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The number of mental healthcare beds for teenagers in England has declined sharply during the coronavirus pandemic as private providers cut capacity despite a surge in demand for treatment.

The availability of hospital beds for children and teenagers with mental health problems, most of whom are aged between 13 and 18, has fallen by a fifth since 2017, with more than half of these cut last year, according to figures from the Care Quality Commission, analysed by Candesic, a healthcare consultancy.

About 325 beds have been removed in the past five years — a drop of 20 per cent — leaving just 1,321 beds for children and teenagers in England, the research found.

The fall comes as 65 per cent of NHS Trust leaders reported that they were unable to meet demand for children and adolescent mental health services, resulting in higher thresholds for treatment, longer waiting times and more placements further away from family homes.

Michelle Tempest, analyst at Candesic, said the combination of rising demand and falling bed numbers for teenagers had created a significant gap in the market.

“Even if the private sector is willing to increase capacity, the dearth of staff will prevent them from doing so as most do not want to risk the reputational damage of a negative CQC rating,” she said.

Mental health is one of the most heavily outsourced parts of the NHS system, alongside elderly care. Although more than 98 per cent of the beds are paid for by the NHS, private providers, which include the Priory Group, Cygnet Health Care and Huntercombe Group, manage more than half the capacity.

They have been cutting beds even as the number managed by the NHS remained stable at about 651 over the past five years.

There are some concerns that the shortage will enable private providers to charge the NHS higher fees for care, which costs between £500 and £1,300 a bed a day.

Private providers said they had been removing beds in mental health hospitals as a result of staffing shortages that had affected patient care.

They are also receiving patients with more severe problems who require more care than five years ago, a trend that appears to be compounded by social media and the pandemic, they said.

The Priory, Britain’s biggest mental healthcare provider, owned by Waterland Private Equity, said the closures were “the result of having to address a sector-wide shortage of specialist child and adolescent clinical staff”.

“As a responsible provider, we cannot run services which compromise our high quality standards ,” it said. “These decisions have been taken in partnership with NHS England.”

NHS England said the decline in beds reflected a decision to prioritise investment in community services for children and young people, keeping adolescents out of hospital and with their families.

“The NHS has put in place 24/7 crisis lines, created hundreds of mental health support teams in schools and is working with local authorities and charities to make as much support available to families and young people in the community before an admission to hospital is needed,” it said.

Jess Lievesley, interim chief executive of St Andrew’s Healthcare, a charity in the East Midlands, said the additional investment by the NHS in community crisis teams as part of a move to keep teenagers at home had contributed to its decision to cut 84 beds over the past five years.

However, he added that the shortage of qualified staff had also resulted in “reduced capacity for new patients, particularly in specialist and high-need secure units”.

In June 2021 NHS England announced an additional £10m in capital funding for additional beds, including for teens with eating disorders.

The CQC said its own review had shown that during the pandemic “there were difficulties in accessing specialist inpatient care, with a lack of CAMHS [child and adolescent mental health services] inpatient beds available”.

Source: This post first appeared on Duk News

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