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Children 'trapped' in hospital by lack of mental health care

Lack of provision in primary care is leaving children with mental health problems stuck in hospital

A lack of provision in primary care is leaving children with mental health problems stuck in hospital long after they are deemed fit for discharge, according to the Education Policy Institute (EPI).

The think tank published its Inpatient Provision for Children and Young People with Mental Health Problems report on 26 July, which highlighted shortcomings for mental healthcare both in and out of hospital.

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EPI mental health director Emily Frith, who wrote the report, found that children spent 9,000 ‘wasted’ days using inpatient services from October 2015-February 2017. These children were deemed fit for discharge, but community services were too lacking to guarantee their continued treatment.

While NHS England did not reveal to Ms Frith how many children were involved in those 9,000 days, the problem was shown to be worsening as the number of ‘wasted’ days in December 2016-February 2017 was up 42% on the same period one year earlier.

Janet Davies, chief executive for the Royal College of Nursing (RCN), called for a drive to increase recruitment in mental health and community care as a way of combatting the deficiencies exposed by the report.

‘The youngest and most vulnerable are being let down by a lack of beds and nursing staff in all parts of the country,’ she said.

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‘It is vital that NHS England has enough nursing staff to provide safe inpatient care but also has enough nurses in the community to allow people to be supported after being discharged. Without that support close to home, people are trapped in hospital and the bed shortage is perpetuated.

‘Mental health and community care are two of the areas hardest hit by the severe shortage of nurses. Seven of the top ten NHS trusts with the high nurse vacancy levels are mental health trusts. Without the right number of staff, services are overstretched and unable to cope - leading to unacceptable waiting times and compromised patient care.’

Inequalities and falling standards across inpatient services were the main focus of the report, with 1,440 hospital beds available for children in 2016 – up 71% since 1999 – but a wide disparity of availability in different areas of the country.

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The north east had 3.03 beds per 100,000 people, coming out on top, while the south west had 1.1 per 100,000 – well below the recommended standard.

Imbalance in patient-to-staff rations were also highlighted, with one in nine units failing to meet minimum standards and 24% of units struggling to recruit new staff.