NHS England is considering putting inpatient child and adolescent mental health services out to tender in a bid to tackle “out of area” placements for vulnerable young people.
The national commissioning body has confirmed to LGC’s sister title Health Service Journal that it is considering measures to reduce the number of “long distance transfers within CAMHS”, including “any necessary tendering for services”.
It comes amid widespread concern over the specialised CAMHS services – known as tier 4 services – commissioned by NHS England.
In February, HSJ revealed that a moratorium by NHS England on commissioning new services was exacerbating a shortage of specialist mental health beds for younger people, and leading to young people being placed in facilities many miles from their homes.
A tender notice issued by NHS England links the procurement exercise to an ongoing internal review of tier 4 CAMHS.
The review involves assessing current provision and “commissioning issues”, and identifying quality, access and environmental standards for the services. A “provider engagement event” related to the tender scheduled for April this year was postponed, which an NHS England spokeswoman said was “to allow a more considered view”, but that it was “the intention to hold the event in late July”.
NHS England was unable to tell HSJ how much it currently spends on tier four CAMHS due to the complexity of collecting the necessary data. The spokeswoman added it would know by the end of July, in time for the provider engagement event.
However, sector leaders told HSJ a tender for inpatient care alone was unnecessary, and that the focus should be on joining up commissioning of outpatient and community provision with specialised hospital services.
Birmingham Children’s Hospital Foundation Trust chief executive Sarah-Jane Marsh said: “Many of the issues in tier four have their solutions in community or social care, not bed-based services. The real issue is we could get many inpatients treated at home with intensive support, but we can’t move the money to where we need to provide the service.”
Mental Health Network chief executive Stephen Dalton agreed that the gap between clinical commissioning groups – which commission the outpatient and community services – and NHS England needed to close.
He said: “We don’t need a beauty contest. We need to create incentives to connect the local commissioning with the national, and for local commissioners to get a reward for coming up with more efficient, lower cost, closer to home interventions.”
Alison Rose-Quirie, chair of the Independent Mental Health Services Alliance, said: “While we welcome the procurement of CAMHS, in our view a simple and time-limited procurement process to create more beds for children and adolescents so that they can get the right care in the most appropriate setting more quickly, would be preferable.”