NHS ‘highly dependent’ on substandard private beds for children’s mental health care

A ‘high’ dependency on private sector mental health hospitals is placing children at greater risk of substandard care, the NHS has admitted.

In a briefing from August, NHS leaders admitted that for children’s mental health services there is a “high dependency” on the private sector where hospitals are at greater risk of being closed due to poor quality and workforce problems.

According to the figures, 60 per cent of children’s psychiatric intensive care beds, beds for the most acutely ill children, are provided by the private sector.

Figures obtained by The Independent from the Care Quality Commission show more than one-third of children’s beds in the private sector are rated requires improvement compared to 12 per cent of NHS-run beds. While four per cent of private beds are inadequate compared to three per cent of NHS units.

The Department for Health and Social Care is currently debating on measures to take following the string of scandals within mental health units exposed in recent months.

In October this year, The Independent revealed allegations of systemic abuse by private children’s mental health hospitals run by The Huntercombe Group.

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The news also comes after a review into an NHS run CAMHS hospital, Tees, Esk and Wear Valley’s NHS FT, found “systemic” failings by the hospital led to the deaths of three young women.

The NHS winter briefing in August, seen by The Independent said regarding children’s mental health beds: “Supply is severely constrained: Bed occupancy is 87.6 per cent. Workforce pressures close on average 50 of 178 closed beds (from 1354 commissioned beds) and there have been a number of unexpected service closures over the last 4 years linked to quality and safety concerns.

“This is resulting in long waits and high dependency on the Independent Sector (60 per cent for PICUs and over 80 per cent for low secure provision) where there is an increased risk of unplanned closures due to quality of provision and workforce issues.”

Chris Dzikiti, director of mental health at health regulator Care Quality Commission (CQC), said: “We highlighted in our recent ‘State of Care’ report our concerns that the health and social care system is gridlocked. We also know that children and young people’s mental health services are facing a number of issues, driven by increased demand and lack of capacity across the system.

“It is absolutely essential that every young person who needs mental health support has access to good, high quality care, regardless of who is delivering it. More needs to be done to support children and young people’s mental health and it is vital all of us working in this area come together to ensure each and every child gets the support they need, when they need it.

“We will continue to monitor all services to ensure that improvements are made where needed and that people are safe.

In a report last month, the CQC said some areas of the NHS do not have enough CAMHs beds to meet needs which has increased the chances of children people admitted to “inappropriate environments.”

It found in 2021-22 there was a 32 per cent increase in children being admitted to psychiatric wards due to a lack of unavailable beds.

The Independent revealed last month the NHS was falling short of access targets for children’s community mental health services by 20,000 patients a month.

However, a previous internal report by the NHS, revealed by The Independent this year, also suggested a key problem with children’s beds is not the number, but the length of stay when children are admitted, thus impacting bed availability.

The report also found staffing levels in children’s mental hospitals were lower in The Independent sector with four of our five of hospitals with the highest vacancy rates recorded in private units.

According to the figures the cost per admission for a private sector children’s mental health can £140,000. This is almost double the highest seen for an NHS-run unit.

Labour shadow mental health minister Dr Rosena Allin Khan told the Independent: “Demand for mental health treatment continues to grow, with many patients, including children, languishing for days in emergency departments, waiting for a mental health bed - this is all amplified by successive Conservative governments cutting a quarter of NHS mental health beds.”

“The Government simply doesn’t have a handle on the crisis.”

An NHS spokesperson, said: “The majority of inpatient mental health care for younger people is provided by the NHS, and this year we have accelerated our plans to transform and expand services for these patients, with over 689,000 children and young people being supported by July 2022 - 175,000 more than before the pandemic.

“This includes rolling out mental health support teams in 4,700 schools and colleges covering 2.4 million pupils a year ahead of schedule, 24/7 crisis lines which provide support to hundreds of thousands of children every month, and offering intensive home treatment for children and young people who need additional help and care.”