• CCGs sought to limit access to under pressure children’s mental health service
  • Had tried to stop routine referrals for children from outside the area
  • NHS England intervened

Commissioners have backtracked on a decision not to accept routine referrals for children from outside its area to an under pressure mental health service.

The two clinical commissioning groups in Shropshire sent a letter to neighbouring CCGs and local authorities late on 26 February, warning its 0 to 25 mental health service would not have capacity to meet routine referrals for children in care who were deemed to be out of area.

They have since withdrawn their letter, however. HSJ understands this was following intervention from NHS England, which sent a briefing to the CCGs to days later.

In May 2017, Shropshire and Telford and Wrekin CCGs awarded a prime provider contract to South Staffordshire and Shropshire Foundation Trust for a tier three children and adult’s mental health service for 0 to 25 year olds.

One senior source involved in the discussions said the 0 to 25 service was “struggling to keep up with the population we have already”. The source said a “huge hidden waiting list of around 800” was discovered when the new service went live in May 2017.

“These are children with huge needs and nobody is saying that they shouldn’t be looked after. They clearly need some kind of therapy but we can’t just continue to absorb more and more and more,” the source added.

In a statement to HSJ, a spokeswoman for the two CCGs said: “Our county has a high number of residential units, which attract a large number of out of area placements (793 children in the care of local authorities and 535 out of area placements). Many of these young people and children require ongoing access and support from our local services, including CAMHS.

“During the recent re-procurement of our CAMHS service, a number of workforce issues were highlighted which we are now addressing in order to meet the demands for ongoing support.

“In light of these staffing challenges, and the need to reduce waiting times for patients, we issued a letter to placing providers to explain the current position relating to routine ongoing care and highlighting alternative local providers. The letter also confirmed we would continue to accept crisis referrals for out of area looked after children.”

The statement added that “following feedback and advice on national policy” commissioners the CCGs had withdrawn their original letter and since issued another, advising that they will be “arranging a multiagency meeting to determine a way forward” and would value input from out of area local authorities.

The statement said: “We are continuing to work with the provider to find workable solutions to the workforce and capacity issues in the short term.”