3.2 South Gloucestershire service activity
South Gloucestershire also provide services across the four tiers, although the efficacy of this model is under scrutiny. Themes emerging from a range of local stakeholder events and focus groups highlight a desire for a joined up care pathway that is clearly mapped and comprehensible by both patients and professionals, as well as a greater range of alternative interventions for children and young people who do not meet the existing service thresholds, such as talking therapies, key workers, and peer support. Appendix B provides information on services offered to South Gloucestershire children and young people at the various service tiers.
‘Off-The-Record’ service activity
As shown in figures 4 and 5 for both age groups, 16-18 and 19-25 years, the highest referrals are made during January and February. Higher numbers of referrals for 16-18 year olds are being received from South Gloucestershire than Bristol. The pattern then changes for 19-25 with twice as many being referred in Bristol compared to South Gloucestershire.
Figure 4: SG referrals to ‘Off-The-Record’ (16-18 year olds)
Source: ‘Off the Record’
Figure 5: SG referrals to ‘Off-The-Record’ (19-25 year olds)
Source: ‘Off-The-Record’
CAMHS service activity
Referrals to tier three CAMHS have increased in the last five years for South Gloucestershire while the percentage of acceptance has decreased (see table 2).
According to ONS 2014 published statistics, in South Gloucestershire an estimated number of 1,060 children aged 17 and under would require Tier 3 service. This is twice the number of children who have been referred and accepted for these services.
Table 2. South Gloucestershire Tier 3 referrals
| Year | Total referred | Rejected | Accepted | % of accepted given an appt. | % accepted |
| 2010/11 | 787 | 203 | 584 | 83% | 74.2% |
| 2011/12 | 721 | 184 | 537 | 78% | 74.5% |
| 2012/13 | 874 | 328 | 546 | 82% | 62.5% |
| 2013/14 | 967 | 328 | 639 | 79% | 66.1% |
| 2014/15 | 842 | 342 | 500 | 73% | 59.4% |
| 5 yr average | 838 | 277 | 562 | N/A | 67.1% |
Source: CAMHS
Hospital admissions data
The rates shown in figures 6 to 9 were obtained by extracting all admissions where any of the diagnoses fields had an ICD code that started with F, in under 19 year olds, South Gloucestershire residents. The data was extracted via SQL coding from the database supported by the SWCSU. Hospital admissions due to mental health conditions have increased over the last five years for South Gloucestershire (figure 5) as have admissions for self-harm for those under 19 years of age (figure 7).
Figure 6. Hospital admissions due to mental health conditions, 10-19 year olds, South Gloucestershire residents, 2010/11-2014/15
Figure 7. Self-harm admissions in under 19, South Gloucestershire Residents, 2010-2015
Source: SUS database. The data was extracted via SQL coding from the database supported by the SWCSU. The above rates were obtained by extracting all admissions where any of the diagnoses fields had an ICD code in X60-X85, in under 19 year olds, South Gloucestershire residents.