This site is intended for health professionals only

At the heart of general practice since 1960

pulse june2020 80x101px
Read the latest issue online

GPs go forth

Children rejected by NHS mental health trusts as criteria for GP referrals tightens

EXCLUSIVE GPs are facing increasing difficulties in getting their child referrals accepted by NHS mental health trusts in England unless their patients are severely mentally unwell, a Pulse investigation reveals.

A Pulse analysis of data on referral criteria used by 29 NHS mental health trusts in England (out of 56) has found a third only accept patients with ‘severe/significant’ conditions for specialist child and adolescent mental health services (CAMHS).

Just one in five NHS mental health trusts accept referrals for children with all severities of mental health conditions, according to the data Pulse collected through Freedom of Information (FOI) requests (see table, below.)

Meanwhile, a Pulse survey of 935 GPs found nearly 30% said criteria for CAMHS referrals have become stricter in the past year.

GPs have warned children are being forced to wait until their condition escalates before being seen by a specialist and that the strict referral requirements reflect the lack of resources to deal with spiralling demand.

In some cases patients have to attempt suicide in order for their referral to be accepted by specialist CAMHS, according to GPs who spoke to Pulse as part of the investigation.

The lack of NHS specialist treatment on offer means mentally unwell children are often told to seek help from charities instead, but these services largely do not have doctors in place, instead offering counsellors.

This is at a time when referrals for children’s mental health services are rising – up by 18% between 2017/18 and 2018/19, according to NHS Digital data.

BMA GP Committee chair Dr Richard Vautrey said tighter referral requirements are being used to manage demand.

He said: 'As with all other areas of the NHS, specialist children's mental health services are under growing pressure with insufficient resources to cope.

'The use of increasingly strict referral criteria to help manage this demand can mean that only the sickest patients are getting the care they need.

'This in turn means many young people with less severe – but still serious nonetheless – issues are not getting access to the specialist care their GP believes they need, or are having to wait until their condition worsens before they are seen by a specialist.'

He added: 'This delay is distressing for the young person and their families and can cause problems for the GP, who struggles to provide adequate support because of a lack of alternative local options.”

An NHS England spokesperson said: ‘The NHS is ahead of its target on ensuring as many children as possible receive mental health care, and the long-term plan commits to ensuring an extra 345,000 children and young people get the care they need by 2023, backed by extra funding of £2bn.’


Readers' comments (17)

  • Vinci Ho

    I tell you what
    This will be another mess for PCNs to tackle ?!

    Unsuitable or offensive? Report this comment

  • It's not really the fault of secondary care.

    CAMHS is suffering the same problem GPs are...recruitment.

    No one simply wants to work in CAMHS and I don't blame them.

    Unsuitable or offensive? Report this comment

  • A pretend service. You can refer but you get nowhere. Without the support, when things go wrong, they will blame the GP who is trying her/his best to help. A terrible system.

    Unsuitable or offensive? Report this comment

  • Where's Optimus?

    Alot of pseudo services out there at the moment

    call the police at night .... good luck if anyone comes
    solve the problem yourself and they'll happily come and arrest you... the next day
    (simpsons chief wiggum.. we cant protect you but we can persecute you)

    call nhs 111.. fob off untill own gp or dentist available next day

    call amnbulance
    fob off to see own gp
    often very unsafe to leave like this
    gp refers in when seen later

    if you are registered with a dentist .. you must call them
    if you are not registered with a dentist then you cannot see an emergency dentist

    If there is going to be no cahms
    gp's need clear guidelines so we can prescribe for mental health in children
    Otherwise peadiatric psychiatry ?
    peadiatric referrals?

    Unsuitable or offensive? Report this comment

  • Where's Optimus?

    oh well ... lets get brexit done (bull5h1t)

    Unsuitable or offensive? Report this comment

  • CAMHS = child avoidance mental health service

    Unsuitable or offensive? Report this comment

  • Very Well meaning child psychiatry services, but how effective are they?

    Unsuitable or offensive? Report this comment

  • Always was a pointless exercise in referral. The only speciality ever to send a rejection flowchart with their refusal letter so I can play a game of snakes and ladders with the worried parents. The CAMHS speaker at the monthly education meeting nearly needed a police escort. Glad to be gone.

    Unsuitable or offensive? Report this comment

  • The English absolutely hate children. The UK has the lowest age of criminal responsibility in Europe. Waits for ASD/ADHD diagnosis are often over 1y. We keep them inside on PlayStations and feed them until we have high rates of childhood obesity and even diabetes. Volunteer work is impossible with endless checks and long hours for adults and a general culture of mistrust. They are divided by class and the really unfortunate ones are packed off to boarding school and then we wonder why we see so many enduring mental health problems?

    Unsuitable or offensive? Report this comment

  • |Sensible Doc | GP Partner/Principal|03 Jan 2020 1:07pm

    What do you expect when you incentivise the breakdown of the family unit, single parenthood, de-emphasize health and financial responsibility, and you do so via increasing the size of the state and reducing the size of the economy/private sector/tax-take.... I.e. socialism

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page

Have your say