Mr. Jim Ryan:

The Deputy has asked about sign-off. Not all young people who will be accepted for CAMHS will require speech and language services, for example. When they are being assessed initially as part of an overall multidisciplinary assessment, there is a need to ascertain what element of our service they will need. In that situation, ideally the psychologist will be there in addition to everybody else. If we do not have a speech and language service, as is occasionally the case, we might be able to buy it in on an agency basis or we might be able to go to primary care to say we need speech and language assistance. Our teams develop from consultants to NCHDs to nursing staff to AHPs. A consultant is needed to start a team because he or she is the team leader. We are very conscious of the need to have a full multidisciplinary team approach because that is what CAMHS does best, but there are occasions when that is not in place.