An interim report published by HSIB (Healthcare Safety Investigation Branch) warns that children and young people exhibiting high-risk behaviours are being cared for in NHS paediatric wards which may not be a safe, or suitable, environment for them. Further, this practice can impact on the wellbeing of those patients and their families, and pose a risk to other patients and staff.
During the course of an investigation into the risks associated with the design of paediatric wards in hospitals, HSIB has uncovered significant challenges in caring for children and young people exhibiting high-risk behaviours.
The purpose of the interim report (‘Keeping children and young people with mental health needs safe: the design of the paediatric ward’) is to highlight urgent emergency safety risks to the healthcare system. Whilst some of the risks it highlights are known by the wider system, HSIB considers that the risks may not be fully understood or considered holistically.
The report emphasises that paediatric wards are designed to care for patients who only have physical health needs and not for those with mental health needs. Wards contain many self-harm and ligature risks and staff, patients and families have commented that they are crowded, busy and noisy, unsuitable for children and young people experiencing a mental health crisis and/or with sensory needs.
HSIB has visited acute paediatric wards at 18 hospitals across England. Thirteen of those 18 hospitals stated that the paediatric ward was unsafe and not a suitable environment for children and young people with high-risk behaviours.
This risk is of growing concern as the number of children and young people with needs other than treatment for physical conditions has risen over the last six years. Data show the rates of probable mental disorder in children aged 7-16 years is now one in six, and in young people aged 17-19 it’s one in four. The knock-on effect has been that paediatric wards in acute hospitals are increasingly caring for children and young people who may display high-risk behaviours. Further pressure is added by the current demands on the health and social care system, and the concerns over NHS staff wellbeing.
HSIB has called for immediate action to be taken by Integrated Care Boards and NHS organisations to facilitate a system-wide response to reduce the safety and wellbeing risks associated with admitting children and young people with high-risk behaviours to an acute paediatric ward.
