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Wednesday, 22 October 2014

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Children's mental health services overhaul falling short in Cumbria

An urgent overhaul of children’s mental health services in Cumbria is “falling short” of providing the care needed.

Greg Canning photo
Greg Canning

A damning review, leaked to the News & Star last year, called the county’s child and adolescent mental health service (CAMHS) both outdated and inadequate.

The shock report, commissioned by NHS Cumbria Clinical Commissioning Group (CCG) and the Cumbria Partnership NHS Foundation Trust, was written by three independent experts.

It claimed the team – which supports children and young adults with issues including eating disorders, depression, attention deficit disorder and autism – is drastically understaffed and dysfunctional.

Since the publication of that report, health bosses have been drawing up proposals to restructure the service and are consulting staff and unions over their proposals for the restructuring of the service.

The review was welcomed by staff and patients, who praised the work of those within mental health but admitted there were not enough staff.

Since the launch of the consultation in December though, the unions have become unhappy, claiming the proposals do not go far enough to guarantee the future safety of Cumbria’s most vulnerable children.

John Morris, workplace representative for union Unite, explained: “It is clear that the service has been in need of significant turnaround for quite a time.

“As a union representative I am very concerned that the trust is seeking to do away with a number of highly specialised and experienced clinicians, and replacing them with a larger number of staff with lower levels of skill and experience.”

He continued: “The management proposals fall a long way short of the recommendations of the external review and of recommendations made by the clinical reference group.

“So far the response of trust management has fallen far short of a guarantee that the new structure will be fit for purpose.

“Negotiations are continuing, and we hope that a solution that will be found that will provide an enhanced clinical service as well as saving the jobs and livelihoods of many dedicated staff.”

The Royal College of Nursing has also expressed its reservations.

“It is absolutely essential that we get the review right,” Royal College of Nursing officer Greg Canning said. “The resultant service must ensure that Cumbria’s children are properly supported.

“In particular, while we recognise that these are challenging financial times, the service must be safe regardless of what day or time of day it is provided.”

He added: “Sufficient resources must be provided to ensure that the service employs the right number of staff, with the right skills mix, in the right places, and at the right times.”

Mr Canning called on the trust to take an “evidence-based approach” to the restructure, and urged it to demonstrate that its actions were based on “national best-practice, rather than merely a desire to save money”.

Cumbria Partnership NHS Foundation Trust has vehemently denied that its actions are to do with cost-cutting – insisting it is now investing more into CAMHS, and has already made funding available for two additional consultants.

In a statement, it said that the review had found the service was large enough, but needed to be restructure to meet the needs of children.

“We have agreed a joint action plan with Cumbria clinical commissioning group based on their findings,” it explained.

“The review told us we need more staff with nursing and psychology qualifications who can work with children with major mental health difficulties. To achieve this, we have to change the mix of staff and the consultation outlines our suggestions.

“We are proposing a significant increase in the number of nursing staff and the workforce will increase overall by almost eight whole-time equivalents.”

A spokeswoman for the trust said there will be various stages of the action plan to increase staff numbers, in line with the review recommendations.

“This plan is our first phase,” she said. “We are jointly discussing with the PCT the plan for better investment in the future.

“Everyone working in the service will be qualified and competent and the suggested structure is very similar to that in CAMHS services elsewhere.

“Our priority is to listen to staff views about the proposed structure.

“We acknowledge this is a difficult time for them but we must make changes to improve the service.”

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