There are “serious and deeply ingrained problems” with the commissioning and provision of children’s and adolescents’ mental health services, the health select committee has found, plus the rest of today’s news and comment

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5.00pm In the King’s Fund blog, assistant director of policy Richard Humpries examines whether the better care fund plans will work.

4.51pm Experimental treatment proposal prompts soul searching among the medical and legal fraternities in the wake of desert disaster, writes Michael White in his weekly HSJ column.

4.29pm Monitor has selected PwC to supply the team that will “help find a long term solution for patients” at Tameside Hospital Foundation Trust.

PwC is expected to begin work at the trust this month. The £2m project will be funded by Monitor.

In a statement issued by the regulator this afternoon, said PwC had been chosen following a competitive procurement process.

The consultancy firm will “test and develop a locally-generated idea of fully integrating healthcare services for the local population, bringing health and social care services together in a radical new approach”, the statement continues.

Monitor announced it was taking to take action at the trust in September, “because it is facing challenges providing acceptable levels of care and is financially unsustainable in its current form”.

Marianne Loynes, enforcement director at Monitor, said: “Patients in Tameside deserve to get quality, sustainable care, and we are now one step closer in helping the trust to provide this. Working with local people, staff and the healthcare system, PwC will help pioneer this new approach and find the best solution for Tameside Hospital.”

3.50pm Strong leadership skills have set Dr Manjit Obhrai apart – from his early career as a consultant to his more recent post as medical director at Mid Staffordshire Foundation Trust – rather than his Kenyan Indian origin, as he tells Varya Shaw.

3.44pm Discussing diversity brings difficult truths to bear on an organisation, and fostering it is about more than well meaning strategies – it needs to be enthusiastically embraced by managers, says Lubna Haq, head of healthcare consulting for Hay Group, as part of our week celebrating BME pioneers in healthcare.

2.59pm EXCLUSIVE: NHS patients who underwent eye surgery at a private hospital suffered complications because of an overdose of an antibiotic used during their cataract procedures, an investigation has found.

Private provider Ramsay Health Care, which operates the Mount Stuart Hospital in Torquay, told HSJ that the complications experienced by patients referred to the hospital by South Devon Healthcare Foundation Trust resulted from “process failure and human error”.

2.57pm Win a free digital subscription to HSJ: complete our technology survey.

Five digital subscriptions to HSJ are up for grabs, along with the chance to help shape the NHS’s digital future. To be in with a chance of winning, simply take part in our short annual technology survey.

Health secretary Jeremy Hunt outlined an ambition for a paperless NHS by 2018, nearly two years ago in January 2013. It represents a tough challenge but has focused minds on transforming the health service’s digital capabilities.

HSJ, in association with CCube Solutions, is surveying NHS and health technology professionals to build the most comprehensive picture possible of:

  • stakeholder views about the progress so far;
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We know your time is precious so the survey has been designed to be quick and user friendly. It should only take a few minutes to complete the survey but your responses will provide a valuable picture of attitudes emerging across the service and help shape the debate about building a better digital future for the NHS.

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2.35pm REVEALED: The NHS and independent sector organisations which have reached the next stage of bidding for two huge contracts to run cancer and end of life care services in Staffordshire have been revealed.

In a move which has proved controversial, four clinical commissioning groups are seeking to award two 10-year “prime provider” contracts - one for cancer and one for end of life care - with a total value of £1.2bn.

Click here to see which providers are today due to be named as pre-qualified bidders for both contracts, commissioners said.

2.25pm Responding to the health select committee’s CAMHS report, Hilary Cass, president of the Royal College of Paediatrics and Child Health, said: “For too long policy makers have failed to tackle the crisis in child and adolescent mental health– so much so that it is now becoming a hidden epidemic. 

“1 in 10 children aged 5-16 have a diagnosable mental health disorder. Nearly 80,000 suffer from severe depression and incidents of suicide and self-harm amongst young people in the UK have not decreased over the last 30 years.

“If a child with a physical illness is forced to travel hundreds of miles for a bed, if funding for hospital services are severely cut or if there is huge variation in the provision of care for children with a physical condition – it is deemed a national scandal. And yet we continue to see budget cuts and increases in waiting times for CAMH services, and increasing numbers of children and young people being held on adult mental health wards and high numbers still held in police cells.

“Today’s report paints a picture of a service in crisis, but provides some real solutions to transform the landscape.

“We fully support the emphasis on early intervention; children and young people with mental health problems can become adults with mental health problems. All professionals working with children and young people need to be better equipped to recognise and act on the signs of mental ill health in children and young people , with more care delivered outside the hospital setting.

“It is absolutely crucial that the prevalence study of child and adolescent mental health is conducted regularly and extended to under 5’s with better evidence collected on the mental health of children and young people from ethnic minorities. The current variation in services for children and young people with mental health needs is unacceptable and far too few paediatric departments have sufficient and timely paediatric liaison services.

“Adolescence is considered a risk period for serious mental health disorders, substance misuse, and risk-taking behaviours. We welcome the report’s focus on transition to adult mental health services and plans to review progress in this crucial area again in 2015.

“There is a clear message to the next Government: get to grips with the CAMHs crisis or put the mental health of thousands of children, young people and adults at risk.”

Lisa Murphy, a member of the RCPCH’s youth advisory panel, said: “As someone who can relate through my own personal experience to many of the issues outlined in this report, I am very happy to see them receive long awaited acknowledgement at such an important level. Access to mental health services is a multi-dimensional issue - not only does an efficient and equitable service need to exist, but both young people and those with a duty of care for them need to know what is expected of them to make it a reality.

“Myself and many within the college have been advocating for mandatory inclusion of mental health training within teacher training and development, as we believe this is crucial to ensuring that young people who require intervention are identified early and receive the help they need.

“If you ask a young person being treated for a mental health problem who was crucial in helping them on the road to recovery, chances are they won’t name a mental health professional, but the teacher who asked them if anything was wrong, or the youth worker who gave them a safe space to open up.

“And while many people in these roles have the passion for helping the young people in their care, they do not always have the knowledge and support to do so. It is heartening to see the education of teachers, and young people themselves, in such a prominent position on the agenda for change in mental health service provision.

“When a young person has been brave enough to ask for or accept help, it is vital that this is forthcoming as quickly as possible. Too often young people are left waiting for months and months to receive the care they need, leading to their mental health potentially having a severe and debilitating adverse effect on their relationships, their education and their future.

“Left waiting to access services we start to worry that we are wasting people’s time, that we are being ridiculous about our problems, that we are not sick - we are weak. These are exceptionally dangerous thoughts for any young person to have, as they are leading to many young people taking drastic steps to gain back control of their mental health.

“Therefore I welcome the recommendation to improve the support and funding for early intervention services, and believe that this is an vastly important step in reducing the burden of mental health on healthcare services, and more importantly on the lives of young people.”

2.11pm Around 7 per cent of acute spells are priced incorrectly due to clinical coding errors, a study has found.

A Department of Health-commissioned study of 50 acute trusts found that on average 7 per cent of providers’ spells of care were incorrectly priced due to inaccurate coding.

At one trust the error rate in audited care spells was as high as 45.8 per cent. The best performing trust was found to have an error rate of 1.1 per cent.

1.55pm There is wide national coverage of the health select committee report, published today, into hildren’s and adolescents’ mental health services.

In The Guardian, violent video games, the sharing of indecent images on mobile phones, and other types of digital communications, are harming young people’s mental health, according to the report, amid evidence of big increases in self-harm and serious psychological problems among the under 18s.

Cyber bullying and websites advocating anorexia and self-harm are also posing a danger to the mental wellbeing of children and young people, the commons health select committee says in its report.

In The Times, teachers should be trained in spotting mental health problems and urgent research is needed into how the internet increases stress, promotes bullying and encourages anorexia, the report recommends.

1.40pm The Daily Telegraph reports that the average care home resident will not gain from government pledges to limit their fees, according to economists.

Research by the Centre for Economics and Business Research shows that the average care home resident will die without becoming eligible to benefit from a £72,000 cap on care home fees.

1.30pm The five year forward view’s publication gives good reason to suspend cynicism, stand together and work towards a transformed NHS fit for the 21st century, says Rob Webster, chief executive of the NHS Confederation.

12.17pm In response to the health select committee report, Peter Hindley, who chairs the child and adolescent faculty for the Royal College of Psychiatrists, said: “This report reiterates some of the key concerns the College has consistently highlighted.
“Clearly there are significant problems with access to inpatient mental health services, and as the report rightly highlights, it is unacceptable that children and young people’s safety is being compromised while they wait for a bed to become available.
“Of particular concern is the wholly unacceptable practice of taking children and young people detained under s136 of the Mental Health Act to police cells. Our manifesto: Making Parity a Reality also highlights this issue and one of our key asks for the next government is that it should ensure the use of police cells as ‘places of safety’ for children be eliminated by 2016, and by the end of the next Parliament occur only in exceptional circumstances for adults.
“However, we are also delighted that the Health Select Committee has highlighted the importance of early intervention and effective services to minimise the need for inpatient care. This needs to be underpinned by joined-up, effective commissioning.
“We urge the government to take on board the recommendations of this report to help ensure vulnerable children and young people with mental health problems are given the support and help they need and deserve.
Liz McDonald, who chair’s the body’s perinatal faculty, said: “We share the health select committee’s concerns about the gross inequality of provision of perinatal mental health services, which is putting the well-being of thousands of mothers, infants and families in jeopardy.

“It is vital that every area has a perinatal mental health strategy in place so that all women who need specialist perinatal mental health services have access to them.”

12.04pm Efi Hershkovitz, chief executive and founder of Danshell which operates secure CAMHS services in the South of England under the Oakview brand, said: “Today’s health select committee report cites ‘serious and deeply ingrained problems’ in children’s mental health services.  

“We are extremely disappointed by the government’s response to the developing crisis and we are endeavouring to communicate with the appropriate decision makers about how the independent sector can contribute to a solution.

“It must be very difficult for the young people and their families when they cannot access appropriate support and the changes made to commissioning have actually disabled the system as each specialist commissioning team grapples with its own budget rather than looking holistically and nationally at the needs of this vulnerable service user group. 

“CAMHS are in meltdown and this position is putting independent providers under enormous financial pressure as there is no flexibility and we are turning down referrals based on budgets rather than need and young people are ending up being placed huge distances from their families and friends.

“The mental health of children and young people cannot afford to be ignored, early intervention is crucial to achieving the most positive outcomes that benefit the individual, their families and society as a whole.

“Government, commissioners and providers must come together to find effective solutions before the ‘major problems’ cited by the Health Select Committee become insurmountable.” 

11.58am HSJ correspondent James Illman tweets from the EHI Live conference in Birmingham:

10.40am In response to the health select committee report into children’s and adolescents’ mental health and CAMHS, Anna Feuchtwang, chief executive of National Children’s Bureau said: “Sadly it will come as no surprise to many in the sector that the committee has found serious problems in the commissioning and provision of CAMHS across the country.

“The areas highlighted for action echo those changes we have been calling for. Schools need to be better supported to make a positive contribution to children’s emotional wellbeing; there needs to be better data on children’s needs to inform planning of services; and there needs to be clear national direction-setting backed by resource.

“All agencies need to fulfil their responsibilities to children in this area and we must not shy away from holding them to account. As the committee rightly points out, local authorities’ role in public health should provide an opportunity to strengthen, not weaken their contribution. The NHS must be able to identify and meet need, with better training for GPs and high quality specialist services close to home.

“In its inquiry into children and the police, the All Party Parliamentary Group for Children, supported by NCB, found evidence of increasing numbers of children being detained in police custody when suffering a mental health crisis. We therefore welcome the Committee’s strong recommendations in this area.

“The peak onset of most mental health conditions is between 8 and 15 years and young people tell us that having mental health needs better addressed is one the key improvements they most need. Our recent report, Why Children Die, highlighted the fact that suicide is a leading cause of death in young people.

“We look forward to the report of the children’s mental health taskforce, who we hope will be in a position to set out clear actions to address this situation.”

10.35am There are “serious and deeply ingrained problems” with the commissioning and provision of children’s and adolescents’ mental health services, the health select committee has found.

In a report published today, the committee found that problems “run through the whole system from prevention and early intervention through to inpatient services”.

The committee found “major problems” with access to inpatient mental health services. The safety of children and young people’s safety is being compromised while they wait for a bed to become available, and even after beds are found, these may be in distant parts of the country, impacting on their contact with family and friends. 

The report also criticises clinical commissioning groups for cutting funds for early intervention services.

“While demand for mental health services for children and adolescents appears to be rising, many CCGs report having frozen or cut their budgets.

“CCGs have the power to determine their own local priorities, but we are concerned that insufficient priority is being given to children and young people’s mental health.” 

It recommends that NHS England and the Department of Health  monitor and increase spending levels on CAMHS “until we can be assured that CAMHS services in all areas are meeting an acceptable standard”.

It is clear that there are currently insufficient levers in place at national level to drive essential improvements to CAMHS services, It also calls for a “clear national policy directive for CAMHS, underpinned by adequate funding”, noting that there are “insufficient levers” in place to drive improvements,“including insufficient scrutiny from the CQC”. 

The Committee also hit out at the “wholly unacceptable practice” of taking children and young people detained under section 136 of the Mental Health Act to police cells. “In responding to this report we expect the Department of Health to be explicit in setting out how this practice will be eradicated,” the report says.  

Other concerns outlined in the report include:

  • “the quality of education children and young people receive when they are being treated in inpatient units”
  • “increased waiting times for CAMHS services and increased referral thresholds” in community CAMHS services and “unacceptable variation”
  • “availability of services which bridge the gap between inpatient and outpatient care is extremely variable, and current commissioning arrangements act as a perverse incentive driving admissions as these are then funded by NHS England rather than CCGs”
  • “lack of reliable and up to date information” on children’s and young people’s mental health

You can read the full report here.

10.00am There is a pressing need to create a post of chief psychologist to advise ministers on behavioural perspectives to key health issues, argues Narinder Kapur, professor of neuropsycholgy at University College London.

9.50am Good morning and welcome to HSJ Live.

We start the day with the news that the NHS commissioning system is on track to miss its target surplus by £184m in 2014-15, with much of the overspend attributed to the spiralling cost of the cancer drugs fund.