• The new safety watchdog has published its investigation into the transition from child and adolescent mental health services to adult services
  • The Healthcare Safety Investigation Branch sets out a number of recommendations for national leaders
  • Warns that more needs to be done to stop young adults falling into a “void” when they leave CAMHS but are not eligible for adult services

The long term plan for the health service must address the “void” which leaves young people with serious mental health problems unable to access support when they turn 18, according to a new report.

The Healthcare Safety Investigation Branch has published its national investigation report into the transition from child and adolescent mental health services to adult services.

It follows the branch’s investigation into a teenager who committed suicide within months of being transferred from CAMHS to adult services.

The report, the second from the new safety watchdog, sets out a series of recommendations for national leaders to improve services, including:

  • NHS England should require services to move from age based transition criteria to more flexible needs based criteria;
  • NHS England should work with partners to meet the needs of young adults that require support but do not meet current criteria for adult services; and
  • The Care Quality Commission should extend its inspection remit to examine the whole care pathway from CAMHS to adult services.

The report said the requirements to move to a needs based transition criteria and fill the gap for young adults not eligible for adult services should be part of the long term plan expected this autumn, in the wake of the new funding pledged by the prime minister last month.

It is estimated that more than 25,000 young people transition from CAMHS to adult services each year, with one study reporting only four per cent of young people received an “ideal” transition.

HSIB national investigator Amber Sargent told HSJ young people can find themselves in a “void” if they are not eligible for adult services when they turn 18.

She said it was vital that children are not just cut off when they turn 18, and moving from age based criteria to needs based would help address this “cliff edge” point.

Ms Sargent added: “Everyone ages differently and to have this hard and fast cut off ties clinicians hands. 

“The striking thing was this cliff edge moment – you turn 18 and for the first time you don’t have the structure of education, you’re moving away from home and then your services say we are done now, you either have to move to another service or go back to your GP.”

HSIB was set up by outgoing health and social care secretary Jeremy Hunt to investigate and provide system wide learning from errors.

It has sent its recommendations to NHS England, NHS Improvement and the CQC. 

The CQC said it did not have the legal authority to implement HSIB’s recommendations, adding that it has called for a change in legislation to allow it to inspect local systems. However, it said it can still use inspections to review the interface between CAMHS and adult services.

An NHS England spokesman said mental health will be a top priority in the long term plan expected this autumn.

He added: “There’s been a step change in access to high quality children’s mental health services in recent years, and as the NHS in England develops a long term plan for the health service, mental health will be a top priority, with our young people supported from birth, through childhood and their teenage years, into early adulthood.”