Dr. Maura Young:

I am sorry for interrupting earlier. The governance arrangements of a CAMHS team are complex. The consultant is the de facto team leader and has clinical responsibility for the care delivered within the CAMHS team. However, each discipline within the CAMHS team reports to its head - the social worker reports to the head of social work and the nurse reports to the director of nursing. Each reports up through his or her discipline. In reality, although the consultant is the nominal lead, he or she finds it difficult to get his or her wishes down to each of the disciplines because each of those are line managed by itself.

In an attempt to bring this together in some shape or form, my predecessor brought together a CAMHS governance group. Within that group were all of the line managers of the disciplines that worked on the ground - social work, occupational therapy, psychology, speech and language, and medical.