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NHS chief admits plans to expand CAMHS workforce in doubt

Government plans to expand mental health services for children over the next four years have already been thrown into doubt, after NHS England’s lead on mental health admitted recruitment of the necessary workforce may need to be rethought.

Under the plans, laid out in the Five Year Forward View on Mental Health, NHS England wants to expand the offer of psychotherapy in child and adolescent mental health services (CAMHS) so that an additional 70,000 patients are able to access help each year by 2020/21.

To do this, the plan is to recruit some 1,700 extra therapists and supervisory staff to CAMHS across the country.

However, speaking at a recent London meeting on implementing the programme, NHS England national clinical director for mental health Professor Tim Kendall said the organisation may need to draw up alternative plans, given the workforce is already significantly under-staffed and needs to recruit more than half this number just to fulfil current needs.

Professor Kendall said: ’There is a big investment already under way with the aim of ensuring that people who currently work in CAMHS services can provide evidence-based psychological interventions. But it’s also to recruit an extra 1,700 staff.

‘Now I’ve got to say I think that’s a really difficult thing for us to do, not least because we are 1,000 staff short. So we are putting our minds to a ’plan B’ and ‘plan C’ if that proves difficult.’

NHS England in the announcement of its Five Year Forward View for Mental Health that the £1.4bn already committed for children and young people’s (CYP) mental health over five years 'should be invested to ensure that by 2020 at least 70,000 more children and young people have access to high quality care'.  

An NHS England spokesperson said: ‘We are pursuing “plan A” not an alternative. Don’t confuse [a Health Education England] audit of current vacancy rates with the goal of adding 1,700 extra staff on top of those actually in post.’

The spokesperson added: ‘We acknowledge that children and young people’s MH services are under resourced but it is also important to remember that services which promote good mental health should also be provided as well by schools, local authorities and the voluntary sector and we have been emphasising the need for joint work and “single points of access”, so in some circumstances the right person to see the child may not be in the NHS service, it might be in the school.’

Doubts over funding of child mental health services

The £1.4bn promised for children's mental health in 2015 includes an extra £150m over five years for children with eating disorders and an extra £1.25bn over five years for better care for anxiety and depression, self-harm and conduct disorders.  

This is on top of the £1bn funding announced to support the rest of the plans for adult mental health, although Pulse revealed that the new funding is not 'new' money as it will come out of existing CCG budgets.

The new doubts about recruitment come after Pulse revealed GPs were struggling to get help for children with mental health problems seen, with two-thirds of those they refer being discharged without receiving treatment.

Readers' comments (9)

  • Vinci Ho

    (1) Definition of resources : money , manpower , expertise and time . One for all , all for one. This situation demonstrates how short-sighted and visionless Agent Hunt and his ministries(of Truth , Plenty and Love) have been.
    (2) Ironic as both Princes came out to talk very openly about the mental impact of losing their mother twenty odd years ago , stressing the importance of mental health problems.
    (3) Auntie May singled out mental health as a priority and so was the ambious targets set by Stevens in the Next Step in Five Years Forward Plan (with a dedicated chapter on mental health).

    If I am correct , copy and paste what Stevens wrote will be the 'pledge' on the manifesto if that is to be included.

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  • Doctor McDoctor Face

    Cant GPs do that when there arent in A&E?

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  • Doctor McDoctor Face

    they

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  • Well really when you think about it his many extra people do you really need to print off the standard rejection letter and bung it in an envelope with a handy flowchart of doom explaining why they can't see homicidal little Jonnie who's as stable as the San Andreas fault?

    You know, the one with the tick boxes in the style of computer-says-no? Sorry but they aren't mad enough yet/sorry threats of self harm aren't enough, please re-refer once they've tried it/sorry we think this is for community paediatrics and no we don't care they've already rejected your referral/sorry we think there is an endocrine cause, please refer to paediatrics/sorry we have no capacity/ sorry but you mentioned parental divorce in your referral, here's a leaflet on Teen Relate/sorry but we aren't commissioned to do anything educational/sorry we don't accept avoidance disorders exist, please refer to health visitor for parental coaching.

    I've lost count of how many children have been failed by CAMHS across my career. Many now languish at Her Majesty's. It's tragic. Those weasel words about voluntary sector provision just expose the lie, don't they? No help is coming folks. These are truly the end times for our NHS.

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  • I have to say this was one of the most frustrating areas and glad I now don't see the repeated failures of CAHMs - now I've left the frontline.

    However in their defence, these issues aren't usually organic mental health - usually its social - family breakdown, inadequate parenting etc

    Anyone who mentions the social aspect is shot down. No amount of drugs or therapy replaces a father who walks out or abuse or alcohol issues.

    This entire aspect of medicine both in adults and children need difficult adult conversations about the mistakes of society without fear about having a discussion.

    None of the above will be raised at the election though!!

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  • Re Grinding Premolars 4.32pm

    Spot on! The Child Avoidance Mental Health Service has been a sick joke for years. If the huge effort and dedication they put into dodging/rejecting/deflecting GP referrals was spent actually seeing vulnerable children we wouldn't have a problem.
    Clearly the individuals working at CMHS must be under huge pressure, and it's not fair to blame them for the basket-case organisation they work for.
    The tragedy is that it will have to take a few high profile teenage suicides before CAMHS receives the massive investment in resources it is so obviously lacking.

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  • Most professionals who work in mental health are absolute black belt masters of work avoidance IMHO.

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  • ...and the trajectory of most mental health workers is: 1. Go into it feeling like complete martyr 2. Realise you can't do anything about s**t life syndrome see Smith point above 3. Play the overworked victim card 4. Go off sick 5. Become mental health patient yourself.

    Sorry to sound cynical but seen it so many times!

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  • Time for co-payment. Better to pay a small fee [like many countries] than paying with time and continuing illness and morbidity [ waiting on lists and suffering without proper treatment]as we do now.
    This Govt. will not fund health care properly and probably no Govt. taxation ever can.

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