Recommendation 29

HM Government Not Addressed

The Government is considering this recommendation. Where inpatient care is needed it should be the highest quality, close to home and for the shortest possible time. We are focussed on ensuring all patients, including people with a learning disability and autistic people, receive safe and high-quality care, and that they are treated with dignity and respect. Delivering improvements in the quality of inpatient care is dependent on also improving alternatives to admission, which is being delivered through the transformation of community children and young people’s mental health services under the NHS LTP. In addition, there is a continued need for improvements across the whole system, in areas such as children’s social care and health and justice to ensure appropriate placements are available when necessary. NHSE/I Specialised Commissioning leads on the provision of inpatient children and young people’s mental health services. Improving the quality of care is a priority, including by reducing inappropriately long lengths of stay and reducing incidents of restrictive practices. The introduction of NHS-Led Provider Collaboratives, which includes a focus on children and young people’s mental health, is further improving provision, and children and young people’s mental health is one of the current workstreams of the Getting It Right First Time (GIRFT) programme. The revision of service specifications for all inpatient children and young people’s mental health services (starting in 2022) will be supported by a review of service models to ensure children and young people have access to evidence-based treatments, education and meaningful activities. Additionally, work in partnership with the Quality Network for Inpatient CAMHS (QNIC) will support accreditation of all children’s mental health inpatient providers over a three-year period (Sept 2022- 2025) to improve the quality of care across all providers. Workforce capacity and skills contributes to the challenges in providing quality services for children and young people. The development of an inpatient workforce strategy, competency framework and increasing access to a range of training will support recruitment and retention of staff alongside other programmes such as the development of new workforce roles, including the new youth intensive psychological practitioner being developed by HEE and NHSE/I. The national Quality Improvement Taskforce for Children and Young People’s Mental Health, Learning disability and Autism Inpatient Services was established in October 2019 to improve the quality of inpatient care. The Taskforce has commissioned 46 projects that will result in improved quality of care for children and young people receiving care in inpatient services. Priority projects delivered to date include: • The development of a competency framework that which details the attitudes, knowledge and skills that need to be brought together to deliver effective interventions when working with children/young people and their families/carers. It was developed in partnership with the National Collaborating Centre for Mental Health, which is a collaboration between the Royal College of Psychiatrists and University College London. The Framework is relevant to all practitioners offering inpatient care to children and young people with mental health problems as part of a multidisciplinary team. The work was overseen by an expert reference group, comprising experts in delivering inpatient care to children and young people with mental health problems. This included clinicians, researchers, and experts by experience, all selected for their expertise in research, training and service delivery. • Human rights training has been developed in conjunction with the British Institute for Human Rights to ensure that frontline staff are aware of their responsibilities under the Human Rights Act to support changes in culture on inpatient wards. To date, just under 500 staff have attended sessions over the past year. • Introduction of Family Ambassadors. In recognition that families have reported feeling excluded from input to the care of their children, the Quality Improvement Taskforce for Children and Young People’s Mental Health has developed and implemented a role into the system to support families, with people physically working in post, in less than 18 months. A huge amount of work is still ongoing around creating support packages for these roles, including training, evaluation and wider promotion activities. These roles are capable of transforming the relationship between families and the providers of services. • The development of a resource pack9 following a review by the Taskforce of current inpatient care as well as pre-admission and post-discharge pathways. The review has been informed by a number of data sources such as the GIRFT report as well as taking account of the experience of children and young people and parents. The aim of the pack is to act as a toolkit for prov