HeadStart Newham - Cross systems working

In early 2021, HeadStart Newham harnessed its existing relationships with organisations and services in the borough to bring about Newham’s multi-agency collective (Newham MAC), a group of organisations and services that connect to allocate support to children and young people waiting for, or in need of, mental healthcare through Child and Adolescent Mental Health Services (CAMHS). Its purpose is to provide swift and creative therapeutic support to young people in need by making best use of available resources and building cross-partnership relationships.

‘We don’t want the narrative to be, “you haven’t met the threshold for something”, we want the narrative to be, “if you’re having mental health and wellbeing difficulties, you can come to the MAC and you will get support”’ HeadStart Newham

Newham MAC launched in March 2021 in response to the growing numbers of children and young people waiting for specialist support through CAMHS. It is open to all children and young people aged 0-18 in Newham, and accepts referrals for five main cohorts of young people:

  1. Those on the CAMHS waiting list (classed as Green[1] cases)
  2. Those who do not meet CAMHS threshold
  3. Those who have been referred to but not engaged with CAMHS
  4. Those transitioning from a CAMHS intervention
  5. Those who have been referred from Newham MAC partners

Without intervention from Newham MAC, these cohorts of young people may have had to wait a significant time for support, or may not have received support at all, leading to escalation in need. Cases are referred with parental consent to be presented at the panel and there will be a discussion amongst professionals regarding how exhibiting needs may best be met, with mutual agreement between Newham MAC, parents and young people where they will receive support. Interests and strengths of the young person such as sports, arts, crafts, music and computing inform this decision, alongside their age, gender, ethnicity, school and presenting issues, and the group discusses cases on a weekly basis. The partnership was set up virtually, and weekly meetings remained online throughout 2021.

We are happy with the service, thank you for everything – a parent


Newham MAC developed organically from HeadStart in response to growing numbers of young people waiting for mental health support throughout the Covid-19 pandemic. The crisis led to a sharp increase in the number of referrals to CAMHS on top of an already long waiting list in pre-pandemic times.[2] Data also shows that there was an increased need for crisis services in 2020, particularly in the months of September and October when children and young people were expected to return to school.[3] In addition to an increase in quantity, there was also an increase in the overall complexity of referrals during and after 2020.[4] 160 cases were discussed at Newham MAC between March and September 2021, with almost equal amounts of boys (52%) and girls (48%) from a range of racial and ethnic backgrounds. Most young people referred – 76% - were over the age of 10, and the main 4 areas of need were:

  • Anxiety, low mood, low self-esteem and/or depression
  • Autism spectrum condition, attention deficit disorder and/or a learning disability
  • Trauma/Adverse childhood experiences (ACEs)
  • Those suffering from a range of health problems.

Feedback from throughout this period has been positive and encouraging:

‘I finally got to meet the young person face-to-face and it was like a dream. I took her and her best friend out and got to really engage with her’ Newham MAC partner

‘Mum is very excited and would like to sign her son up once our new programme is open for recruitment’Newham MAC partner

Newham MAC puts young people at the centre of an enthusiastic partnership of high-quality services. It enables timely and swift allocation of cases to organisations, who are able to locate and begin working with young people quickly, making the best use of their resources and skilled staff teams. Newham MAC has transformed the way services work in the borough by bringing together organisations from different sectors in a way that they wouldn’t have before. Educational and voluntary community sector organisations, for instance, are brought together by the Newham MAC where cases are carefully brokered with the support and input from a range of organisations and clinical child mental health services. Although each service is different, they all work towards the common goal of improving the lives of children and young people. Newham MAC has created a network for this common goal to be achieved collaboratively.

Organisations with different offers, expertise and experience are invited to discuss the same cases, offering their own insights and perspectives on what may help a young person and in which way. Alongside partnered organisations, CAMHS and other clinical agencies such as school health and East London NHS Foundation Trust and Mental Health Support Teams (MHSTs) clinicians join the meetings to discuss and advise on the cases. One benefit of this is the support practitioners and clinicians offer each other and this peer supervision approach means that young people referred receive a more fully-rounded, diverse and detailed change to case formulation. Newham MAC is not in operation to replace CAMHS, but offers another dimension of support, known as social prescribing. Social prescribing is central to Universal Personalised Care, and is the practice of referring people to a range of local, non-clinical services to help them with their mental health as well as other health conditions, complex social needs that affect their wellbeing and those who are lonely and isolated.[5] It enables a more holistic and personalised approach that can help prevent the need for escalation to specialist services, provide young people with support whilst they wait for specialist support, and offer an alternative for those who are seeking support but do not want to engage with CAMHS.

Case Studies[6]

Young person A would not engage with CAMHS or any other professionals, so they were referred to Newham MAC and taken on by The Exit Foundation. They [The Exit Foundation] have worked with this young person from the point that they wouldn’t leave their room, to taking them and their friend out.

Young person B is a young person with autism who is not currently attending school. They have a challenging housing situation, sharing a one-bedroom property with a sibling and parents. They are hypersensitive about their health and struggle to see positives in themselves. They were referred to the Exit Foundation who have worked with them on their Stress Bucket and their strengths. They are also linking the young person up with local Youth Zones – attending sessions with them to help them make connections.

Young person C was referred to the MHST team with low mood symptoms, including reclusive behaviour. A member of their family had previously contacted CAMHS and we were able to conduct an assessment with them and the young person before beginning. They have engaged and been able to be honest and open up about some of their depressive thoughts for the first time. The Educational Mental Health Practitioner (EMHP) has involved the young person’s family and have been able to develop a whole family approach with their case. The EMHP found being able to listen and discuss with other practitioners during the Newham MAC meeting helpful in deciding how well the young person fits in the remit and the support that the MHST are able to provide.

Future directions

Having a full-time coordinator of the Newham MAC is central to sustaining the partnership, and providing effective therapeutic support for Newham’s young people. Other opportunities for development are:

  • Developing a self-referral, single-point-of-access service for children and young people’s mental health in Newham.
  • The smooth allocation and follow-up of cases with both partners and young people.
  • Organising the partnership and taking into consideration the needs of each organisation, such as the mental health training needs of each organisation and their referral processes for signing up new young people.
  • Joining up with other practices on both local and national levels, including Mentally Healthy Schools Teams and linking with schools.
  • Tracking young people’s engagement and outcomes from partnered organisations.
  • Requesting feedback from young people, parents, organisations and CAMHS.
  • Collecting and analysing data, writing and publishing impact reports.
  • Developing training opportunities for the partnership, such as in mental health and inclusivity.

As the end of 2021 draws near, the partnership continues to expand and the Newham MAC has commissioned research and evaluation projects to evidence its first-year successes. This includes analysis of cost savings and avoidances across the system by National Children’s Bureau, and research evaluation of the MAC model by the Youth Resilience Research Unit at the Queen Mary University of London. This work aims to quantify the benefits of the partnership to CAMHS and wider system benefits, the positive impact it has had on its young people, and evidence the efficacy of treating children and young people’s mental health and wellbeing through a collaborative, cross-partnership social prescribing approach.

Organisations and services involved in the Newham MAC are:

Active Newham

A leisure trust managing Newham’s leisure centres, parks, sports facilities and volunteering programmes.

Alternatives Trust East London

Providing long-term and intensive parenting support and counselling to women and their children. 

Ambition, Aspire, Achieve

Helping young people to grow confidence and overcome challenges through programmes and activities including targeted youth work, arts projects and an employability programme.

Aston Mansfield

Facilitating social, physical and creative programmes for children and young people in Newham.

Bonny Downs

Working with communities to improve health and wellbeing, learn new skills and bring people together.


Providing specialist, clinical mental health support to children and young people, including embedded CAMHS clinicians.

Caramel Rock

An educational charity providing training and job opportunities to young people.

Change, Grow, Live

Specialising in substance misuse and criminal justice intervention.

Community Links

Tackling health and social inequality in East London.

Early Help

Providing the right support at the right time as difficulties emerge for children, young people and families.

East London Dance

Empowering young people to become involved in dance and develop their ideas and artistry through professional training programmes.

Diesel Gym

An established and successful non-profit mixed martial arts gym, investing profits into Newham community projects in areas such as sports for all, mental health and youth crime.

Exit Foundation

An organisation dedicated to providing support to those ready to exit a life of crime and gang-related activity.

Fight for Peace

Inspiring young people to reach their potential and promoting peace in our communities.

St Giles Trust

Using expertise and real-life past experiences to empower people facing unemployment, poverty, criminal exploitation, complex barriers and the criminal justice system.

Kids Time

Fun workshops for children aged 5-18, and their parents or carers, when a parent or carer in the family has a mental illness.


Providing free, online counselling for children and young people.

Mental Health Support Teams

Delivering evidence-based mental health interventions for children and young people in schools and liaising with external specialists to help children and young people get the right support, and stay in schools.


Helping young people thrive through sport.

Newham Music

Providing high quality music education for Newham’s young people.


National Health Service.

Pathfinder Project

Providing access to support for children, young people and families experiencing trauma relating to the Covid-19 pandemic.


Providing counselling and mental health support in schools.

Public Health

Helping people stay healthy and protecting them against things that negatively impact their health.

Rein UK

Eliminating racial discrimination, promoting equality of opportunity, justice and good relations between people of different racial groups.

School Health

Clinical staff providing support for children’s health in schools.

Skills for Growth

Supporting disadvantaged young people into employment.

Street Games

Changing lives and communities through neighbourhood sporting programmes.


Creating positive futures for young people growing up in inner-city estates in London.

West Silvertown Foundation

Enriching lives through shared opportunities for participation, inclusion, learning, generosity and good health.

West Ham United Foundation

Promoting health and economic wellbeing by providing the best inclusive community engagement programmes in sports, education and inclusion.

Youth Empowerment Service

Providing opportunities to discover new talents and interests, and developing essential skills for life and work.

Youth Offending Team

Working with young people involved with the law to reduce offending behaviours and stay away from crime.


Supporting young carers aged 5-18, and up to 25 with additional needs or responsibilities. 


[1] When a case is classed as ‘Green’ this means that the young person has been assessed as needing some input from CAMHS but no evidence of immediate risk

[2] London Borough of Newham. (n.d.) Children and young people’s joint strategic needs assessment. [PowerPoint]. Retrieved from https://www.newham.gov.uk/downloads/file/3607/cyp-jsna-august-2021.

[3] London Borough of Newham. (n.d.) Children and young people’s joint strategic needs assessment. [PowerPoint]. Retrieved from https://www.newham.gov.uk/downloads/file/3607/cyp-jsna-august-2021.

[4] Kathy Dee. (2021). Providing earlier young person-centred support: multi-organisational panels. Presented at The Anna Freud National Centre for Children and Families event: Supporting young people’s wellbeing across the system: learning from HeadStart. (2021).

[5] NHS. (n.d.). Social prescribing. Retrieved from https://www.england.nhs.uk/personalisedcare/social-prescribing/.

[6] All case studies are anonymised and details changed to prevent identification of young people.