Dear Mr Eccleston Following your recent Regulation 28 Report to Prevent Future Deaths issued on 3rd April 2019, please find the details of the joint response from Sheffield Health and Social Care NHS Foundation Trust and Sheffield Children's NHS Foundation Trust_ The MATTERS OF CONCERN and the Trusts' responses are as follows:
5.1 A gap in services was identified for 16 and 17 olds with urgent mental health issues; such as Aryan had. On gth January 2018, Aryan was assessed as requiring urgent mental health input, commencing the next This was not available as a service for under 18's in Sheffield and sO a referral to Adult Mental Health Services was made in order to obtain this. The adult service refused to take the referral because Aryan was still a child. This gap in provision between the two services meant that Aryan did not receive the urgent mental health input which he required and there is a risk that other under 18's in his situation might also suffer the same problem Sheffield Children's and Sheffield Health and Social Care Trusts have been working collaboratively to provide robust solutions to the gap in service provision: We would like to draw out the following actions in particular to give assurance that we have responded definitively and quickly to ensure that a safer more effective response is given to young people experiencing mental health crises in the city_ John Somers SVS Votttreteer 4435 Sarah Jones Chief Executive Standard Chair Charitv May year day:

An addendum to the Transitions Policy has been jointly approved by both Trusts that ensures that emergency home treatment will be provided to 16/17 year olds by Sheffield Health and Social Care's adult services, should require crisis intervention out of hours and where are not known to Child and Adolescent Mental Health Services which mirrors that already present for those known to the Services_ This was implemented with effect from January 2019. 2 To ensure a process of continuous learning and development; there will be a review of the care and treatment of any young person accessing care as described above. Written summaries of their care will be produced, and a review will be personally overseen by the Associate Director in Sheffield Children's and the Director of Operations and Transformation in Sheffield Health and Social Care Trust. This was implemented with effect from February 2019. Up until the end of April 2019 no patients accessed the service through this route_ 3_ To provide improved access to and sharing of relevant clinical information between the two Trusts, it has been agreed that Sheffield Health and Social Care staff working in the crisis assessment and home treatment team will have 'read only' access to electronic patient records for CAMHS activity at Sheffield Children's_ This has been in place from 1st April 2019, following implementation of 'SystmOne' electronic record solution at Sheffield Children's CAMHS. Service leads from both Trusts are working collaboratively to ensure that additional staff training is delivered by the end of June 2019, so that revised process workflows are embedded, i.e_ to maximise the use of the shared clinical information where required. The Trusts acknowledge the significant impact the gap in service provision has had in this case and are both fully committed to work together; and with NHS Sheffield Clinical Commissioning Group (CCG) to make lasting and tangible improvements in service delivery: We trust this response addresses the matters of concern you raised with uS_

Dear Mr Eccleston, Following your recent Regulation 28 Report to Prevent Future Death issued on 3rd April 2019, please find detailed below the joint response from NHS Sheffield Clinical Commissioning Group and Sheffield Children's NHS Foundation Trust The MATTERS OF CONCERN and the Trusts responses are as follows:
5.1 A gap in services was identified for 16 and 17 year olds with urgent mental health issues, such as Aryan had: On 9th January 2018, Aryan was assessed as requiring urgent mental health input; commencing the next day: This was not available as a service for under 18's in Sheffield and Aryan did not receive any contact from Child and Adolescent Mental Health Services (CAMHS) until 15th January 2018. In evidence was told that additional resources in the CAMHS service were close to agreement in order to prevent this kind of problem arising in the future. However; this would be subject to commissioning process from the Clinical Commissioning Group for Sheffield which could not be guaranteed:
5.2 It was accepted in evidence by the Medical Director of Sheffield Children's Hospital on behalf of CAMHS that such additional resource was required. The delivery of the necessary funding to properly resource the CAMHS team was not guaranteed. Sheffield Children's NHS Foundation Trust and NHS Sheffield Clinical Commissioning Group have been working collaboratively to develop a robust long term solution to the issues you have highlighted. The two organisations have considered the potential models and have agreed the most appropriate way forward to be through the reconfiguration of the existing Sheffield Treatment and Recovery (STAR) Service into a CAMHS Home Intensive Treatment Team (HITT) The Sheffield Together John Somers SVS Volunteer cildrensi Sarah Jones Chief Executive Standard 'O1sable9 Chair charity: At Cdrt'

This new team will be responsible for children and young people up to the age of 18 years and will be aligned with, and where appropriate, undertake, joint working with the Home Intensive Treatment Services provided by Sheffield Health and Social Care NHS Foundation Trust_ In addition the Mental Health Liaison Team will support 0-18 year olds attending either Sheffield Children's or the Northern General Hospital's Emergency Departments. Access to the HITT will be within 24 hours when required whilst the Liaison Team will operate to meet the demands through the Emergency Departments with an on call rota in place for out of hours. At the time of writing, the business case for the HITT team has been completed and was approved by the CCG on 7th May 2019,with a plan to begin a phased implementation from the autumn 2019_ The service will be evaluated to ensure that it meets the needs of the young people who are its service users_ The CCG and the Trust recognise that there is urgency to the situation and are working closely to ensure that there is no delay to its implementation noting also the temporary change in pathway agreed between Sheffield Children's NHS Foundation Trust and Sheffield Health and Social Care NHS Foundation Trust; Furthermore, the Trust has already begun to recruit nursing staff to the new service in anticipation of its formal commissioning: Both the CCG and the Trust acknowledge the significant impact the gap in service provision has had in this case and are both fully committed to work together to make iasting and tangible improvements in service delivery: We trust this response addresses the matters of concern you have raised with uS.