• NHS commissioners said to be “very concerned” over St Andrew’s Healthcare reducing CAMHS beds
  • Provider’s decision came in response to CQC concerns over its 110-bedded CAMHS unit in Northamptonshire
  • Chair of St Andrew’s Healthcare says commissioners cannot “have it both ways”

NHS commissioners cannot simultaneously demand bed capacity remain the same and the quality of services improve, the chair of an under-fire provider of mental health services has told HSJ

Peter Carter, the new chair of child and adolescent mental health provider St Andrew’s Healthcare, said the organisation has been given a “hammering” by the Care Quality Commission, with a large unit in Northamptonshire given its second “inadequate” rating earlier this month.

But when the charity decided it would need to reduce bed capacity significantly to improve service quality, he said commissioners and regulators were “really concerned” by the plans.

At the end of February, St Andrew’s announced it intended to reduce beds within the Fitzroy House facility in Northampton from around 110 to around 30. This would represent a 4 per cent reduction in the CAMHS bed base nationally.

Mr Carter, a former NHS trust and Royal College of Nursing chief executive, told HSJ: “We had a meeting with NHS England and NHS Improvement, the CQC and different commissioners from different parts of the country.

“All of whom were saying, ‘We are really concerned about this’, which is quite ironical isn’t it. On one hand we’re getting a hammering [on quality], on the other we’re saying we’re going to do something about it.

“There are some individuals getting outstanding care [from St Andrew’s Healthcare]. But, of course, if your child is receiving suboptimal care, someone saying to you, ‘Well, some parts are great’, are of no consequence to you. To put it simply, if we were a general hospital and let’s say doing 100 operations a week and clinical audit demonstrated 50 of those you weren’t doing properly, you’d stop [doing] it.”

He said under the provider’s previous leadership, CAMHS was expanded and the provider built Fitzroy House to address the gap in services nationally. A gap, he said, which was created by 20 years of decommissioning of tier four beds.

However, he argued the provider did not have enough clinical expertise to manage the 110-bedded unit, which provides services to children with highly complex needs.

He said: “If St Andrew’s Healthcare hadn’t expanded it would be what it used to be [which is] a highly respected specialist service. And we’re going to get it back to that. I’m sure [the previous leadership’s] motives were honourable… [but] its quite clear in parts of St Andrew’s Healthcare, they overstretched themselves.

“That’s why we’re doing what we’re doing, even though we’re aware its putting pressure on the system. I mean you can’t have it both ways. If you say to me, ‘Well Peter, rather than close why don’t you develop those services?’, we say we simply don’t have the time, that would take several years and the root cause of it has been very poor NHS planning and commissioning.

“I stress no child is going to be thrown out but we have ceased admissions and the NHS will have to get on top of this and have to address these issues.”

In response to comments by Mr Carter a spokeswoman for NHS England and NHS Improvement said: “We can confirm that St Andrew’s Healthcare is proposing to make some changes to mental health, learning disability and autism services for young people on its Northampton site.

“All of our patients and their families can be assured that we are working closely with St Andrew’s to ensure the safety of current patients and to find the best solution for them going forward. We are rigorously reviewing the proposals to ensure they are in the best interests of our patients and are working to fully understand and to mitigate any potential impacts on patients at a regional and national level.”

This story was updated at 14:09 with a response from NHS England and NHS Improvement.