Of those areas that were selected as Mental Health Support Team Trailblazers in 2018/19, 12 are four week wait pilot sites, building consensus on the definition and measurement approach for a potential access and waiting time standard as part of the NHS Clinically-Led Review of NHS Access Standards. Rather than testing a specific waiting time, these pilot sites were asked to focus on reporting the initiatives they were using to tackle long waiting times, and exploring what we might measure to support a clinically meaningful response to children and young people in need of mental healthcare. These pilot sites have worked closely with service users, parents and carers, and have focussed on the potential impact on equalities and health inequalities.

As part of the 2020 government spending review two new pilot sites were commissioned. The sites participating in the pilots are outlined below:

North West

• Greater Manchester
• Liverpool and Sefton (new as of 2021/22)

North East and Yorkshire

• Northumberland
• Doncaster and Rotherham

Midlands

• Stoke-on-Trentand North Staffordshire
• South Warwickshire
• Nottingham and Nottinghamshire (new as of 2021/22)

South West

• Gloucestershire

South East

• Buckinghamshire
• Oxfordshire

London

• Camden
• Tower Hamlets
• Haringey
• Bromley

In July 2021, the NHS published the Mental Health Clinically-Led Reviews of Standards report, which sets out the final recommendations on new mental health standards and began a public consultation process which ended on 1 September 2021. For children and young people presenting to non-urgent, community-based mental health services, the new proposed standard is that children, young people and their families/carers should start to receive help within four weeks from request for service (referral).

Given the range of needs that children and young people present with to mental health services, the new standard for non-urgent care focuses on ‘referral to help’. This will help to ensure all patients and all services in children and young people’s mental health are covered by the same standard and a new standard does not disadvantage people, or their services, where those referred need a specialist assessment or a longer period of engagement prior to starting treatment. It is inclusive of those people using services where the need is for support or advice and does not disincentivise services offering effective and efficient single session interventions, where appropriate.

Piloting has now been extended to the end of 2021/22, with the addition of two new pilot sites, supported by the recent government pledge of £79 million for children and young people’s mental health services. This will allow continued focus on testing, refining and embedding the proposed new standard, and development of a robust trajectory for implementation and setting of future performance thresholds. Pilot sites will also help inform the package of measures required alongside a waiting time standard to develop a well-rounded and robust view of the impact of this programme.