Inadequate Care for Children’s Mental Health at Telford Hospital

The Shrewsbury and Telford Hospital NHS Trust has been forbidden from admitting any new patients under the age of 18 who present solely with acute mental health needs after accusations that they have failed to keep young people safe.

This follows after the Care Quality Commission (CQC) carried out an unannounced inspection of the children and young people’s service at the Princess Royal Hospital in Telford on 24 February 2021 after receiving concerns about the quality and safety of treatment provided.

Safety Concerns

The inspection found that many children had not received an adequate risk assessment on admission and that staff "generally relied" on rapid tranquilisation, with one child receiving this 27 times during their admission. The inspection also found that staff had not received appropriate restraint training, and that some staff had not had any restraint training at all. Other concerns raised showed that staff did not fully understand how to protect children and young people from abuse and that they did not consistently follow local and national guidance for safeguarding referrals.

A Section 31 notice, which aims to prevent further harm, was issued two days later placing the trust under urgent conditions. The trust was ordered to review the records of all acute mental health inpatients under the age of 18, and not to admit any more unless they had associated physical needs. The CQC also ordered the trust to implement safeguarding systems and to train all staff working with under-18s with mental health needs to ensure they were “appropriately competent” to do so.

A Section 29a notice was also issued on 12 March which accused the trust of failing to take account of children, young people and their families’ individual needs and preferences, particularly in regards to food choices for those with eating disorders.

As a result of the inspection, the trust’s rating for children and young people’s services was downgraded from ‘Requires Improvement’ to ‘Inadequate’.

Improvements

Nursing Director, Hayley Flavell has since confirmed that the trust addressed some concerns immediately and drew up plans to correct others, including devising a system to track young patients’ location and to ensure that all staff have received appropriate training.

Ms Flavell said that, “There is now an opportunity to look widely at how we care for adults who attend our emergency department with mental health issues. We’re going to see more mental health coming into the organisation, so we need to make sure what we do isn’t just focussed on children and young people.”

Chief Executive at the trust, Louise Barnett agreed that the inspection had been an opportunity to improve, but said, “It absolutely shouldn’t take an inspection with a series of conditions and warning notices,” to provoke it.

The CQC continues to monitor the trust closely to ensure that patient safety improves and has confirmed that they will return to check that sufficient action has been taken.

The implications of the COVID-19 pandemic has created a surge in mental health problems amongst children and young people. It is therefore vital, now more than ever, that young patients are able to access the help and support they need. Lanyon Bowdler’s award-winning clinical negligence team includes members of the Law Society’s Clinical Negligence Panel and AvMA panel members. The team has extensive experience of dealing with mental health claims and if you have concerns about the care you have received, our team is happy to discuss the matter with you and guide you through the process sensitively.