Hertfordshire chose to use the THRIVE Framework for system change (Wolpert et al., 2019) in their transformation as a review of their child mental health services suggested that the current tiered system was acting as a barrier for children and young people to receiving help. The THRIVE Framework offers the five needs based groupings as a different way to think about and organise services, it has provided a very useful framework to engage partners and professionals in developing needs based provision.
Hertfordshire focused on engaging the whole system, with a particular focus on schools as its first priority. CAMHS Transformation Schools Link Managers are working to support the development of emotionally healthy whole school approaches as well as encouraging consistency, quality assurance and recording of outcome measures. The transformation programme is supporting schools and other commissioned providers of care to develop THRIVE-like practice within their own organisations.
Hertfordshire held a multi-agency engagement event in October 2016 that was delivered in collaboration with the National i-THRIVE Programme team and included an assessment of how THRIVE-like Hertfordshire currently is. The event helped to begin to disseminate a wider understanding of the National i-THRIVE Programme and how it would be the vehicle for delivering better support for the emotional wellbeing of children and young people in Hertfordshire.
A big success for Hertfordshire so far has been their introduction of a CQUIN (Commissioning for Quality and Innovation) target of 28 days to assessment and also the pilot of a new ‘Nurture Group’ at a local primary school to support those children in the ‘Getting Risk Support’ grouping.
The Hertfordshire Young People’s Substance Misuse Service and Families First Early Help multi-agency service was developed using principles of the THRIVE Framework to support needs-led multi-agency collaboration.
Work in progress for Hertfordshire includes the development of workshops to support innovation and collaboration within each of the THRIVE Framework’s needs based groupings and the production of a THRIVE-like emotional and mental health and wellbeing continuum of provision to support the transformation programme.
Plans are in place for mental health workers to be placed into multi-disciplinary early help teams who will provide triage, assessment and up to six weeks of interventions. In response to feedback from children, young people, families and professionals this assessment will be the single trusted assessment that accesses all emotional and mental health services within the Hertfordshire continuum.
One next step for Hertfordshire is to formalise the transformation work and embed them within service delivery and commissioning. Hertfordshire aims to showcase the benefits and impact of the changes to date for children, families and professional networks to encourage continued development of collaborative working to deliver needs-led provision. Hertfordshire will also be reviewing the transformation work to share good practice and identify further opportunities to strengthen existing provision to ensure the needs of children and young people are at the forefront of service delivery.
If you would like further information on Hertfordshire’s work with i-THRIVE, please contact:
Sarvjeet Dosanjh, CAMHS Senior Commissioning Manager, Hertfordshire County Council, firstname.lastname@example.org.