How they are developed

Making a difference to children and young people using services:

We believe that it is important that our standards reflect the issues which make a difference to the experience of the person using the service.  For this reason, the standards follow a patient pathway through care and how the service interfaces with other services. The standards have been developed through consultation with young people and the 3^rd edition has been revised in collaboration with QNCC’s Young Person Advisors.

Meeting national requirements:

We recognise that services are under increased pressure to demonstrate that they comply with national policies and guidelines.  For this reason our standards incorporate requirements and recommendations set out nationally.  This means that the review cycle will enable your service to demonstrate where it is currently meeting national requirements and will support the service to meet them where isn't.

The standards are aligned with national policy including the following:

• The Department of Health’s No Health Without Mental Health
• The Care Quality Commission’s Essential Standards of Quality and Safety
• The Department of Health’s You’re Welcome Quality Criteria
• The Welsh Assembly Government’s Healthcare Standards for Wales
• A range of policy documents from the Scottish Executive, including Getting it Right for Every Child; Better Health, Better Care; and Delivering a Healthy Future
• The revised Mental Health Act and Code of Practice
• NICE guidance

Reflecting the views of those in the field:

We know that those who are in the field have the best understanding of the issues and challenges that they face in providing high quality care.  Our current set of standards was revised following consultation with over 150 CAMH professionals in member services, and review by the project team and Standards Development Group.

Keeping up-to-date:

The first edition of the standards was published in 2006, following a review of relevant literature and extensive consultation with CAMH professionals, young people and parents.  In keeping with the cyclical process of the QNCC network, the standards have been updated following their initial two year implementation.  We continue to review the standards each year to ensure that they continue to reflect developments in policy and practice and any issues identified through the review cycle and by our members.

Standards for services providing a crisis and/or intensive response

As more CAMH services around the UK are setting up services which work flexibly and intensively in the community, members of the network are interested to establish what constitutes good practice in such services, and how professionals should be supported to deliver the best possible care and intervention. By working closely with local community and inpatient CAMHS and other local agencies, a CAMHS crisis response and/or planned intensive intervention will help ensure those in need access a timely response and intervention from the right professional, in a way that will aid their path to recovery. The additional standards and “core features” outline included in the 3^rd edition of the standards are applicable to crisis teams, intensive teams and CAMHS teams which provide a crisis and/or intensive response as part of their core business.

Definitions

• Responding to a crisis: A crisis response is when a young person presents with an urgent mental health need that requires an immediate response from CAMHS that is not part of a care plan.
• An intensive response is when a young person requires an increased level of CAMHS input and contact that is part of their planned care.

More information about the development of the subset of standards for services providing a crisis and/or intensive response can be found in this presentation by Anne O'Herlihy:

QNCC Standards for a Crisis and Intensive Response in CAMHS

What the standards cover

The standards emphasise the practice and processes that are required to deliver a high quality CAMH service.  Part of the Quality Network’s focus is on the extent to which these CAMHS work with other agencies and services to facilitate multi-agency communication and co-operation.  The ‘multi-agency’ aspect of the Quality Network relates to the attention paid to these interfaces throughout the standards and during the peer review visits.

The standards cover 10 domains, these are:

1. Referral and access
2. Assessment and care planning
3. Care and intervention
4. Information, consent and confidentiality
5. Rights and safeguarding
6. Transfer of care
7. Multi-agency working
8. Staffing and training
9. Location, environment and facilities
10. Commissioning

The complete set of standards is aspirational; we do not expect services to meet every standard, and services can still be accredited as excellent without meeting all the standards.

Evaluation of a service’s quality should also take into account indicators of activity and outcome, such as number of referrals, waiting times and dropout rates.  These indicators will be collected annually as part of the self review in order to inform local reports and enable national comparisons.

How we measure performance against the standards

We recognise that services are diverse and that high quality care might look different from one service to another.  Therefore, standards are categorised into three types.  This is designed to help members to prioritise areas for action.

Type 1 (Essential): These are standards that are critical to care.  Failure to meet these standards would result in a significant threat to patient safety, rights or dignity and/or would breach the law.

Type 2 (Expected): These are standards that a CAMHS team providing a good service would be expected to meet.

Type 3 (Desirable): These are standards that an excellent team should meet or standards that are not the direct responsibility of the team.