NHS England
HSSIB recommends that NHS England, in collaboration with key stakeholders, including young people with lived experience and their families, develops guidance on how acute paediatric wards could be adapted to support children and young people with mental health needs. This work should focus on improving the therapeutic environment.
NHS England welcomes this report and recognises the importance of making improvements to better support children and young people with mental health needs within our acute settings.
In November 2022, we published "Supporting children and young people with mental health needs: a joined-up approach" - a framework to facilitate systems to come together to collectively support CYP with mental health needs who present in acute and paediatric settings - as well as supporting the clinical teams who care for them.
We have also funded paediatric Mental Health Champion roles in acute settings: in acute settings: senior paediatricians and nurses with dedicated time to: develop joint pathways and positive relationships between paediatric and mental health teams; ensure paediatric teams have access to relevant training and support; and to foster a culture that makes mental health everyone’s business.
Health Building Note (HBN) 23 is not on the priority list of documents to be updated at present. We therefore propose to research and co-develop [with NHS England’s Estates experts, NHS England’s Children and Young Persons’s Mental Health experts, and alongside NHS England’s Children and Young People experts] supplementary guidance on therapeutic environments within an acute setting for children and young people.
This will take the form of a National Estates Technical Bulletin (NETB) to enable progress in this area prior to the formal update of HBN 23. As with all our technical guidance, we will ensure the involvement of key external stakeholders including relevant medical Royal Colleges during the development of the NETB.
It is worth noting that whilst we aim to ensure we make improvements in this area, due to the range and nature of care delivered in an acute setting, it is not possible to provide a risk-free space. The investigation found that removing items deemed a risk and creating a more restrictive environment can create more conflict situations. Therefore, in line with the evidence collated in the investigation, the guidance will focus on improving the environment to support therapeutic care.
Actions planned to deliver safety recommendation:
- Literature review and scoping of National Estates Technical Bulletin (NETB). By: TBC. Other dependencies identified: Resource implications for completion of priority documents already in train. Mobilisation of new contract. Additional comments: Project is still being scoped. We are seeking proposals from our delivery partner. Likely to require significant stakeholder input including Royal Colleges.
- Draft NETB - as point 1.
- Technical Engagement - as point 1.
- Process engagement comments - as point 1.
- Final draft - as point 1.
- Publish - as point 1.
Response received on 6 September 2024.
NHS England
HSSIB recommends that NHS England, in collaboration with key stakeholders, updates ‘Health Building Note 23: Hospital accommodation for children and young people’ to include the therapeutic environment for supporting children and young people with mental health needs.
NHS England welcomes this report and recognises the importance of making improvements to better support children and young people with mental health needs within our acute settings.
In November 2022, we published "Supporting children and young people with mental health needs: a joined-up approach" - a framework to facilitate systems to come together to collectively support CYP with mental health needs who present in acute and paediatric settings - as well as supporting the clinical teams who care for them.
We have also funded paediatric Mental Health Champion roles in acute settings: in acute settings: senior paediatricians and nurses with dedicated time to: develop joint pathways and positive relationships between paediatric and mental health teams; ensure paediatric teams have access to relevant training and support; and to foster a culture that makes mental health everyone’s business.
Health Building Note (HBN) 23 is not on the priority list of documents to be updated at present. We therefore propose to research and co-develop [with NHS England’s Estates experts, NHS England’s Children and Young Persons’s Mental Health experts, and alongside NHS England’s Children and Young People experts] supplementary guidance on therapeutic environments within an acute setting for children and young people.
This will take the form of a National Estates Technical Bulletin (NETB) to enable progress in this area prior to the formal update of HBN 23. As with all our technical guidance, we will ensure the involvement of key external stakeholders including relevant medical Royal Colleges during the development of the NETB.
It is worth noting that whilst we aim to ensure we make improvements in this area, due to the range and nature of care delivered in an acute setting, it is not possible to provide a risk-free space. The investigation found that removing items deemed a risk and creating a more restrictive environment can create more conflict situations. Therefore, in line with the evidence collated in the investigation, the guidance will focus on improving the environment to support therapeutic care.
Actions planned to deliver safety recommendation:
- Literature review and scoping of National Estates Technical Bulletin (NETB). By: TBC. Other dependencies identified: Resource implications for completion of priority documents already in train. Mobilisation of new contract. Additional comments: Project is still being scoped. We are seeking proposals from our delivery partner. Likely to require significant stakeholder input including Royal Colleges.
- Draft NETB - as point 1 above.
- Technical Engagement - as point 1 above.
- Process engagement comments - as point 1 above.
- Final draft - as point 1 above.
- Publish - as point 1 above.
Response received on 6 September 2024.
Care Quality Commission
HSSIB recommends that the Care Quality Commission uses the findings of this report to ensure healthcare providers and integrated care boards implement a robust way for risks associated with the adaptations made to acute paediatric wards to be escalated and managed.