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GPs’ support for children’s mental health limited by ‘silo working’, CQC suggests


By Jess Hacker
18 November 2021

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Collaborative working in children’s mental health services needs improvement, the CQC has said after finding ‘GPs were not being involved’ in cross-sector working.

The report (17 November) – which reviewed how services worked together to support young people’s mental health during the pandemic – found a ‘lack of direct contact’ between GPs and other health or social care professionals.

It said that collaborative working between primary care and Child and Adolescent Mental Health Services (CAMHS) could be ‘inconsistent and underdeveloped’, with information often not shared between professionals.

As a result, there were concerns that ‘silo working limited the opportunity’ for children and young people to be cared for holistically, it said.

A review of 149 GP records revealed that only 15% showed that the GP practice was ‘actively’ involved in mental health multidisciplinary team working, it added.

And of these, only 59% showed that the young people had a multidisciplinary team mental health care plan in the patient records.

This indicated that organisational boundaries ‘can still be a barrier to progress’, and that different commissioning arrangements can be ‘challenging’, it said.

However, the CQC did note that there were several ‘positive’ examples of strengthened partnership, citing one area where GPs with specialist interest in eating disorders were monitoring patients alongside CAMHS to support those children still on waiting lists.

It comes as data this week showed that only 63% of urgent cases of young people referred to eating disorder services were seen within one week.

Meanwhile, analysis published in August revealed the number of under-19s waiting for urgent treatment for eating disorders tripled during the pandemic.

Systems moving toward recovery

Dr Rosie Benneyworth, the CQC’s chief inspector of primary medical services and integrated care said that ‘as systems begin to move towards recovery, we need to hold onto and share the hard-won developments’ that have driven better care for children and young people.

‘Demand has soared over the last 18 months and children and young people should not have to reach a crisis point before they get proper mental health support,’ she said.

‘We have to take this opportunity to learn from this incredibly challenging time and do better for them.’

The review was conducted between June and July 2021 across seven integrated care systems (ICSs):

  • Birmingham and Solihull Integrated Care System (ICS)
  • Bristol, North Somerset and South Gloucestershire ICS
  • Buckinghamshire, Oxfordshire and Berkshire West ICS
  • Hertfordshire and West Essex ICS
  • North London Partners in Health and Care ICS
  • Nottingham and Nottinghamshire ICS
  • South Yorkshire and Bassetlaw ICS

Last month, the Treasury had confirmed £5.9bn investment into digital tech and to tackle England’s growing backlog for care, which currently sits at 5.7 million people.

However, chancellor Rishi Sunak faced criticism for not taking it as an opportunity to put mental health on an equal footing with physical health.

Prior to the spending review, NHS Providers cautioned that ‘hard won progress on mental health treatment and services is in jeopardy’ if the NHS does not get the critical investment it needs.

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