Royal colleges publish healthcare standards for young people in custody

The standards - produced by the Royal College of Paediatrics and Child Health (RCPCH), Royal College of Psychiatrists, Royal College of Nursing, Royal College of GPs, Faculty of Public Health, and Faculty of Forensic and Legal Medicine - aim to improve the quality of health services provided for all the 10,000 children coming into contact with the secure estate each year.

Many of the children and young people held in custody have severe emotional, physical and mental health needs, which the royal colleges say the current system is struggling to meet. A patchwork of local guidelines has produced services that are too inconsistent and lacking in an evidence base, it adds.

Funded by the Youth Justice Board and led by the RCPCH, the Healthcare Standards for Children and Young People in Secure Settings sets out 69 standards for the healthcare delivered in young offender institutions, secure children’s homes and secure training centres.

Backed by the four UK children’s commissioners, the standards recommend every child and young person undergoes an initial health screening and risk assessment before the first night, and ideally within two hours of arrival.

A comprehensive healthcare plan, addressing a child’s physical, mental, neurodisability and substance misuse needs, should be established within 10 days of arrival. Health assessments should be reviewed annually and the mental health assessment reviewed within three months of admission.

Each child should have appointed a named healthcare professional to lead on and oversee their care.

It also recommends that staff working in secure settings are trained in child development, safeguarding and child protection, and know which healthcare professional to contact in an emergency. Healthcare staff working with young offenders should have their skills more regularly assessed, it adds.

Dr Hilary Cass, president of the RCPCH, said the lack of consistent standards governing the health needs of children in the secure estate “is simply not good enough”.

She added: “In putting together these standards and talking to young people, we have come across worrying variations in healthcare standards. What these standards aim to do is ensure consistency in care so that health needs are addressed and not neglected.”

The standards were produced after an extensive review of evidence, after which draft guidelines were drawn up and an online consultation launched, which included meetings in March with children and young people’s organisations.