NHS mental health access for children a ‘postcode lottery’

A report from the Children’s Commissioner for England has claimed that children’s access to specialist NHS mental health services in England remains ‘a postcode lottery’.

With the research finding huge differences in spending and referrals depending on where families happen to live, the Children’s Commissioner said that referrals of children and young people dropped as a result of disruption caused by the pandemic, at a time when more of them were struggling with mental health than ever before.

In 2020-21, a total of 497,502 referrals were made to child and adolescent mental health services (CAMHS) compared with 539,000 the previous year, as children became less visible to professionals such as GPs and teachers who usually make referrals.

For those children accepted for treatment, average waiting times fell from 43 days in 2019-20 to 32 days in 2020-21, though there were wide variations across England, and a third of children accepted on to waiting lists were still waiting for their treatment to begin.

Although referrals went down, demand increased, with one in six children suffering from a probable mental health condition, up from one in nine in 2017. As a result, the report said that only 32 per cent were able to access treatment.

Spending on children’s mental health services went up 4.4 per cent in real terms, but some clinical commissioning groups chose to spend significantly less than others. The highest spend per child in 2020-21 was by NHS Isle of Wight CCG at £165, followed by Norfolk and Waveney (£152) and west London (£138). The lowest was Halton at £16 per child – down from £25 in 2019-20 – followed by Trafford and Redbridge, both at £41.

Dame Rachel de Souza said increasing investment was making a difference. “More children have been accepted into treatment and for some children waiting times have reduced. However, there is still more to do. Some children are still waiting a long time for their treatment to begin, and many are still not accepted on to waiting lists.

“There is still wide variation between local areas on what is being achieved. For example, the percentage of children waiting for treatment at the end of the year varied greatly between local areas: from as low as 14 per cent in NHS Castle Point and Rochford and NHS Mid Essex, to 78 per cent in NHS East Sussex.”