‘Two to three years’ before we have enough staff, says trust chief

Tees, Esk and Wear Valleys Foundation Trust has been downgraded from a “good” to a “requires improvement” rating overall following a Care Quality Commission inspection from September to November last year, the report of which was published today.

The trust’s child and adolescent mental health inpatient services were rated “inadequate” and wards at West Lane Hospital, Middlesbrough, were closed by the CQC following the deaths of two 17-year-olds — Christie Harnett and Nadia Sharif — at West Lane last year.

The trust’s rating for the CQC’s responsiveness category was downgraded by one to “requires improvement”, but the CQC upgraded ratings of two areas — “acute wards for adults of working age and psychiatric intensive care units” and “forensic inpatient or secure wards” — and praised staff for treating patients with “compassion and kindness” and for taking concerns seriously.

The trust’s child and adolescent mental health wards remain rated “inadequate” , while its “specialist community mental health services for children and young people” were downgraded to “requires improvement”, along with its “mental health crisis services and health-based places of safety”.

In relation to the community CAMHS, the CQC’s main concern was about staffing levels.

The report said people “waited long periods without contact” and staff “did not know which children were waiting for treatment or receiving treatment”.

It added: “There were not enough staff to meet the number of referrals, complete assessments or deliver interventions and staffing levels were disproportionate across teams. Caseloads were excessively high in some teams and staff and managers had no control over caseload size.”

Colin Martin, the FT’s chief executive, told HSJ that the trust — like many mental health providers — had found it “very tough” to recruit enough staff to deal with increasing demand for CAMHS. He said the trust would look “very carefully” at the risk management of young people who were waiting for services.”

Mr Martin, who is retiring this spring, said: “There are not enough people coming through to meet demand — it could be another two to three years before that happens. That’s the same situation for every provider.

“The pressure in child and adolescent mental health services and the levels of referrals is something we absolutely are working hard to improve.”

There are national moves to increase training, particularly of nurses, to work in mental health and learning disability services, but it is unclear when the supply will substantially increase.

On the CQC’s overall findings, Mr Martin said: “We’re disappointed that we have been rated as ’requires improvement’. We do recognise that we need to make a number of improvements to provide the best possible care. I’m pleased the CQC have recognised the qualities of the staff they have met.”

The CQC’s deputy chief inspector of hospitals and lead for mental health, Kevin Cleary, said: “We found some services had deteriorated while others had failed to make sufficient improvements.” But he praised the “compassion and kindness” of staff, adding: “We were encouraged to find a number of areas of outstanding practice at the trust and a leadership team that was visible and approachable, and that provided development opportunities to staff.”

The trust remains the subject of an independent NHS investigation about the two deaths at West Lane. The investigation, launched in October last year, is still at an early stage with a final report not expected until late 2020. The trust suspended 20 staff members after concerns were raised about West Lane. None have been dismissed so far while some have returned to work.