The NHS is failing young offenders with 'inadequate' healthcare provision, inspectors have revealed. Many primary care trusts are ignoring their legal duty to contribute health professionals to youth offending teams (YOTs), with one in six teams having no NHS representative.

The Healthcare Commission warned that it will include a review of trusts' performance in this area in their annual ratings in an attempt to drive up standards.

A joint report by the commission and the Probation Inspectorate found that a third of teams do not have a mental health specialist even though two-fifths of these children have emotional or mental health needs.

The report warns of a lack of engagement from the NHS 'at strategic level' affecting the management boards of up to 60 per cent of YOTs, multi-agency bodies led by local authorities.

This is 'one of the most significant findings', the authors say, underpinning all other problems affecting healthcare for young offenders.

The investigation was sparked by the findings of YOT inspection programmes. Inspectors make more recommendations to the NHS than to any other agency apart from the police.

Healthcare Commission head of children's strategy Maddie Blackburn told HSJthat in many areas the NHS was working well with the teams. But in others, 'some of the difficulties are about competition with other priorities', she warned.

PCTs could not use re-organisation as 'an excuse' as the report found little had changed between 2003 and 2006.

The report claims funding for health posts on YOTS is 'insecure and subject to the changing priorities of PCTs and local health boards'.

Ms Blackburn added that PCT directors had to show commitment to YOT management boards as well as providing staff for the teams themselves. Young offenders 'are children and young people who often have the most profound health needs and must have access to the very specialist support they require'. The legal duty to provide staff was inherited from the old health authorities but commission lawyers had confirmed it applied to PCTs, she said.

The commission wants access to mental health services for every young offender.

The report insists that ministers must act: 'The responsibility for reducing offending behaviour must not just lie with the Home Office or Youth Justice Board but also the Department of Health.'

A DoH spokesperson told HSJ: 'We fully support the emphasis on partnership working between all relevant agencies, including the NHS and YOTs.'

In a statement, the DoH added: 'Child and adolescent health services should be available up to the age of 18 - subject to the wishes of the patient, who may prefer to be treated in an adult environment.'

Download the report here