Service transformation in children’s services: daring to go where no research has gone before

This paper reports on the qualitative elements of an evaluation of the Midlands and East Mental Health and Wellbeing project, a service transformation project focused on embedding principles of evidence based practice, routine outcomes monitoring and young people’s involvement in Children’s Mental Health Services across the region. NHS Child and Adolescent Mental Health Services (CAMHS) across the UK are – like many other welfare services- being hard-hit by the pressures faced by the NHS’s continuing efforts to deal with increasing demand and stretched resources. With this belt being stretched even tighter with the “Nicholson Challenge”, healthcare services are looking to transform the way they operate to maximise efficiency savings and improve patient outcomes. This has significant implications for the delivery of mental health, counselling and psychotherapeutic services for children and young people. The national Children and Young People Improving Access to Psychological Therapies (CYP IAPT) programme began in the UK in 2011, with the aim of transforming CYP’s mental health services by implementing session by session outcome monitoring, embedding and further developing evidence led practice, focusing on broadening access to young people and improving the participation of children and young people in service planning, development and implementation. This study explores 14 projects across the Midlands and East of England which are seeking to implement the principles of CYP IAPT into their services. This study has particular focus on three case study projects: • Service Transformation: Workforce development through collaboration with voluntary sector organisations • Service Transformation: Developing a single point of entry to CAMHS • Working with Service Users to implement routine outcome monitoring This paper reports on a series of focus groups conducted with both NHS and voluntary sector staff involved in the project. These focus groups were analysed thematically (Braun and Clarke, 2004) to explore the experience of service transformation for staff taking part in the project. This analysis highlights the challenges and successes, impact on roles and professional identities, changing structures, and the experience of transformation for those within the system. This study is the first to explore CYP IAPT principles in service transformation, meaning this study is providing new insights into the impact of service change on the staff working within this system. This enables us to reflect on the way that staff experience and respond to pressures of transformation, and the challenges and opportunities that arise in this process.