Never stop caring…

As a “twin hatter”, i.e. a director of adults as well as children’s services, I listened to the announcement last week about funding for health and adult social care with a heavy heart. 

No one disputes that significant extra resources are needed. However, the allocation for adult social care is negligible compared to the scale of need. It is a privilege to have our NHS, and free health care is a precious resource that is too easily taken for granted, but if we don’t balance the funding for acute services with more resource for community care and support, plus health and wellbeing work, we will never make progress to reduce or manage need better, whatever someone’s age.

What are the implications for children? In the preparations for new integrated care system arrangements from April 2022 onwards, the priority given to the health needs of children remains uncertain, at best. There has been publicity recently about the pressures on acute paediatric wards in caring for children who are very mentally unwell, traumatised and distressed, but not mentally ill. They do not meet the threshold for Tier 4 provision, so are staying on these wards as there is nowhere for them to go.

Major investment was promised in the NHS Long Term Plan for mental health support for children. Programmes such as Mentally Health Schools and Mental Health First Aid have offered the green shoots of hope that the importance of community-based support for children and young people has been recognised. 

The adverse impact of Covid-19, and other pressures, on their mental health have been well publicised and child and adolescent mental health services are currently responding to the higher acuity needs in those who are referred. In the urgency of addressing acute hospital pressures, we need to ensure these community developments continue to be prioritised as part of the solution. We have a role to play in connecting the system and bringing one wraparound support offer to the children and their families in our areas.

In addition, those children in our care with the most acute mental distress are being poorly served by our current placement offers. A shortage of welfare secure placements and a lack of effective care options for our most complex young people is leading to placement breakdowns and use of inherent jurisdiction to establish arrangements that will keep children as safe as possible.

So, what to do? Firstly, we will never stop caring and will work on solutions despite the challenges. The association will continue to raise the profile and need of children and young people everywhere and press for a national plan for children linked to a clear ambition for their welfare and future, with proper resourcing to meet their needs. 

Secondly, we will champion the needs of our most vulnerable children as individuals and there are many examples of great work and positive impact that we can learn from. 

Finally, we need to work with partners to develop creative solutions on a sustainable basis that will offer more of these children a chance to be cared for in a way that meets their needs.

We’re working on it and all help and examples are most welcome!

Charlotte Ramsden is president of the Association of Directors of Children’s Services (ADCS) and strategic director for people at Salford City Council. This blog first appeared on the ADCS website.