A child was kept in an Accident and Emergency observation area for three weeks after suffering a mental health crisis because there was nowhere suitable for her needs.

The girl, aged between 16 and 17 and who has a learning disability, appears to have fallen into a gap between mental health care provision for children and for adults.

She was taken to Aintree Hospital's emergency department earlier this year, as at the time only children under 16 were eligible for treatment for mental health issues at Alder Hey Children's Hospital.

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South Sefton NHS Clinical Commissioning Group (CCG) described the girl, referred to as 'Young Person A', as being "kept in the emergency department observation areas" while "the system tried to respond to her needs".

The service told the ECHO the incident was not "representative of the care we would strive to provide to our patients".

The pandemic has heaped pressure on the region's already struggling children's mental health care providers.

In June in the Sefton area, 54% of children under 16 requiring a referral to Child and Adolescent Mental Health Services (CAMHS) were seen within six weeks against a target of 90%.

This was down from 62.5% in May and 81.4% in April.

Things are more difficult for children over 16, and according to the CCG a "gap in the service" was recovered after this case was investigated.

According to a report by South Sefton CCG chief nurse Chrissie Cooke: "Governing Body members will remember where a young person with a learning disability was taken to ED at Aintree, in mental health crisis.

"The young person was kept in the ED observation areas for 3 weeks whilst the system tried to respond to her needs.

"Following this a rapid review process was held and identified system and provider issues that needed to be rectified.

"All stakeholders developed 30-60-90 day action plans and committed to complete these actions to improve the response to young people like Young Person A...

"The rapid review process exposed a gap in the service cover for 16 & 17 year olds, attending ED in mental health crisis.

"Children under 16 attend Alder Hey ED, where their needs are responded to by the Trust. The Chief Nurse has brokered a temporary agreement between Alder Hey, Merseycare and Southport and Ormskirk Trust to ensure that these young people are not left without an appropriate response."

Since the incident Ms Cooke said Alder Hey and Mersey Care NHS Foundation Trust have recruited to a joint post specifically for young people with a learning disability, and Alder Hey are recruiting to seven Learning Disability trained nurses across the trust.

A spokesperson for the CCG said: "This example of a young person remaining within the emergency department for such a length of time is not representative of the care we would strive to provide to our patients which is why urgent actions were taken to ensure it does not happen again.

"We are committed to continual improvements to our services and have already seen specialist carers for young people with learning disabilities being recruited and training being undertaken to ensure nurses in emergency departments are equipped to support young people in crisis to meet the needs of patients."

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