Child Commissioner / NHS Watchdog Not Happy With The NHS

For issues specific to caring for someone with mental ill health.
Article from this morning's Independent ... a rare disagreement now made public :

Children’s Commissioner attacks NHS England chief over 'unacceptable' mental-health care.

Open letter does not mince words and threatens legal action over waiting-time data.

The chief executive of NHS England, has been accused of disregarding research on the “unacceptable” lack of children’s mental health provision.

In an extraordinary public spat between officials at the top of the country’s care system, Simon Stevens could face legal action from Children’s Commissioner Anne Longfield who has listed a range of complaints in an open letter to him.

Ms Longfield noted a recent report on children’s mental health provision in England – something she said was a top priority – and accused Mr Stevens of denigrating work on the issue.

Ms Longfield also threatened to use the law to force Mr Stevens to hand over relevant data on waiting times for children’s mental health services, after the report found that only 20 to 25 per cent of children with mental health conditions received helped last year.

“Many told me about their desperate attempts, sometimes lasting years, to access support, and even primary school children raised concerns about anxiety,” Ms Longfield told Mr Stevens in the letter.

“I was very disappointed that NHS England’s response to our report, and your own personal response in front of the Commons health select committee, was to attempt to denigrate the research.

“Not once did you address the central issues raised. Instead, you and your team sought to undermine the important evidence that we are putting forward and strangely ignore the reality of children’s experiences of the service and the frustrations of their parents,” she added.

In a response to Ms Longfield’s letter, Mr Stevens stood by his comments and said her report had provided a “misleading view of NHS care”.

“[The key finding of the report that] the government’s much-vaunted prioritisation of mental health has yet to translate into change at a local level”, was “demonstrably factually inaccurate”, Mr Stevens said, according to The Observer.

The war of words between the two is set to be discussed at the Health Select Committee on Tuesday.

“It’s very important that there is a constructive relationship between the Office of the Children’s Commissioner and NHS England,” Sarah Wollaston, chair of the committee, said


Little comfort for those readers directly affected by the increasing cutbacks in mental health provision right across the whole care system ??
A further warning ... NHS Watchdog this time ... in today's Guardian :

https://www.theguardian.com/society/201 ... atment-cqc

Children waiting up to 18 months for mental health treatment – CQC.

NHS watchdog’s report sounds alarm that accessing care for under-18s in England takes so long, amid self-harm concerns.


Children with mental health problems are waiting up to 18 months to be treated, a government-ordered report will reveal next week, in an indictment of the poor care many receive.

A Care Quality Commission report into child and adolescent mental health services (Camhs) will warn that long delays for treatment are damaging the health of young people with anxiety, depression and other conditions.

The NHS watchdog will conclude that when under-18s in England do get help from the NHS, it is “caring”. However, it will voice alarm that so many of them encounter much difficulty once they are referred by their GP or a teacher at their school.

Experts at the CQC who have drawn up the report, due to be published next Friday, were surprised to find that accessing care took so long and delays occurred in so many parts of England. Children can wait months after referral before their initial assessment and then further months before they start treatment.

Long delays are leading to some children starting to self-harm or fall out of education, couples breaking up and parents having to stop working so they can look after their child, the charity Young Minds said. Statistics show that one in five children referred for treatment in England cannot be seen by overstretched child and adolescent mental health services, and some families end up seeking private care.

“Improvements have been happening in some areas, but we regularly hear from parents who can’t get a referral, with their GP telling them to seek a referral via their school and vice versa. We also hear from parents who have been waiting for months for an initial assessment, and whose children’s conditions have got worse during that time,” said Jo Hardy, the head of parent services at Young Minds.

“Some parents tell us that their children have started to self-harm during the wait or that they’ve dropped out of school, which not only has a big impact on their own education, but also means that one of the parents has to give up their job to look after them.

“We hear from parents who’ve separated because of the pressure the wait is putting on the whole family, or who talk about the damaging effect it’s having on their other children,” she added.

The report’s authors learned that many child and adolescent mental health service units were struggling to cope because rising demand for care coincided with worsening staffing levels, especially at weekends, which is undermining the quality of care patients receive. It will also highlight how bed shortages are forcing the NHS to send children sometimes hundreds of miles away from their home area in order to be treated.
Judge warns of 'blood on our hands' if suicidal girl is forced out of secure care
Read more

In August Sir James Munby, the president of the family division of the high court, said Britain would have “blood on its hands” unless the NHS found a bed for a 17-year-old girl, known only as X, who was at serious risk of taking her own life. He condemned the “disgraceful and utterly shaming lack of proper provision in this country” for young people struggling with mental illness.

“I welcome the CQC’s focus, including highlighting the very long waiting times and difficulty accessing care that too many children and young people endure,” said Dr Bernadka Dubicka, a psychiatrist and chair of the child and adolescent faculty of the Royal College of Psychiatrists.

Shortcomings in child and adolescent mental health services care mean some children end up experiencing a full-blown mental health crisis, she said.

“Although there has been some additional investment, money is not reaching the frontline, demand is increasing and children are being pushed into crises. Every day children and young people are being let down by the current inadequate provision across the system.”

The report was due to come out last week, but publication was delayed until next Friday after Downing Street intervened. No 10 asked the regulator to look into the state of mental health care for children and young people and made clear Theresa May’s keenness for the regulator to analyse an area of NHS care in which weaknesses have been causing acute concern to MPs, medical groups and families. The number of under-18s – especially girls – ending up in hospital as a result of self-harm has risen sharply over the past 10 years.

May has taken a particular interest in children’s mental welfare as part of her focus on mental ill health as one of the “burning injustices” she has pledged to tackle. It was a key element of her “shared society” speech in January, which was the first detailed exposition of her beliefs and philosophy since she entered No 10 in July last year.

Jeremy Hunt, the health secretary, last year claimed that child and adolescent mental health services were “possibly the biggest single area of weakness in NHS provision at the moment” and said “we are letting down too many families and not intervening early enough when there is a curable mental health condition”. Anne Longfield, the children’s commissioner for England, last week said there was “shockingly poor support” for children with mental health problems.

The CQC’s review of the evidence comes as the government prepares to publish a green paper on children’s mental health, which is intended to lead to what ministers, mental health experts and children’s campaigners say are overdue major improvements in care.

A CQC spokesperson said: “We have been tasked by the government to identify the strengths and weaknesses of the healthcare system to support children and young people’s mental health and help improve understanding of the pathways that they follow and the obstacles that they face. We will publish the first stage of this thematic review next week.”

Claire Murdoch, the mental health director for NHS England, said: “It is factually unarguable that after years of underinvestment, NHS funding for young people’s mental health services is now going up. In the past year alone, the figures show young people’s mental health spending has gone up by £100m.”

But she added: “But NHS England has also been explicit about the scale of unmet need, which recent improvements have inevitably only been able to begin to tackle.”


The words ... TITANIC and ICEBERG ... spring to mind.

Given the " Quality " of those saying that somethings definately wrong here , one issue that does require immediate attention ... and that's saying the very least.

Again , another example of the Government not protecting it's most vunerable citizens through it's institutions.
One letter in today's Guardian ... in response to the very first posting ... worth including ... any readers see the same ?
I fully support the children’s commissioner’s request to NHS England to provide information about how local clinical commissioning groups are spending their increased budgets on community-based provision for children with mental health difficulties.

But there is another startling fact that she highlighted in her recent report.

That is that the bulk of NHS mental health spending is accessed by only a tiny number of children, who are admitted to largely privately owned, low-secure hospitals. Unlike in adult mental health, no information is published on the outcomes.

No one disputes that some children require in-patient treatment but for NHS England to be unable to say if this expensive treatment has had any benefit means public money is being spent without accountability and without consideration for the best interests of the child.

After our adolescent daughter was placed in a low-secure hospital, there was little incentive from the hospital or child and adolescent mental health services – despite the legal necessity to ensure the least restrictive option – to make provision for her discharge. She spent 20 months in low-secure provision, only to be transferred to an adult hospital once she reached 18.

When there, she was discharged home within the month. This is not because the adult hospital was “better” but because the consultant and community-based services accepted that prolonged hospital stays for particular mental health difficulties can be counterproductive. Adult services provide good local crisis care, something that should be more readily available in children’s mental health provision.