In: Children and Young People’s Mental Health Crisis Peer Review - Summary Findings Report
Healthy London Partnership November 2018
- This report summarises the findings from peer reviews of London’s nine mental health crisis pathways for children and young people (CYP) conducted between November 2017 and May 2018. The peer review follows publication of HLP CYP mental health crisis guidance and the subsequent CCG self-assessment against the recommendations.
• Paediatric ward utilisation for short term stays and crisis stabilisation but varied arrangements and age cut offs (some paediatric wards up to 16 years, others up to 18 years old).
• NMoC (Tier 4 CAMHS) in place in two areas (NWL and South London Partnership) and plan to reduce length of stay and out of area placements. Plan to use efficiencies to improve prevention, early intervention and crisis pathways.
• Plan to roll out a NMoC across North Central/East London footprint.
• Some instances of CYP not having support plans in place once return to local areas following out of area (OOA) Tier 4 inpatient stays.
Recommendations:
• Support acute sites to admit patients to paediatric wards when appropriate, where this is not currently possible.
• Bed management team provision should be in place across all Tier 4 CAMHS teams provides economies of scale and allows clinicians to treat patients rather than trying to find beds.
• Develop discharge plans in collaboration with other CAMHS Tier 4 inpatient services when required.
Positive practice (not limited to but including):
• NELFT – Young Person’s Home Treatment Team (YPHTT) provides AOT via a hospital at home model and is available 24/7 365 days a year. It also acts as a gatekeeper for the inpatient ward and prevented 200 inpatient stays in one year (2017).
• NELFT inpatient facilities at Brookside Unit and turnaround plan (refurb and recruitment campaign) has led to an outstanding CQC rating for child and adolescent mental health wards.
• Enfield Alliance (AOT) have reduced operating bed days (OBDs) by 43% from 2009/10 to 2016/17.
• South London Partnership had improved relationships, shared learning and led to shared policies (e.g. escalation policy), and decreased the number of inpatient admissions and OOA placements.
• Bed management teams in place at BEHMHT, SLAM, CNWL and NELFT.
