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Creating a new vision

for Surrey CAMHS

For a better life

NHS Foundation Trust

Surrey and Borders Partnership

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Welcome

Surrey and Borders Partnership NHS Foundation Trust (SABP) and a range of dynamic, innovative partners will be introducing a new and transformed model of CAMHS services in Surrey from 1 April 2016. We are excited to be working together to improve the health and wellbeing of children, young people and families at an earlier stage by increasing access to services, broadening choice, expanding self-help and peer support and extending reach to vulnerable and under-represented groups.

Our integrated service model puts children and young people at the heart of all we do with a focus on getting them to the right support fi rst time and preventing ill health. All the CAMHS partners are ambitious about supporting Surrey families to live well and achieve an excellent quality of life. Children and young people were fully involved in the development of our new CAMHS model and will continue to work with us throughout the mobilisation period. They will also advise on the language we use and how we name our services to ensure they are meaningful and relevant to people their age.

The CAMHS partnership is based on a lead and subcontractor structure and builds on existing joint working with key delivery partners, including Surrey County Council, child health services and the voluntary sector.

We are all working hard to mobilise the new service model but recognise the challenges ahead to keep services going over the busy winter period whilst making all the necessary changes to be ready for the launch in April. However, we have every confi dence that with such committed staff and partners we can meet this challenging timetable.

Linda McQuaid

Interim Director

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SINGLE POINT OF ACCESS TAMHS PRIMARY MENTAL HEALTH VOLUNTARY SECTOR COUNSELLING KOOTH ONLINE.COM EARLY HELP PARTNERSHIPS PARTNERSHIP WORKING ADVICE PHONE LINES IAPT 14+ WEBSITE W EL LB EI N G A N D R E S I L I E N C E S E R V IC E S T A R G E T E D S E R V I C E S S P E C I A L I S T S E R V I C E S C R I S I S S U P P O R T S E R V I C E S CHILDREN YOUNG PEOPLE & FAMILIES

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What is Diff erent about our new CAMHS Service Model

The new CAMHS model will look and feel different for families, children and young people receiving the service and for referral agencies, not only because of the additional investment in existing and new services, but also because it will include:

A Single Point of Access for all referrals, which will navigate children and young people to the most appropriate service and through the system

A “no wrong door” i.e. all children, young people and families will be supported to fi nd the right help at the right time

The threshold criteria for acceptance into CAMHS will be lowered and volumes are expected to increase signifi cantly

Expanded operating hours 8am-8pm Monday to Friday and 9-12 on Saturday Services will be made more accessible and user friendly through more convenient

locations and online services

Automated clinical scheduling will ensure capacity, appointments and room availability is transparent and easier to manage

A more managed model of care with clear outcome monitoring after every session A fully operationalised range of NICE compliant pathways, including:

New behaviour pathway Introduction of CYP IAPT

Additional and specifi c support for adopted children and their families. Many other current CAMHS pathways will be enhanced

Reporting requirements from commissioners on activities and outcomes will be more demanding

Continued work with CAMHS Youth Advisors and development of an employment pathway for young people.

Key Elements of the New CAMHS Service Model

1 - Single Point of Access - SPA

A new single point of access, called CAMHS One Stop, will be managed by our partner Beacon UK who have a proven track record in delivering similar services. They will take all referrals (including routing crisis calls) and enquiries via multiple routes: i.e. telephone, email, website, fax and letter. This will replace various routes into CAMHS and will navigate children and young people’s families to the right service, ensuring targets such as referral to initial screening, referral to assessment and assessment to fi rst direct intervention are met.

Beacon will oversee and report on all direct and indirect service activity and outcomes. The pathways and the role of the CAMHS One Stop in tracking progress through these services is illustrated below.

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CAMHS One Stop will operate from 8am to 8pm Monday to Friday and 9am to 12 noon on Saturday. It will:

Manage emergency / crisis, urgent and routine referrals and enquiries

Operate a 111 diversion service, with the SPA navigators undertaking a ‘warm transfer’ to the appropriate service, providing a handover before leaving the call

Operate an advice line for professionals who have a concern regarding children and young people

Operate an advice and guidance line for parents, children and young people Provide access to 365 / 24 / 7 on-call consultant psychiatrist.

Additionally the CAMHS One Stop will:

Manage the web-based service directory that maps local provision for families in Surrey Provide weekday referral screening/triage to appropriate service pathways, proactively

ensuring support from the most appropriate service according to agreed clinical ‘Levels of Care’ criteria

Increase case fl ow and support appropriate step-up and step-down to other services

Provide informed navigation to the wellbeing and resilience services or other voluntary sector partners, where appropriate, using the service directory

Follow-up on signposted and referred cases to ensure those signposted have identifi ed and contacted appropriate services.

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Use information to collaborate with service delivery teams to improve quality/outcomes and track people’s journeys over time

Manage the EPR clinical scheduling function to make appointments and monitor people’s journey through our pathways.

2 - Prevention and Early Intervention Services - Building

Wellbeing and Resilience

These will be available across all pathways as early support and as a stepdown from targeted/community CAMHS, and include:

Guided self-help and support materials – digital (CAMHS

website and kooth.com) telephone and paper-based Primary Mental Health Workers (PMHW) – supporting

children, young people, families and professionals in the community

Voluntary sector counselling / peer mentoring and schools

programmes

Kooth.com – online BACP accredited counselling

and moderated support

Parental support/programmes.

These services will help to achieve positive outcomes across all domains: Enhancing quality of life

Helping recovery from ill health Giving a positive care experience

Helping CYP to develop/maintain good health Improving access to information

Providing safe, supportive and non-stigmatising environments Reducing re-referrals

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3 - Targeted Services

These will help vulnerable groups, working with voluntary sector partners. The services include:

Primary Mental Health

3Cs Looked After Children (expanded) Adopted Children

CAMHS Care Leavers (expanded) HOPE Service

STARS (Sexual Trauma and Recovery Support) (expanded) PIMHS (Parent and Infant MH Service) (expanded)

Behaviour Pathway for children with Neurodevelopmental Disorders (renamed BEN).

4 - Specialist Services

We will address complex needs using a wide range of evidence-based interventions aligned with NICE recommendations, including:

Community CAMHS CYP Learning Disabilities Eating Disorder Service

Mindful Service 16-25 year olds (expanded).

5 - Crisis Support

Providing responsive support and intervention for children, young people and families with complex needs, these include:

HOPE Service

Extended HOPE Service

365 / 24 / 7 psychiatrist on call Paediatric liaison

Home treatment team for 16-18 year olds

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Care Pathways

The new model for CAMHS is based on a range of NICE compliant pathways. One example of these can be seen below

All the CAMHS care pathways set out the journey from referral to assessment - to intervention - and then to discharge. All pathways include a focus on monitoring and manging risk.

Surrey CAMHS System

Our new service model for CAMHS is based on a lead and subcontractor structure and builds on existing joint working arrangements with partners. The organisational model can be seen below:

Care Pathways

The new model for CAMHS is based on a range of NICE compliant pathways. One example of these

can be seen below and others will be made available through the CAMHS mobilisation Dropbox1

1 Please note the mobilisation Dropbox is currently being set up and access details will follow.

All the CAMHS care pathways set out the journey from referral to assessment - to intervention - and then to discharge. All pathways include a focus on monitoring and manging risk.

Surrey CAMHS System

Our new service model for CAMHS is based on a lead and subcontractor structure and builds on existing joint working arrangements with partners. The organisational model can be seen below:

Care Pathways

The new model for CAMHS is based on a range of NICE compliant pathways. One example of these

can be seen below and others will be made available through the CAMHS mobilisation Dropbox1

1 Please note the mobilisation Dropbox is currently being set up and access details will follow.

All the CAMHS care pathways set out the journey from referral to assessment - to intervention - and then to discharge. All pathways include a focus on monitoring and manging risk.

Surrey CAMHS System

Our new service model for CAMHS is based on a lead and subcontractor structure and builds on existing joint working arrangements with partners. The organisational model can be seen below:

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The Surrey CAMHS partners

Surrey and Borders Partnership Foundation Trust

Surrey and Borders Partnership NHS

Foundation Trust (SABP) is a leading provider of health and social care services for people of all ages with mental health problems, drug and alcohol problems and learning disabilities in Southern England.

We deliver high quality care across our 140 services, all of which are registered with the Care Quality Commission. We employ approximately 2,400 staff across 47 sites, serving a population of 1.2 million in Surrey.

We will be leading on the new service model for Surrey CAMHS and are excited to have brought together and to be working with a wide range of dynamic and high performing partners to create an innovative, integrated vision for Surrey CAMHS.

Surrey CAMHS will continue to improve the wellbeing and resilience of children and young people across the county through a wide range of partners. These partners will support the delivery of targeted and specialist services - connecting with universal services to ensure support is available at every level, from primary mental health in schools to urgent needs via HOPE.

Barnardo’s

Barnardo’s transforms the lives of the most vulnerable children across the UK through our services, campaigning and research expertise. As one of the UK’s leading children’s charities, Barnardo’s works directly with over 200,000

children, young people and their families every year. We run over 900 vital services.

Every Barnardo’s service is different but each believes in the potential in every child and young person. We will support them, stand up for them and bring out the best in each and every child. We do this because we believe that every child deserves the best start in life and the chance to fulfi l their potential. With the right help, committed support and a little belief, even the most vulnerable children can turn their lives around.

In the Surrey CAMHS Model Barnardo’s will deliver the following services:

Parenting Programme: A Parenting Programme for parents of children and young people with Attention Defi cit Hyperactivity Disorder (ADHD).

Cygnet Training Programme: This Programme will train Surrey and Borders Partnership NHS

Foundation Trust staff to support children and young people with Autistic Spectrum Disorders and Complex Behaviour, and their families.

www.barnardos.org.uk

NHS Foundation Trust

Surrey and Borders Partnership

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Beacon UK

Beacon Health Options is a world-leading managed mental health care company who manage the care of 47 million people worldwide.

We believe that recovery is always possible and best achieved and sustained in the community. We believe that care should be geared towards helping people achieve the outcomes that matter to them, and that care should be delivered in the most fi scally responsible way.

Operating across 70 countries including the UK, Beacon works alongside NHS trusts, CCGs, social care, voluntary sector and private healthcare organisations to better support people with mental health conditions.

Beacon is part of the CAMHS Forward Thinking Birmingham partnership, which provides care for 0 to 25 year olds with mental health conditions in Birmingham, covering a population of more than 440,000 young people. This innovative model brings together traditional child and adult services to bridge the transition age gap.

In Surrey we will bring our expertise in access, utilisation management and data analytics to support the delivery of services through the single point of access to ensure that as a partnership we achieve the best possible outcomes for children, young people and their families.

www.beaconhealthoptions.co.uk

Brain in Hand

Brain in Hand is personal assistive technology for use by individuals and it compromises:

A personalised website where each user can record their daily diary

and anticipate strategies for dealing with each event, along with preparing for unexpected events that are known to trigger high anxiety. The website is structured in a solution-focussed way that maps well to Cognitive Behavioural Therapy, Behavioural Activation Therapy, Dialectic Behavioural Therapy and WRAP plans

A smartphone app for use during daily life, via which the user accesses their coping strategies as needed and quickly records which are of most use. The app also contains a “traffi c light” mood management system, inviting the user to periodically record whether they are feeling okay (green), beginning to struggle (amber) or need help urgently (red)

An SMS alert system, via which one or more support workers will receive a text message when a user presses red, or three ambers in a row. Services can then determine and agree with their users how these will be responded to

24/7 secure capture of all daily-use data including coping strategies employed and mood monitoring results.

Our team have a wealth of experience in supporting organisations to successfully implement Brain in Hand and we will provide training and onsite support to ensure that Surrey CAMHS clinicians and other staff can seamlessly integrate the use of Brain in Hand into their delivery within the behaviour pathway. This will allow the Brain in Hand system to act as a catalyst for change; facilitating the coproduction of effective and personalised support.

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Catch22

A forward-looking social business, Catch22 has over 200 years’

experience providing public services that help people in tough situations to turn their lives around.

Our programmes help those we work with to do the best they can in school or college and develop skills for work, live independently on leaving care or custody, gain new skills and confi dence as parents, build resilience and improve their emotional wellbeing, steer clear of crime or substance misuse, and play a full part in their community.

Catch22 will enhance and add capacity to the Mindful service. Through the provision of engagement workers and an Apprentice, the experienced Mindful staff will be freed up to ensure service coverage over a wider geography and better targeting of resource according to people’s needs.

Our experience has shown that Young People often respond better to people of their own age, so we will recruit people under the age of 26 into these positions. With a direct link to Catch22’s countywide substance misuse service, the team will also bolster the provision for young people with dual diagnosis. Through the inclusion of an Apprentice within the team the partnership is also demonstrating its commitment to workforce development in Surrey.

www.catch22.org.uk

National Autistic Society

Surrey Resource Centre provides support within the local community, through a variety of social groups, clubs, organised outings, and family support coordinators.

NAS provides services from primary years through to adulthood. In partnership with

the CAMHS Surrey Resource Centre we would like to provide continuity of support for children across the spectrum.

Aims of service:

Provide information, advice and practical and emotional support to families pre and post diagnosis, and at other times of diffi culty or crisis

In-depth guidance regarding understanding of autism

Accessing help locally to parents and carers of children with autism

Discussion and practical support surrounding behaviour diffi culties and education Talks by NAS professionals, parents, experts or people with autism spectrum Information and signposting for families

Talks at external groups such as CAMHS parent support groups

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Richmond Fellowship

We have an established partnership with Surrey and Borders that gives us a strong platform to offer effective integrated services to the young people of Surrey.

Richmond Fellowship Group provides over 150 services to 9,580 people across England with a turnover of £50 million per annum. We are a major third sector market leader of mental health and complex needs services around offending and substance misuse to adults and young people.

Richmond Fellowship will offer education, training and employment support as part of the Wellbeing and Resilience services for young people aged 16-25 receiving CAMHS services. To accompany this we will also offer our My Time wellbeing App and link to a Facebook page for peer support

Our work with young people in Surrey will:

Enable people to take control of their life and build resilience Use education as a route to recovery

Support the expansion of volunteering through Surrey Timebanking Deliver a model of peer support

Inspire people to live a life that’s worth living - with or without on-going symptoms.

www.richmondfellowship.org.uk

Surrey Youth Support Service

The YSS emotional and mental health pathways have been

developed to enable earlier intervention and a holistic response to young people with mental health problems.

Through providing an integrated health, social care and education offer the YSS is able to deliver improved outcomes for young people and to reduce the demand for specialist mental health services.

The blend of skills within a highly integrated approach to supporting vulnerable adolescents has delivered outstanding outcomes over the last three years meaning that, amongst other successes, Surrey’s young people are now more likely to be successfully participating in education, training and employment and less likely to be involved in the criminal justice system than young people anywhere else in the country. Key components behind this success are:

Multidisciplinary teams working locally from each of 11 boroughs Assertive outreach to the neediest of young people and families Case management and relational one-to-one intervention model Being outcomes driven with young people at the heart of all we do

High level of integration with omni-competent staff delivering all aspects of the service Being central to the strategic partnership between police, county council and health.

www.surreycc.gov.uk/people-and-community/young-surrey/help-and-advice-for-young-people/ youth-support-service

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Xenzone

Xenzone has been developing and delivering online mental health services since 2001 and launched KOOTH.com, our

award winning service for children and young people, in 2004.

We are proud to be a BACP (British Association of Counsellors and

Psychotherapists) accredited service. Through our KOOTH service we have had the privilege of working with many local authorities and CCGs across

the UK and have built a model of online and blended support and therapy that works well with local services on the ground.

Xenzone fed into the recent task force on children and young people’s mental health, and were applauded as leading the way in online services in the ‘Future in Mind’ report. Since then we have been invited to meet the Department of Health around CAMHs services and what works in digital services.

The enduring elements of why we are well placed to deliver services are commitment to young people’s mental health, principles of co-delivery and inclusion, and knowledge and expertise of the technologies needed.

We are committed to working fl exibly to develop and deliver services that work well for children, young people and the carers and professionals who support them.

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Voluntary Youth Services

Eikon

The Eikon Charity is well-established with a strong reputation. Over 20 years Eikon has developed and a proven and distinctive approach to supporting vulnerable young people.

We work with over 3,000 young people each year – in schools, in youth clubs and on the streets – and we have learnt what works. Early intervention, our personal approach and supporting a young person for as long as it takes are the foundations for the impact we have.

Our bespoke programmes are tried and tested and we are trusted and respected by young people, parents and partner agencies alike. We are also one of Surrey County Council’s preferred providers of youth support services.

Eikon works to prevent social and emotional barriers that are known to have a serious, negative impact on young people and their futures. Young people come to Eikon because they feel worried, afraid, depressed and isolated due to diffi culties at home or at school and, in some instances, problems spread from individuals to friendship groups or even entire school years.

www.eikon.org.uk

Heads Together

YMCA East Surrey has operated Heads Together youth counselling service for over 20 years as part of a Youth Service offer which encompasses a range of inclusive projects. Our projects refl ect our organisational objectives to help young people to believe in themselves, to support them to achieve their goals and to inspire them to be the best they can be.

Heads Together’s core service is one-to-one counselling for young people aged 14-25. In 2014/15 we received approximately 550 referrals and around 300 young people went on to have counselling sessions. The service is run by a Manager and small team of part-time staff. All Heads Together staff are qualifi ed counsellors and members of BACP. Counselling is provided by a mixed team of 22 volunteers (either in training or qualifi ed) and qualifi ed counsellors paid on a sessional basis. We evaluate the effectiveness of counselling by using qualitative and quantitative tools, including YP-CORE.

We currently deliver services from several venues across East Surrey including YMCA venues in Redhill and Reigate, youth centres at Horley and Epsom, and community venues in Merstham, Oxted, Leatherhead, Tadworth and Dorking.

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Learning Space

Since 1997 Learning Space has been providing high quality services for children, young people and families across East Surrey. The principles of early help, timely interventions, integrated working and co-production are embedded in our successful delivery model.

In particular the emphasis on individual strengths as the starting point for

assessments and holistic understanding of need, make our solution-focused mode of delivery unique in Surrey.

We deliver measurable improvements in the resilience of children and young people. Objective

measurement and feedback from referrers shows positive change in the behaviour, skills and attitudes of the young people we support.

Our interventions as part of Surrey CAMHS will provide an alternative to more traditional clinical locations. We will engage with young people wherever they feel most comfortable, including schools, and aim to be available at an early stage in order to prevent escalation of issues.

We are able to work with children and young people from aged 5 upwards and can also offer support for the wider family if appropriate.

www.learningspace.org.uk

The Lifetrain Trust

The Lifetrain Trust is an education and personal development charity for young people in Surrey.

We work with young people who are at risk of growing up without the skills and emotional health needed to progress in life and fulfi l their potential. We are here to get them back on track to a better life with training, education and work opportunities.

Lifetrain gets involved at a local level with young people who, through no fault of their own, are at signifi cant risk of failing academically and growing up without the skills to become successful adults and members of society. Often from diffi cult or neglected family backgrounds these vulnerable boys and girls who may have suffered violence or abuse have no self-belief or ability to make good choices for themselves and consequently can end up excluded from school or in trouble with the police.

Each year we work with over 2,000 vulnerable young people providing them with opportunities to gain qualifi cations and supporting them to improve their self-confi dence and self-esteem with the objective of guiding them towards further training or employment.

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Relate West Surrey

Relate is a national registered charity with 75 years’ experience in helping people with their relationships.

Relate West Surrey is part of the Relate Federation but is a charity in its own right and a not-for-profi t organisation. We offer confi dential relationship counselling support to individuals, couples, children, young people and families in seven Boroughs: Woking, Guildford, Waverley, Surrey Heath, Elmbridge, Runnymede and Spelthorne.

In Surrey, with a high rate of divorce and remarriage, blended and extended families are on the increase and may be experiencing diffi culty readjusting to a change in family dynamics. We can see children under the age of 10 as part of our family counselling service.

Relate is able to undertake relationship education work with individuals and organisations; training courses range from parenting skills for those with children with ADHD or other challenging behaviour, Teen Talk to help parent teenagers, to basic counselling skills, peer mentoring and relationship

education in schools.

As part of the new CAMHS service, Relate West Surrey will provide young people’s counselling for young people aged 10-18 in North West Surrey.

Relate West Surrey also offers counselling services at outposts in Staines, Thorpe and Stanwell, Walton and in Farnham.

www.relatewestsurrey.org.uk

Reflex Woking

Refl ex exists to empower children, young people and young adults.

Refl ex equips young people with the skills and opportunities they need to overcome barriers they face and achieve their full potential. Each of our programmes offers young people a platform of skills from which to express their feelings, thoughts and emotions positively and to grow in confi dence.

Our dedicated Outreach Workers provide a platform for informal learning, building positive relationships with young people, modelling acceptable behaviour and helping them to access appropriate services that support their transition to adulthood.

Our non-formal education tutors deliver tailor-made programmes embedded with proven learning techniques. Regardless of the creative medium used, each Refl ex programme is designed to develop young people’s creative thinking, helping them to refl ect on life experiences and challenging their negative attitudes.

Whether young peoples’ needs are social, emotional, spiritual, intellectual or physical, we offer a holistic range of support where every young person is valued and respected as an individual.

We believe every young person has potential

We believe every young person has the power to change We believe every young person can make a difference.

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Step by Step

Step by Step is a regional charity spanning Surrey,

Hampshire and West Berkshire, which is entirely focused on providing transformational support services for vulnerable young people aged 11 - 25.

We specialise in young people and we support over 1,100 young people each year. To provide truly transformational services requires expert staff, who are trained and skilled across a range of disciplines. Our services include ‘Foyer’ style supported accommodation, training services, targeted NEET to EET work, early intervention services, a drug and alcohol service, housing advice, information, advice and guidance services, supported lodgings, family mediation and counselling.

In West Surrey, we deliver the one-to-one early intervention contract working with 13-18 year olds at Level 2 and 3 with the aim of providing intensive, targeted asset-based support, which prevents the need for specialist Level 4 intervention.

By working with an aspirational focus, young people are more likely to engage and succeed in their chosen endeavours.

As part of the Surrey CAMHS service we aim to offer one-to-one youth counselling delivered by student counsellors and experienced volunteers, managed by a service coordinator.

www.stepbystep.org.uk

Windle Valley Youth Project

Life – full on! We support young people aged 11-18 in Surrey Heath to become all they can be.

We work alongside people in their communities and in youth clubs, providing courses and short interventions, one-to-one support, mentoring, advocacy and youth social action, helping them achieve their dreams and supporting them when things get tough.

We are deeply integrated in the local community, working in partnership with schools, police, Surrey Heath CCG, other youth work organisations, the Borough Council and of course local residents.

Our work operates in three integrated streams:

Community youth work: offering youth clubs, detached youth work and sports in the most needy areas

Support: building resilience and life skills in young people through courses, one to one youth work, and solution-focused mentoring. We aim to use and develop evidence based practice and our interventions include CBT based group programmes and The Resilience Framework

Youth Social Action: building agency and a wide range of life skills our youth social action work is based on specialist skills in developing peer led programmes and includes running the award winning Surrey Heath Youth Council.

Our work is all about the well-being of the young people we journey with and we are leaders in improving the mental health of young people in Surrey Heath.

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Publication ref: A66524/CAMHSBrochure/V1

Surrey and Borders Partnership NHS Foundation Trust 18 Mole Business Park, Leatherhead, Surrey KT22 7AD

Tel: 0300 55 55 222 Textphone: 020 8964 6326 www.sabp.nhs.uk @sabpnhs facebook.com/sabpnhs

We look forward to

working with you to deliver

the new service model for

CAMHS in Surrey.

References

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