Mental health trusts ‘must improve on learning disability/Camhs’

Mental health trusts must improve services for people with learning disabilities and children and young people, a sector leader has admitted as the Care Quality Commission identified problems in both areas in its annual health check, published today.

However, Steve Shrubb, director of the NHS Confederation’s Mental Health Network, hailed trusts’ overall performance despite a sharp fall, from 64% to 30%, in the proportion rated excellent and a rise from 4% to 9% in those rated ‘weak’ from 2007-8 to 2008-9.

Mental health trusts, which last year were the best performing category of trust in the check, faced a tougher regime this year, with seven new performance indicators.

Trusts have called for tougher regime

Shrubb said trusts themselves had called for a tougher regime, in response to claims by the CQC’s predecessor, the Healthcare Commission, that previous assessments had been easier than those faced by primary care, acute and ambulance trusts.

Shrubb cited the view of Cynthia Bower, chief executive of the CQC, that mental health trusts “had risen to the challenge” of this year’s assessment.

But he admitted that trusts needed to improve in the provision of services for learning disabled people with mental health problems and children and young people.

Learning disability failures

Thirty one per cent of the 57 trusts rated were deemed to have failed and a similar proportion to have underachieved on a new indicator on best practice in mental health services for learning disabled people.

And 43% underachieved and 7% failed on an indicator on providing child and adolescent mental health services.

Shrubb said improvements in both departments required a person-centred approach to patients’ needs.

On the learning disability issue, he said: “It’s about being absolutely clear that you understand what kind of service people with learning disabilities want and need, and not just applying services based on people with mental health problems [alone].”

Adults are main focus

On Camhs, he said: “Mental health trusts put a lot of focus on their main area of business which is adults. These results remind us that we have to focus on understanding other groups. It’s absolutely clear that the majority of organisations need to do better on Camhs.”

The annual health check also reiterated concerns about the NHS’s overall performance on child protection, with a drop from 96.4% to 90.7% in the proportion of trusts meeting the core standard on safeguarding children.

In a report published in July, the CQC said trusts were failing to comply with requirements including providing sufficient child protection training and working with local safeguarding children boards.

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