limitations of a web-based consultation and suggested that a wider consultation process was required that could capture the views of children and young people who are traditionally often left out of the consultation process.

After several more meetings, a partnership was formed.  One of the comissioning team was keen to work directlly with the group to include their views within the service re-design. She commissioned the group to lead the consultation by having a series of road shows across Worcestershire during summer 2011.

The group had several planning meetings in which they discussed the language and design of a questionnaire. They considered a range of information-gathering tools and suggested using mobile phones and voice recorders as a method of gathering feedback.

The appearance of the questionnaire including the appropriate font style was up for discussion. However, pitching the questions at the correct level was very important to the group, with the main concerns being lengthy and or complex question. They felt that a range of open-ended and closed questions with space for additional comments was a good way of capturing the views of young people.

Young people made decisions about the number of hours per week that volunteers would work and agreed the type of rewards and incentives that they would offer.  Reaching the deadlines within a short time-frame was challenging, but the group was determined that with hard work they would achieve targets and reach deadlines.

To quote the young people:  “We are excited about the opportunity we have been given. If we can make changes to the lives of a few young people it would have been worthwhile.”

One key issue that was identified from the consultation was the need to reduce waiting times for appointments. This information has been used to help to improve services offered by CAMHS, who have recently been praised for making significant changes to the service.

In particular, waiting times have reduced since May 2011 when nearly a quarter of new referrals to the service had to wait longer than 18 weeks for a first appointment.  The latest figures show that in April 2012 no cases waited longer than 18 weeks to be seen and the average waiting time continues to reduce.

“The staff in CAMHS have worked extremely hard to make some significant improvements to the service in a short period of time.  They are now putting in place new processes to make sure service improvement remains a priority.  Key to this is hearing from service users and partners about what is working well and what can still be improved on.”

Angela Kirton, Commissioning Manager for CAMHS

The group are now firmly embedded in work to continue to improve CAMHS in Worcestershire. They have formed a Young Person’s CAMHS Board which meets regularly with senior managers. Current projects include advising on the design of a new CAMHS website and leaflets and posters to recruit more members. They are also taking part in staff training to help CAMHS staff understand the needs of young people better. Future plans include helping CAMHS to implement the ‘You’re Welcome’ criteria in all parts of the service.

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