Children and young people with mental health problems, their families and carers want timely access to evidence-based, high quality care, in the right setting. They have made it clear that more services should be provided in the community and that, where an inpatient stay is required, it should be as short as possible. They have also made clear that it is unacceptable for some young people to travel excessive distances, be placed inappropriately on paediatric acute or adult wards, or struggle to access inpatient care at all.
At NHS England we have listened to the views of families and professionals and are taking action to deliver on our commitment to improve outcomes for children and young people.
Clinical Commissioning Groups (CCGs), together with their partners, are taking steps to improve community services, including for those in crisis.
We are supporting the whole system modernisation of Children and Young People’s Mental Health Services (CYPMHS) with a programme of support for CCGs and their partner agencies, including:
- the development of effective evidence based services that work with partners across the voluntary sector, education and social care
- delivering improvements in our own direct commissioning of services in the secure system and inpatient beds.
Our goal is to minimise the number of children and young people requiring inpatient care, using these intensive resources more effectively to increase access to services in the community.
Following extensive engagement we have identified a need to improve national distribution of inpatient beds as well as a need to provide more effective integrated treatment pathways. Our regional specialised commissioning teams are implementing new recommendations relating to inpatient care, aiming to improve patient outcomes and experience by:
- eliminating inappropriate out of area placements;
- improving local bed availability aligned with community services;
- eliminating inappropriate under-18 placements in adult beds;
- ensuring a sufficient national bed stock for surge management;
- integrating and collaborating with local commissioners and providers;
- developing service specifications that support these ambition.
The implementation of the changes will take place in three phases:
- Stabilisation of the current situation, increasing inpatient capacity where there is unmet need whilst shifting the focus onto community services will happen over a period of 18 months. This phase will focus on the opening of up to an additional 180 beds.
- Transition to reduced bed numbers by removing surplus inpatient supply where the capacity does not match local need will happen concurrently over a period of 12 to 30 months
- Transformation to a predominantly community-based model to drive out variations in practice, deliver quality outcomes and better patient experience, and maximise young people’s life chances will happen over a period of 6 to 36 months, whilst phases 1 and 2 are being delivered.