health services must improve: Inspectors

Mental health services at Birmingham Women and Children’s NHS Foundation Trust must improve, inspectors say.

Issues within this area have led to watchdog the Care Quality Commission (CQC) warning enforcement action will be taken if progress is not made.

But the trust, which was inspected last year, responded to concerns and mitigated any risks, the CQC said.

The trust said it was disappointed by the findings, which saw its mental health service rated as inadequate.

Following the inspection, the trust’s overall rating has dropped from good to requires improvement.

The CQC looked at specialist community mental health services for children and young people, child and adolescent mental health wards (CAMHS), community-based mental health services for adults of working age and mental health crisis services and health-based places of safety.

The inspection – in June, July, August and October – also looked at critical care and surgery at Birmingham Children’s Hospital.

But concerns within specialist community mental health services and CAMHS wards prompted inspectors to issue a letter of intent telling the trust urgent enforcement action would be taken if significant assurances were not made.

Self-harm risk

“Staff didn’t always review or complete risk assessments for each child or young person, including after an incident within the mental health service,” Lorraine Tedeschini, CQC’s deputy director of operations in the Midlands, said.

“For example, one young person’s risk assessment had not been updated since 2018 despite records stating they were at risk of self-harm and suicidal thoughts.

“It was concerning that staff weren’t continually monitoring children and young people on mental health waiting lists for changes in their level of risk in order to intervene if anything changed.”

The trust responded and “took quick action” to address concerns in how it was managing incidents at the service, she added.

Positive areas of work included well-run acute services, with staff supported to develop their skills.

Inspectors also found “a continuation of exemplary care” at Birmingham Children’s Hospital in critical care and surgery services which should be commended, Ms Tedeschini said.

Following the inspection, the trust’s overall rating has dropped from good to requires improvement.

Caring dropped from outstanding to good, responsive and well-led dropped from good to requires improvement, effective remained good and safe remained requires improvement.

The overall rating for mental health services dropped from requires improvement to inadequate.

The trust, which runs the women’s and children’s hospitals and Forward Thinking Birmingham, said it accepted “both the findings and improvement actions that have been set out by the inspection team, specifically in relation to our mental health services” and continued to invest that area.

“Following the inspection, we have continued to work very closely with the CQC team, addressing the urgent concerns highlighted immediately following their initial inspection feedback, and establishing a clear improvement programme to address all remaining areas,” Matthew Boazman, interim chief executive, said.


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