The Government has set up a taskforce to review community child and adolescent mental health services, after an NHS England review concluded that children were being sent to specialist inpatient services inappropriately.
Care minister Norman Lamb said the taskforce would look at pooling commissioning budgets across all tiers of the service, to help remove the ‘potential perverse incentives’ that meant children were being ‘shunted’ into tier 4 services when they should be managed in the community.
Speaking at a Commons Health Committee hearing on child and adolescent mental health services (CAMHS) on Tuesday, Mr Lamb said: ‘We must show how we can achieve a much more rational use of resources that are available and avoid the potential perverse incentives that exist at the moment.
‘There is a potential perverse incentive to shunt children into tier 4 [services] because the financial responsibilities then transfer to NHS England.’
The announcement comes after NHS England pledged to set up an additional 50 beds in CAMHS tier 4 services across the country, following a review of tier 4 services that was triggered by reports of acutely ill children having to be transferred to mental health trusts far away from home, and even being admitted onto adult mental health wards.
However, NHS England said the shortage of beds had also been caused by children ‘being inappropriately admitted to specialised units’, as a result of ‘gaps in CAMHS tier three services and other local health and social services provision’ and ‘weaknesses in commissioning and case management’ in tiers 1-3 services.
The new taskforce will be headed up by Jon Rouse, the Government’s director general of social care, and include senior representatives from NHS England – likely including former GP and long-term conditions tsar Dr Martin McShane – as well as from the Department of Education, local government and the voluntary sector.
A recent Pulse investigation revealed that GPs were struggling to refer children presenting with mental health problems to CAMHS tier 2 and 3 services, with many facing further cuts in services as a result of budget cuts imposed locally by CCGs.
Questioned by the new health committee chair and former GP Dr Sarah Wollaston as to whether there was enough funding, Mr Lamb acknowledged ‘there are funding issues’ but said the Government’s pledge to introduce waiting time targets for mental health would redirect money into mental health.
He said: ‘We have to address the imbalance in the levers and incentives in the system that always disadvantage mental health.’
‘We’ve got a commitment now in the mandate to start the introduction of access and waiting time standards in mental health from next year, and for me this is potentially transformational.’
‘We’ve never had this in mental health before, and the idea that in mental health you have no sense of entitlement to get access to a service within a specified time, whereas you do in physical health, cannot be justified. We’re ending that imbalance, which drives where the money goes.’