Camhs Stress Test 2021

Trends in Child and Adolescent Mental
Health Services & the Cordis Bright

CAMHS stress-test
December 2021
Original material is © Cordis Bright 2021 1

Introduction
• This document presents an analysis of trends in Child and Adolescent Mental Health Services
(CAMHS) in England.
• It also looks at how these trends vary by local area. It highlights that Clinical Commissioning Groups
(CCGs) are often experiencing different pressures to the national average. We use 13 indicators to
identify those which we think are experiencing the most pressures in relation to CAMHS provision.
• This analysis forms part of a portfolio of stress-tests that Cordis Bright produces. Please visit our
website for stress-tests on children with special educational needs and looked after children.
• The purpose of these stress-tests is to provide new insight by analysing existing publicly-available
datasets in new and different ways.
• The CAMHS stress-test has proved particularly difficult to design because the data that is available
is relatively limited, there is often a lack of consistent reporting periods, and indicators do not cover
all aspects of provision that we would have liked.
• In places, we have had to combine datasets in atypical ways to create proxy indicators which give a
flavour of potential trends in the system. We have drawn any conclusions carefully and tried to be
fully transparent in the slides and references in the calculations that have been undertaken.
• We hope that, despite these ‘health warnings’, the analysis is helpful for local planning purposes –
both now and into the future when we expect Covid-19 to have significant impacts on the mental
health and wellbeing of children and young people.
• This is the second version of the stress-test and we are keen to refine and expand future versions. If
you have any feedback, please send to colinhorswell@cordisbright.co.uk.

A note about indicators & data availability
Indicators
• We have chosen the following indicators to form the basis of the stress-test:
– Numbers and rates of open referrals
– Numbers and rates of children and young people in contact with mental health services
– CCG spend on CAMHS
– Distance of open wards stays from home address for children and young people
– New emergency and urgent referrals to crisis care teams
– Numbers of bed days in CAMHS tier 4 wards
Data availability
• The majority of data used in this analysis was available either on a monthly or a quarterly basis. As
it was not possible to aggregate this data to create yearly figures without avoiding potential overlaps
or double counting, we have opted to use monthly and quarterly data to provide a snapshot of
service use and spending within a specific timeframe.
• For monthly data, we have analysed data from November 2020, and have used data from
November 2016, 2017, 2018 and 2019 for historical comparisons.
• For quarterly data, we have analysed data from Q3 2020/21, and have used data from Q3 2016/17,
2017/18, 2018/19 and 2019/20 for historical comparisons.
• A number of CCGs have undergone mergers in recent years. In these situations, we have combined
the data from the previously separate CCGs to calculate a figure for the newly merged CCGs for
previous years – for example, to calculate the 2016 indicators for Shropshire, Telford and Wrekin
CCG, we combined the data from Shropshire CCG and Telford and Wrekin CCG from those years.

Helping you think about next steps
If this analysis raises questions for your local CCG or local authority then Cordis Bright can help in the
following ways:
• We can produce bespoke versions of this stress-test plotting your CCG’s performance against each
indicator. This helps understand your relative strengths and weaknesses. We are able to do similar
for a basket of CCGs, e.g. your statistical neighbours. There is a small charge for this analysis.
• We are experts at service reviews and evaluation. Relevant experience includes an evaluation of a
children and young people’s Emotional Wellbeing and Mental Health Transformation Programme;
evaluation of a Trauma Recovery Model approach within youth offending; a multi-site evaluation of
the Living Well approach to improving mental health.
• We also offer needs assessments, helping you map local need and service provision and identifying
gaps and areas for improvement. These can be population-wide, e.g. mental health services for all
children and young people, or focused on particular cohorts, e.g. looked after children or children with
complex needs, or particular aspects, e.g. training needs assessments for those working with children
and young people who may have emotional and mental health needs.
Our team draws upon the expertise of people who have previous experience within children and young
people’s mental health as well as children’s services more generally. If you would like to discuss any of
these options further then please contact Colin Horswell on colinhorswell@cordisbright.co.uk.

The national picture

Open referrals1 in children & young people mental
health services at the end of reporting period
(Monthly data, each November)
The number of open referrals in children

and young people mental health services
at the end of each November has seen a
major increase of 126% over the past five
years, from 152,011 open referrals at the
end of November 2016 to 344,178 in
November 2020.

Open referrals per 1,000 of population aged 0-18
30
27
25
Per 1,000 of population aged 0-18
20
15
In November 2020, the equivalent of 27

12 per 1,000 children and young people had
10
an open referral to children and young
people mental health services. This rate
has increased over time, from 12 per
5 1,000 in November 2016 to 27 per 1,000.
0
Nov-16 Nov-17 Nov-18 Nov-19 Nov-20

People in contact with children & young people mental
health services in England2
350,000
309,311
Number of people in contact with CYP MH
300,000
250,000
200,000
services
There has been a 118% increase in the number of

150,000 people in contact with children and young people
141,894 mental health services in the month of November
in England since 2016. This rate of increase is
100,000 slower than that for open referrals. There may
indicate a lack of capacity to respond to increasing
demand for mental health services.
50,000
0

People in contact with children & young people mental
health services per 1,000 of population aged 0-183
30
25
Per 1,000 of population aged 0-18
24
20
15 Similarly, the proportion of the population

aged 0-18 years who are in contact with
CAMHS services in November of each
10 11 year has increased since 2016, i.e. from
11 per 1,000 to 24 per 1,000. This
indicates that the number of people in
5 contact with these services is increasing
more rapidly than the overall population of
children and young people aged 0-18.
0

Children & young people mental health services
planned CCG annual spend3
(Annual data)4
£900m
Planned CCG annual spend on CYP MH
The planned spend for CCGs on children and £872m

£850m
young people mental health services has
increased from £614m for 2017/18 to £872m for
£800m 2020/21. This is an increase of 42%.6
£750m
services
£700m
£650m
£600m £614m
£550m
2016-2017 2017-2018 2018-2019 2019-2020 2020-21

Children & young people mental health services
planned CCG annual spend per capita
(Annual data, for population aged 0-184)
£80
Planned CCG annual spend per capita on
£70
£69
£60
CYP MH services
£50
£49
£40
This increase in planned spend
corresponds to an increase in spend per
£30 capita of the population aged 0-18 from
£49 per capita to £69 per capita. This is
an increase of 41%.
£20
£10
£0
2016-2017 2017-2018 2018-2019 2019-2020 2020-21

Other indicators
• The remainder of this section looks at indicators for more acute CAMHS provision.
• This reflects the data that is publicly available.
• We feel these indicators might give some insight into some of the pressures faced across CAMHS,
not just those at higher tiers. Hence their inclusion.

New emergency referrals & urgent referrals to crisis care
teams
(for patients aged 0-17 as a percentage of all people in contact with children and young people
mental health services, monthly data, November)
2.0%
1.8%
% of all people in contact with CYP MH
1.6%
1.4% Data on new emergency and urgent

referrals to Crisis Care teams is only
1.2% available from November 2018 – it shows
services
a 0.3% decrease over the two years.

1.0%
0.8% 0.9%
0.6%
0.6%
0.4%
0.2%
0.0%

Open wards stays at least 50km from home address
(for patients aged 0-18, as a percentage for all ward stays for patients aged 0-18,
monthly data, November)
50%
45%
% of all wards stays for patients aged 0-18
40%
35%
30%
25% 26.5%
20% 23.3%
The proportion of open ward stays that are at least 50km from the
15% home address each November has seen a 3% increase over the past
four years. This suggests that CCGs are finding it increasingly difficult
10% to cater for children and young people closer to home. Given increases
in referrals and contacts, this could be the result of the volume of
5% children and young people that CAMHS services are engaging with.
0%

Number of bed days for children & young people under
18 in CAMHS tier 4 wards
(Quarterly data, Q3)
140,000
Number of bed days for CYP under 18 in
120,000
102,567
100,000
CAMHS tier 4 wards
80,000 88,097
60,000
The number of bed days for children and
young people aged 0-17 in CAMHS tier 4
40,000 wards during Q3 has fluctuated over the past
5 years, rising to 119,096 in Q3 2017/18, but
ultimately showing a decrease of 14%
20,000
between Q3 2016-17 and Q3 2020-21.
0
Q3 2016-2017 Q3 2017-2018 Q3 2018-2019 Q3 2019-2020 Q3 2020-21

Bed days of children & young people under 18 in
CAMHS tier 4 wards
(as a percentage of all people in contact with children & young people mental health
services, monthly data interpolated from quarterly data)6
50%
45%
% of all people in contact with CYP MH
This overall decrease is also witnessed in

40% the number of bed days in proportion to
contacts with total number of people in
35% contact with children and young people
mental health services in the month of
30% November. The rate decreased by 14.6%,
services
from 24.1% to 9.5%.

25%
24.1%
20%
15%
10%
9.5%
5%
0%

The CAMHS Stress-Test
The national averages disguise substantial differences
between CCGs

We have chosen 13 indicators to be part of the
stress-test
• Open referrals in CYP MH services per 1,000 0- • Percentage change in new emergency & urgent
18 population (Nov 2020) referrals to crisis care teams (2018-2020)
• Percentage change in number of open referrals • Number of open ward stays at least 50km from
(Nov 2016 to Nov 2020) home address (2029)
• People in contact with CYP MH services per • Percentage change in number of open ward
1,000 0-18 population (Nov 2020) stays at least 50km from home address (2016-
• Percentage change in people in contact (Nov 20)
2016 to Nov 2020) • Number of bed days for CYP under 18 in
• CYP MH services CCG planned spend (2020- CAMHS tier 4 wards (Q3 2020)
21) • Percentage change in number of bed days of
• Planned spend per capita (2020-21) CYP under 18 in CAMHS tier 4 wards (2017-20)
• Change in CYP MH planned spend per capita
(2017-18 to 2020-21)
• New emergency & urgent referrals to crisis care
(Nov 2020)
See slides for fuller description of each indicator

1. Open referrals in CYP mental health services per
1,000 people of CCG population aged 0-18 (Nov 2020)
90
England average 27
80
Number of open referrals per 1,000 people
2 CCGs equal to
average
70
60 58 CCGs with lower 46 CCGs with higher

aged 0-18 in CCG
rates rates
Lowest rate: 8 Highest rate: 78 (Wirral
50 (Somerset CCG) CCG)
40
30
20
10

2. Percentage change in number of open referrals in
CYP mental health services (Nov 2016 - Nov 2020)
12%
England average: +1.1%
10% 6 equal to average
8%
54 CCGs with higher rates.
% change number of open referrals
6% 44 CCGs with lower rates. Highest rate: +6.0% (Wirral

Lowest rate: -7.3% (Manchester CCG)
4% CCG)
2%
0%
-2%
-4%
-6%
-8%
-10%
-12%

3. Number of people in contact with CYP mental health
services per 1,000 people of CCG population aged 0-18
(Nov 2020)
80
England average: 24
70 4 equal to average
Number of people in contact with CYP per
45 CCGs with higher

60 rates
58 CCGs with lower Highest rate: 73 (Wirral
1,000 aged 0-18 in CCG
rates CCG)
50 Lowest rate: 9
(Somerset CCG)
40
30
20
10

4. Percentage change in people in contact with CYP
mental health services (Nov 2016 - Nov 2020)
12% England average: +0.9%
3 equal to average
10%
% change in people in contact with CYP MH
8%
44 CCGs with lower rates. 55 CCGs with higher rates.
6% Lowest rate: -6.8% (Manchester Highest rate: +5.7% (Wirral CCG)
CCG)
4%
2%
services
0%
-2%
-4%
-6%
-8%
-10%
-12%

5. CYP mental health services CCG planned spend4
(2020/2021 planned spend)
£40m Average spend per CCG: £8.23m

1 equal to average
£35m
CCG planned spend on CYP MH services
67 CCGs with lower rates. 38 CCGs with higher

£30m
Lowest rate: £762k (Halton rates. Highest rate:
CCG) £37.04m (North West
£25m London CCG)
£20m
£15m
£10m
£5m

6. Spend per capita on CYP Mental Health
(of CCG population 0-18 (2020-21 planned spend))
£160
England average: £69.30 per capita
0 equal to average
Spend per capita of CCG population aged 0-
£140
61 CCGs with lower 45 CCGs with higher
rates. Lowest rate: rates. Highest rate:
£120 £25.18 (Halton CCG) £145.43 (Norfolk and
Waveney CCG)
£100
18
£80
£60
£40
£20
£0

7. Change in CYP mental health planned CCG spend
per capita
(for population aged 0-18 (2017-18 planned spend – 2020-21 planned spend))6
£150
£100
England average: +£18.72 per capita
£50 0 equal to average
Change in spend per capita of CCG
£0
population aged 0-18
-£50
-£100
-£150
72 CCGs with lower rates.
-£200 Lowest rate: -£355.74 (Kent
CCG) 33 CCGs with higher rates.
-£250 Highest rate: +£86.67 (East
Staffordshire CCG)
-£300
-£350
-£400

8. New emergency & urgent referrals to crisis care
(for patients aged 0-17 as a percentage of all people in contact with CYP mental
health services (Nov 20))
Highest rate: 6.4% (North
Cumbria CCG)
7% England average: 0.9%
2 equal to average
6%
aged 0-17 as a percentage of all people in
referrals to Crisis Care teams for patients
contact with CYP mental health services

New emergency referrals and urgent
Lowest rate: 0% (51 CCGs)

5%
4%
3%
2%
1%
0%

9. Percentage change in new emergency & urgent
referrals to crisis care teams
(for patients aged 0-17 as a percentage of all people in contact with CYP mental
health services (Nov 2018 - Nov 2020))8
10%
% change in emergency and urgent referrals
-10%
-30%
to crisis care teams
-50%
-70% Highest rate: +6.3% (Manchester
CCG)
-90%
England average: -1.9%
-110% 0 equal to average
-130% 178 CCGs with lower rates.

Lowest rate: -145.4% (Lincolnshire CCG)
-150%

10. Number of open ward stays at least 50km from
home address
(for patients aged 0-18 as a percentage of all ward stays for patients aged 0-18
(Nov 2020))
England average: 16.8%
0 equal to average
100%
90% Highest rate: 100%
% of all ward stays for patients aged 0-18
(Bedfordshire, Luton and

80% 40 CCGs with lower rates. Milton Keynes CCG; Frimley
Lowest rate: 0% (40 CCGs) CCG; and Shropshire,
70% Telford and Wrekin CCG)
60%
50%
40%
30%
The sizeable proportion of CCGs with a value of 0 for this
indicator is due to the suppression of data in CCGs
20% where there were less than 5 open wards stays at least
50km from home address in November 2020 in the
10% dataset.
0%

11. Percentage change in number of open ward stays
at least 50km from home address
(as a percentage of all ward stays for patients aged 0-18 (Nov 2016 - Nov 2020))
England average: +8.0%

0 equal to average
120%
100%
% change open ward stays > 50km from
80%
60% Lowest rate: -75% (Cumbria CCG)
40%
home address
20%
0%
-20% 17 CCGs with higher rates. Highest
rate: +100% (Bedfordshire, Luton
-40% and Milton Keynes CCG; Shropshire,
Telford and Wrekin CCG)
-60%
-80%
-100%
-120%

12. Number of bed days for children and young people
under 18 in CAMHS tier 4 wards
(Q3 2020/21)
3,500
England average: 846 bed days
0 equal to average
3,000 34 CCGs with higher
Number of bed days for CYP under 18 in
70 CCGs with lower number.

Lowest rate: 7 bed days rates.
(Knowsley CCG) Highest number: 4,593
2,500 bed days (North East
London CCG)
CAMHS tier 4 wards
2,000
1,500
1,000
500
0
13. Percentage change in number of bed days of CYP
under 18 in CAMHS tier 4 wards
(as a % of people in contact with CYP mental health services (Nov ‘17 – Nov ‘20))
1000%
% change bed days of CYP in CAMHS tier 4
500%
0%
wards

-500% Highest rate: +21.3% (Castle
Point and Rochford CCG)
-1000% 86 CCGs with lower rates.

Lowest rate: -90.9% (Leeds CCG)
-1500%
England average: -5.3%
1 equal to average (Knowsley
CCG)
-2000%

The 20 “most stressed” CCGs for each
indicator

The 20 “most stressed” for each indicator
Open referrals CYP in contact with MH services
Per 1,000 population % change 2016-2020 Per 1,000 population % change 2016-2020
Wirral Wirral Wirral Wirral

Surrey Heartlands Surrey Heartlands Coventry And Warwickshire North Tyneside
Tees Valley North Tyneside County Durham Surrey Heartlands
Sunderland Chorley and South Ribble North Tyneside Bedfordshire, Luton And Milton
Stockport Bedfordshire, Luton and Milton Blackpool Keynes
West Lancashire Keynes Surrey Heartlands Portsmouth
Stafford and Surrounds Coventry and Warwickshire Oxfordshire Stafford And Surrounds
West Suffolk Portsmouth Manchester South East Staffordshire And
Vale Of York Morecambe Bay Bedfordshire, Luton And Seisdon Peninsula
Wakefield Greater Preston Milton Keynes Shropshire, Telford And Wrekin
Tameside and Glossop County Durham Rotherham Cannock Chase
Stoke On Trent Stafford and Surround South Tyneside Hampshire, Southampton And
West Leicestershire South East Staffordshire and Northumberland Isle Of Wight
Warrington Seisdon Peninsula Heywood, Middleton And Coventry And Warwickshire
Trafford West Lancashire Rochdale Chorley And South Ribble
Wigan Borough Shropshire, Telford and Wrekin Salford West Lancashire
St Helens Cannock Chase Sunderland Morecambe Bay
West Sussex Fylde & Wyre Tees Valley Vale Of York
West Essex Hampshire, Southampton and Isle Portsmouth Brighton And Hove
Thurrock of Wight Stockport Kent And Medway
Rotherham Newcastle Gateshead Herefordshire And
Kent and Medway Stafford And Surrounds Worcestershire
Vale Of York Rotherham
Fylde & Wyre

CYP MH spend (indicators 7-9) Emergency/urgent referrals (indicators 10-11)
£ £ p.c. % change 2017-2020 Number % change 2018-2019

North West London Norfolk and Waveney East Staffordshire North Cumbria Manchester
North Central London South Tyneside Stafford and Surrounds Leicester City North East Lincolnshire
North East London Cannock Chase South East Staffordshire Northamptonshire North East Essex
South East London Stafford and Surrounds and Seisdon Peninsula North Yorkshire Derby and Derbyshire
Norfolk and Waveney South East Staffordshire St Helens East and North Stockport
Black Country and West and Seisdon Peninsula Cannock Chase Hertfordshire Halton
Birmingham Sunderland Mid Essex Vale Of York Ipswich and East Suffolk
Birmingham and Solihull East Staffordshire Wakefield Wigan Borough Doncaster
Kent and Medway Wakefield North Cumbria East Leicestershire and Gloucestershire
Hampshire, Blackpool Kirklees Rutland Dorset
Southampton and Isle Kernow Blackpool Hull Leicester City
Of Wight Tees Valley Tameside and Glossop West Leicestershire Tees Valley
South West London North Central London Sunderland East Riding Of Yorkshire South Tyneside
Tees Valley Brighton and Hove Salford Herts Valleys Bedfordshire, Luton and
Devon Barnsley Doncaster Devon Milton Keynes
Bedfordshire, Luton and St Helens Birmingham and Solihull Leeds Southport and Formby
Milton Keynes South Sefton Leicester City Kernow Brighton and Hove
Bath and North East East Lancashire Sheffield Kent and Medway Herefordshire and
Somerset, Swindon and Liverpool East Lancashire Newcastle Gateshead Worcestershire
Wiltshire Manchester Manchester Sunderland Newcastle Gateshead
Derby and Derbyshire Birmingham and Solihull Bury Birmingham and Solihull Kent and Medway
Surrey Heartlands Berkshire West Hull
Nottingham and
Nottinghamshire
Kernow
Bristol, North Somerset
and South
Gloucestershire
Cheshire

Bed days in tier 4 wards
Open wards >50km
(indicators 14-16)
Number % change 2017-2019 Number11 % change 2017-2019
Bedfordshire, Luton and Bedfordshire, Luton and North East London Castle Point and Rochford
Milton Keynes Milton Keynes North West London Northamptonshire
Frimley Shropshire, Telford and North Central London Heywood, Middleton and
Shropshire, Telford and Wrekin Kent and Medway Rochdale
Wrekin Bath and North East Birmingham and Solihull Southend
Bath and North East Somerset, Swindon and Bedfordshire, Luton and North Cumbria
Somerset, Swindon and Wiltshire Milton Keynes Shropshire, Telford and
Wiltshire Bristol, North Somerset and Coventry and Warwickshire Wrekin
Bristol, North Somerset and South Gloucestershire Norfolk and Waveney Lincolnshire
South Gloucestershire Lincolnshire Cambridgeshire and West Sussex
Lincolnshire North East Essex Peterborough Leicester City
Norfolk and Waveney Oxfordshire Herts Valleys Berkshire West
North East Essex Tees Valley Black Country and West East Riding Of Yorkshire
Oxfordshire Kent and Medway Birmingham South East Staffordshire
Tees Valley Norfolk and Waveney Herefordshire and and Seisdon Peninsula
Kent and Medway Herefordshire and Worcestershire Kernow
Cambridgeshire and Worcestershire Hampshire, Southampton Halton
Peterborough Surrey Heartlands and Isle Of Wight Coventry and Warwickshire
Herefordshire and West Sussex Dorset Knowsley
Worcestershire Leeds Surrey Heartlands Surrey Heartlands
Berkshire West Northamptonshire Devon North East London
Herts Valleys Nottingham and Bath and North East Greater Preston
Surrey Heartlands Nottinghamshire Somerset, Swindon and East Staffordshire
West Sussex Cambridgeshire and Wiltshire Oxfordshire
Leeds Peterborough Bristol, North Somerset and
Northamptonshire Trafford South Gloucestershire
Nottingham and Warrington Northamptonshire
Nottinghamshire West Suffolk

Conclusions
• There is a higher degree of variation in how CCGs are performing both as a snapshot in
time and in terms of trends over time.
• In the table overleaf, we highlight those CCGs who are facing multiple stressors.
• CCGs which feature most often in the top 20 of each stressor are:
– Surrey Heartlands
– Bedfordshire, Luton And Milton Keynes
– Kent And Medway
– Tees Valley
• These each have seven or more indicators in the top 20 and are the CCGs that we think
are likely to be experiencing the most ‘stress’ in relation to CAMHS provision.

CCGs facing multiple stressors…
Number of indicators in which CCG is in
CCG top 20 “most stressed”
Surrey Heartlands 9
Bedfordshire, Luton And Milton Keynes 8

Kent And Medway 8
Tees Valley 7
Stafford And Surrounds 6
Stafford And Surrounds 6
Birmingham And Solihull 5
Coventry And Warwickshire 5
Herefordshire And Worcestershire 5
Norfolk And Waveney 5
Northamptonshire 5
Shropshire, Telford And Wrekin 5
South East Staffordshire And Seisdon Peninsula 5
Sunderland 5

Helping you think about next steps
If this analysis raises questions for your local CCG or local authority then Cordis Bright can help in the
following ways:
• We can produce bespoke versions of this stress-test plotting your CCG’s performance against each
indicator. This helps understand your relative strengths and weaknesses. We are able to do similar
for a basket of CCGs, e.g. your statistical neighbours. There is a small charge for this analysis.
• We are experts at service reviews and evaluation. Relevant experience includes an evaluation of a
children and young people’s Emotional Wellbeing and Mental Health Transformation Programme;
evaluation of a Trauma Recovery Model approach within youth offending; a multi-site evaluation of
the Living Well approach to improving mental health.
• We also offer needs assessments, helping you map local need and service provision and identifying
gaps and areas for improvement. These can be population-wide, e.g. mental health services for all
children and young people, or focused on particular cohorts, e.g. looked after children, or particular
aspects, e.g. training needs assessments for those working with children and young people who may
have emotional and mental health needs.
Our team draws upon the expertise of people who have previous experience within children and young
people’s mental health as well as children’s services more generally. If you would like to discuss any of
these options further then please contact Colin Horswell on colinhorswell@cordisbright.co.uk.

References I
Slide 6
Mental Health Services Monthly Statistics: Final November MHSDS Monthly Data File, in:
https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-services-monthly-statistics/mental-health-
services-monthly-statistics-final-november-provisional-december-2016.
services-monthly-statistics-final-november-provisional-december-2017.
https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-services-monthly-statistics/final-november-
provisional-december-2018.
provisional-december-2019.
https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-services-monthly-statistics/performance-
november-provisional-december-2020
Slide 7
services-monthly-statistics-final-november-provisional-december-2016
provisional-december-2018
provisional-december-2019
Population: Mid-2016: SAPE20DT5: Revised, Population 2017: Mid-2017: SAPE20DT5, Population 2018: Mid-2018, and
Population 2020: Mid-2020: SAPE21DT5:
https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/clinicalcommissio
ninggroupmidyearpopulationestimates.
.
References II
Slide 8
https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-services-monthly-statistics/final-
Slide 9
Population: Mid-2016: SAPE20DT5: Revised, Population 2017: Mid-2017: SAPE20DT5, Population 2018: Mid-2018:
SAPE21DT5, and Population 2020: Mid-2020: SAPE21DT5
https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/clinicalco
mmissioninggroupmidyearpopulationestimates.

References III
Slide 10
NHS Mental Health Dashboard Q3 2016-17, NHS Mental Health Dashboard Q3 2017-18, NHS Mental Health Dashboard
Q3 2018-19, NHS Mental Health Dashboard Q3 2018-19, and NHS Mental Health Dashboard Q3 2019-20:
https://www.england.nhs.uk/publication/nhs-mental-health-dashboard/.
Slide 11
Q3 2018-19 NHS Mental Health Dashboard Q3 2018-19, and NHS Mental Health Dashboard Q3 2019-20 :
Population: Mid-2016: SAPE20DT5: Revised, Population 2017: Mid-2017: SAPE20DT5, and Population 2018: Mid-2018:
SAPE21DT5. and Population 2020: Mid-2020: SAPE23DT6a:
Slide 13
Planned spend: NHS Mental Health Dashboard Q3 2016-17, NHS Mental Health Dashboard Q3 2017-18, NHS Mental
Health Dashboard Q3 2018-19, NHS Mental Health Dashboard Q3 2018-19, and NHS Mental Health Dashboard Q3
2019-20: https://www.england.nhs.uk/publication/nhs-mental-health-dashboard/.
Slide 14
Q3 2018-19 NHS Mental Health Dashboard Q3 2018-19, and NHS Mental Health Dashboard Q3 2019-20 :

References IV
Slide 15
Slide 16
Contacts with CYP MH services:


References V
Slide 19
Population 2020: Mid-2020: SAPE21DT5a,

mmissioninggroupmidyearpopulationestimates
Slide 20
november-provisional-december-2020.
Population: Mid-2016: SAPE20DT5: Revised, and Population 2020:Mid-2020: SAPE23DT6a
Slide 21
Population 2020: Mid-2020: SAPE21DT5a,

mmissioninggroupmidyearpopulationestimates

References VI
Slide 22
Slide 24
NHS Mental Health Dashboard Q3 2020-21, https://www.england.nhs.uk/publication/nhs-mental-health-dashboard/.
Slide 25
Population: Mid-2016: SAPE20DT5: Revised, and Population 2020:Mid-2020: SAPE23DT6a
Slide 26
November 2020: Mental Health Services Monthly Statistics: Final November 2020 MHSDS Data File,

References VII
Slide 27
November 2018: Mental Health Services Monthly Statistics: Final November 2018 MHSDS Monthly Data File,
November 2020: Mental Health Services Monthly Statistics: Final November 2020 MHSDS Data File,
Slide 28
November 2020: Mental Health Services Monthly Statistics: Final November 2020 MHSDS Data File,in
Slide 29
Slide 30

References VIII
Slide 31
People in contact with CYP MH services:


Endnotes
1. This measure is effectively a count of open caseload, as is the measure of number of people in contact with services
used in slides 6-9. The number of open referrals for people in contact with services, will generally be greater than the
number of people in contact with services, as the latter only counts a person once regardless of how many referrals
into services they have open at any time.
2. This measure relates to the number of people in contact with children and young people's mental health services at
the end of the reporting period i.e. November of each year.
3. This measure excludes spend on excluding learning disabilities and eating disorders services.
4. National data on the annual planned spend of CCGs on CYP Mental Health was only available from 2017-18.
5. These figures do not take into account inflation over the period.
6. In order to calculate the quarterly number of bed days as a percentage of monthly data of people in contact with CYP
MH services, the number of bed days was divided by 3 to determine an average across the 3 months of the quarter,
and this figure was used to calculate a percentage of the total number of people in contact with CYP MH services in
November for that year.
7. Data for this indicator is only available from November 2018.
8. These indicators do not have a complete top 20 due to a large proportion of CCGs returning values of zero as a result
of data suppression.


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Trends in Child and Adolescent Mental

Health Services & the Cordis Bright

Original material is © Cordis Bright 2021 1

Original material is © Cordis Bright 2021 2

Original material is © Cordis Bright 2021 3

Original material is © Cordis Bright 2021 4

Original material is © Cordis Bright 2021 5

The number of open referrals in children

Original material is © Cordis Bright 2021 6

In November 2020, the equivalent of 27

Original material is © Cordis Bright 2021 7

There has been a 118% increase in the number of

Original material is © Cordis Bright 2021 8

15 Similarly, the proportion of the population

Original material is © Cordis Bright 2021 9

The planned spend for CCGs on children and £872m

Original material is © Cordis Bright 2021 10

Original material is © Cordis Bright 2021 11

Original material is © Cordis Bright 2021 12

1.4% Data on new emergency and urgent

a 0.3% decrease over the two years.

Original material is © Cordis Bright 2021 13

Original material is © Cordis Bright 2021 14

Original material is © Cordis Bright 2021 15

This overall decrease is also witnessed in

from 24.1% to 9.5%.

Original material is © Cordis Bright 2021 16

Original material is © Cordis Bright 2021 17

See slides for fuller description of each indicator

Original material is © Cordis Bright 2021 18

60 58 CCGs with lower 46 CCGs with higher

Original material is © Cordis Bright 2021 19

6% 44 CCGs with lower rates. Highest rate: +6.0% (Wirral

Original material is © Cordis Bright 2021 20

45 CCGs with higher

Original material is © Cordis Bright 2021 21

Original material is © Cordis Bright 2021 22

£40m Average spend per CCG: £8.23m

67 CCGs with lower rates. 38 CCGs with higher

Original material is © Cordis Bright 2021 23

Original material is © Cordis Bright 2021 24

Original material is © Cordis Bright 2021 25

contact with CYP mental health services

68 CCGs with lower rates.

Lowest rate: 0% (51 CCGs)

Original material is © Cordis Bright 2021 26

-130% 178 CCGs with lower rates.

Original material is © Cordis Bright 2021 27

(Bedfordshire, Luton and

Original material is © Cordis Bright 2021 28

England average: +8.0%

Original material is © Cordis Bright 2021 29

70 CCGs with lower number.

15 CCGs with higher rates.

-1000% 86 CCGs with lower rates.

Original material is © Cordis Bright 2021 31

Original material is © Cordis Bright 2021 32

Wirral Wirral Wirral Wirral