Concerns identified at Shropshire’s major hospitals around care of youngsters with mental health conditions

Nursing director Hayley Flavell said the Care Quality Commission had inspected the Shrewsbury and Telford Hospital NHS Trust on February 24.

She said the trust, which runs Royal Shrewsbury Hospital and Telford’s Princess Royal Hospital, is waiting for the report from the CQC, which is expected by the end of the week. However, some concerns have already been raised.

Speaking to the board of directors during an online meeting on Thursday, she said: “The visit did identify some real concerns in terms of the care of children and young people with mental health and, as a result of the visit, we have been served a notice under Section 31 of the Health and Social Care Act. There are six parts of that condition.

“There are parts of the condition that are solely SaTH in terms of training, policies and procedures. There are two elements that are a system wide condition, in terms of we must not admit patients under the age of 18 who present with isolated acute mental health needs and those who do not have any physical health needs that require an inpatient assessment or treatment.

"That’s a very different position to what we have been in because ED [emergency department] is deemed the place of safety.

“We’ve used Ward 19, our children’s ward, at PRH to house these children and young people whilst mental health assessment is taking place or intervention is being sought from the wider system.”

Challenge

She said another condition was that an effective system must be in place to identify where all under 18s are located in the hospital. Ms Flavell said that process was in place.

“But we also need to ensure appropriate oversight of care of these patients must be provided by suitably competent staff,” she added.

“This must include continuous oversight by a registered mental health nurse and regular oversight from a child and adolescent psychiatrist for those under the age of 18 admitted with acute mental health needs, learning disabilities and behaviours that challenge.”

She said there needed to be a “system-wide response” and work had taken place to ensure robust measures were in place.

“I have one registered mental nurse who is a matron for the whole organisation, therefore that oversight can’t be provided by us,” she said.

“It needs to be provided by our Midlands Partnership Foundation Trust colleagues as well as the adolescent psychiatrist.”

Trust chief executive Louise Barnett said: “We take this situation very seriously and have been working hard with our partners to put some immediate measures in place.”

It emerged last week concerns around anaesthetic cover at PRH were raised by the CQC following an inspection.