Actions speak louder: A second review of healthcare in ... - HMCPSI

ACTIONS SPEAK LOUDER
SUMMARY
Health service managers and YOTs’ management boards are certainly beginning
to challenge the outcomes of health interventions more robustly, although this
encouraging development is generally still at an early stage. There was a significant
lack of widespread monitoring and evaluation of health services provided to YOTs,
which prevents interventions from being tailored to meet the needs of children and
young people.
Funding and resources
Resourcing for YOTs by health services has increased in some areas, but was still
inadequate in nearly half of the YOTs inspected for this review. The national average
for this financial contribution has also fallen significantly since our first review.
Although the provision of healthcare within YOTs has improved, to some extent,
since our initial review, 10% of YOTs still had no mental health worker on site and
30% did not have a resource for general health nursing. The most recent Youth
Justice Board figures (December 2008) indicated that 24 YOTs had no health worker
on site, despite this being a statutory expectation. Although universal services, such
as child and adolescent mental health services, GPs, opticians and dentists, had
contingency plans in place to support some of these YOTs, this was hampered by
staff vacancies. Our inspectors have seen improvements in relation to the links and
provision of health services from outside the YOT, but there are still some problems,
particularly with the access and support that child and adolescent mental health
services gave to 16–18 year olds. One positive finding from our inspections was that
the availability of support for those with substance misuse problems has increased
and was more consistently applied throughout the country.
What is clear from our review is that the statutory requirement that this vulnerable
group of children and young people should receive a consistent level of healthcare
remained unmet. There were gaps in provision and clear inequalities across a range
of local authorities. Consequently, core health standards (Ref. 1) were not met. It is
important, for example, to make sure that children and young people who have
offended, or who are likely to offend, are safeguarded through accurate, consistent
assessments of their health needs. Equally important is the need for professionals
to ensure that they exchange information effectively with each other.
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