Commissioners slam child mental health inpatient service
Derren Hayes
Friday, June 27, 2014
Local government commissioners have criticised the management of the children's mental health inpatient service since it was transferred to NHS England last year.
Commissioning managers from three local authority areas told MPs this week that NHS England had commissioned insufficient inpatient beds for children and young people with the result that some children are being placed in facilities long distances from their home.
The management of inpatient child and adolescent mental health services (CAMHS) has come in for criticism since responsibility for it was transferred from regional health authorities to national commissioning in April 2013.
Giving evidence to the health select committee’s CAMHS inquiry, Barbara Herts, director of integrated commissioning and vulnerable people at Essex County Council, said the national commissioning arrangements were not working.
“It is clear there are not enough beds to meet demand,” she said.
“The bureaucracy of NHS structures is very difficult to work with particularly when trying to place vulnerable children at short notice within their own county – inpatient beds are often populated by children from other counties.
“We haven’t seen the planning [of inpatient beds] take effect as promised by NHS England.”
Herts added that her authority was not receiving outcome or activity data on inpatient placements making it hard to plan the levels of local CAMHS support needed to care for patients in the community.
“It’s very difficult to get outcome data out of NHS commissioners. It has made it exceedingly hard to plan and target commissioning, particularly for looked-after children. It’s hard to step up and step down [levels of care for] our children and young people from these [inpatient] units,” she added.
Michael Upsall, children’s commissioning manager for Derbyshire County Council, said there is a “gap” between the inpatient services commissioned by NHS England and the needs of local populations.
He added: “There is a risk of seeing that gap widen and more young people will end up in inpatient provision as a consequence.”
A recent survey of trainee psychiatrists by the Royal College of Psychiatrists found that of those working in child mental health services, 22 per cent had needed to send a child 200 miles to get an inpatient bed.
