This following will be attending the meeting to support this item:

·         Dr Yasin, Community Paediatric Team;

·         Alison Roberts, Deputy Director of Commissioning, MCCG; and

·         Christa Blanckenberg, CAMHS Commissioning Manager, MCCG.

Childhood obesity

Hilina Asrress, Senior Public Health Principal, provided an introduction:

·         34.7% (2016/17) of Merton's children are currently judged to be overweight in Year 6 which means this figure has been reduced below the Health and Wellbeing target, is on par with England and better than London;

·         However, there remains a ten percentage point difference between childhood obesity levels in the east and the west of the borough.  The target is to reduce this to a 9.2% difference through targeted activity in the east of the borough;

·         Further work continues in reducing childhood obesity overall as currently there are an estimated 4,500 children who are either overweight or obese equating to around 150 primary classes.  The Child Healthy Weight Action Plan seeks to achieve this through communication and engagement, tackling the food environment, increased physical activity and health promoting physical environments and working with children in early years and schools; and

·         Priorities for 2018 include reducing sugar intake (signing up to the Local Authority Declaration on Sugar reduction), better use of parks and playgrounds to increase physical activity, working to make Merton more baby friendly to increase breastfeeding rates and the introduction of the Merton Mile to encourage daily physical activity (including marking out a mile in parks to encourage activity as a family taking the Daily Mile in schools out into the community).  Partnership working with key stakeholders including the voluntary and community sector is supporting the delivery of these priorities.

In response to member questions, it was further clarified:

·         The National Child Measurement Programme (NCMP) focuses on Reception and Year 6. We know that there is a significant increase in obesity rates between Reception and Year 6 therefore many interventions are targeted at younger children.  Intervention work also tends to be focused on younger children because this is when the greatest affect on long term health and well-being habits can be achieved;

·         In addition to the initiatives identified within the paper to address the obesity gap, practical activities are being provided in the east of the borough such as a health and well-being awareness raising day where information on physical activity, opportunities to be active and nutritional information were provided.  To support this, the Child Healthy Weight Action Plan will be refreshed in due course taking into account achievements as well a resident feedback from the Merton Great Weight Debate;

·         The target for reducing the gap between the east and west of the borough (from 10% to 9.2%) does represent a significant ambition because it's predicated on the gap increasing to around 13% if no action is taken.  Also the longer term target is to reduce the gap to 8% by 2020;

·         The figure for the rate of childhood obesity in Merton is robust because it is calculated based on the NCMP that occurs in Reception and Year 6 and involves around 95% of children being measured.  There are some schools in the east of the borough where 50% of the Year 6 cohort are either overweight or obese; and

·         Whilst some children may have medical conditions causing them to be overweight/obese, they will still be included in the data given in the NCMP as this is a population level analysis.

Child and Adolescent Mental Health Services (CAMHS)

Alison Roberts, Deputy Director of Commissioning and Christa Blankenberg, CAMHS Project Manager, both from the Merton Clinical Commissioning Group (MCCG), provided an introduction:

·         Waiting times for a tier 3 CAMHS referral are within the eight week target and are reducing further;

·         There is still pressure on waiting times for the neurodevelopment assessment service mainly due to increasing referrals for Autism Spectrum Disorder (ASD) assessments.  Waiting times are reducing and currently only 7% of referrals are waiting over 12 weeks in Merton.  Across south west London, the six clinical commissioning groups are working together to review the service and have in 17/18 invested to reduce waiting times.  The aim is to commission together, to benefit from efficiencies and develop a standardised service across all participating boroughs to ensure accessibility to appropriate services;

·         The psychiatric service for those with eating disorders is receiving increased funding and is meeting its targets;

·         Work is ongoing to increase access to self harm interventions.  This deals with around 140 young people annually.  It is hoped that a pilot project will lead to a longer term procurement; and

·         There is also focus on services for those with anxiety and depression, work force development and training, maintaining a local mental health network for workers, training school staff to recognise and respond to pupil mental health issues, and developing a support offer for families with an ASD diagnosis.

In response to member questions, it was further clarified:

·         The CCG representatives acknowledged the request from members for waiting times to be reduced further.  Highlighted that targets are set nationally but that the objective is always to achieve under these times; also stressed that the CAMHS Single Point of Access aims to triage and assess all children and young people within two weeks of referral. 

·         Whilst it isn't possible to comment on the experience residents may have had several years ago, the additional investment into services aims to continue to improve waiting times;

·         The pilot project looking at a counselling service for young people with depression and anxiety who do not meet thresholds for specialist CAMHS services is to be extended to June 2018 and it is hoped will provide the basis for commissioning a longer term service;

·         The seven school pilot projects mentioned in the report are fairly small scale, giving one off funding to improve the offer provided. Learning from the projects will be shared across schools;

·         The CCG representatives will share data on user satisfaction with services, this data is routinely collected and reviewed; and

·         There has been a rise in diagnosis of ASD reflecting an increased awareness, a population increase and better guidance being available.

Given lack of time, the meeting agreed that the update item on the autism strategy will be taken when the consultation is complete and school readiness will be covered in the schools annual report which will come to the Panel in March 2018.