Shortage of Children and Adolescent Mental Health Service (CAMHs) Beds is the Most Common Reason in Delayed Transfers of Care (DTOCs) in Paediatric Ward

Background: There is a national shortage in CAMHS beds throughout the UK. Additionally, discharge pathway for adolescent and young children with safeguarding and mental health concerns in paediatric ward encompasses close working relationship between acute, mental health and social care services. Yet, there is increasing pressure on all services in regards to patient flow which compromise this partnership hence patient care.

Objectives: To facilitate discharges of paediatric patients with mental health and safeguarding concerns by counting and collecting data about delayed transfer of care from acute setting to mental health or social care services.

Methods: A retrospective survey was conveyed on all paediatric admissions with mental health and safeguarding concerns over a period of 12 months (March 2018-March 2019) at our paediatric ward at Homerton University Hospital. A total of 25 adolescent patients were admitted in the paediatric ward with mental health and safeguarding concerns during this period. Data were collected from their case notes about the safeguarding, medical and mental history and management. Also, data was collected to compare the dates when they were medically fit for discharge with when they were safe to be discharged including the reasons behind delay for discharge.

Results: There was a total of 57 days over the period of 1 year when patients were medically fit for discharge but not fit for discharge due to shortage of CAMHS beds, awaiting discharge planning meeting, court hearing and housing issues. Of note the most common reason in delay in transfer of care was due to shortage of CAMHS beds followed by housing problem. However, in just less than half admissions, there was no delay in transfer of care.