North East London NHS Foundation Trust

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive - this means we looked for evidence that the service met people’s needs. At our last inspection we rated this key question requires improvement. We did not re-rate the service as a result of this inspection.

We found waiting times for children and young people to access initial assessment and treatment following referral were significant and exceeded the national standards. We found staff held excessively high caseloads, which some described as unmanageable. This was a breach of Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This meant services were not planned or delivered in ways that met people’s needs.

• Children and young people did not access care in a timely way. Over 60% were waiting for either initial telephone triage following referral, or for initial assessment or treatment. One hundred and eighty two young people were waiting for initial telephone triage. Eight hundred and twenty three young people had been initially telephone triaged and were now waiting for initial assessment. A further seven hundred and eighty five young people were waiting for treatment, with 361 (46%) waiting over 18 weeks.

• Caseloads varied across pathways and were highest among staff working in triage. Some staff reported individual caseloads over 90 and one said theirs could reach 110.

However,

• People using the service knew how to complain. Staff handled complaints appropriately.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff handled complaints appropriately. The service received 21 complaints during the 6 months preceding our inspection. The most common subject was clinical treatment, followed by delays or cancellations of appointments.

Information on the complaints procedure was displayed on the premises. Most parents/carers we spoke with told us they knew how to complain if they needed to. One told us about the complaint they had made and actions taken as a result. However, 2 carers spoke about their reservations about making a complaint in case this were to negatively impact the young person or their sibling on the waiting list or receiving care.

We reviewed a sample of 2 complaints. Both records contained appropriate details of investigation, outcome and actions taken.

The service enabled carers to give feedback on their service experience through a survey. Most respondents reported good levels of satisfaction in the 12 months prior to our inspection. In January 2025, 44% of carers rated their service experience “good or very good” and 6% “poor or very poor”. However, 7 carers we spoke with told us they had not been offered an opportunity to give their feedback on care.

Children and young people did not access care in a timely way. Over 60% were waiting for either initial telephone triage following referral, or for initial assessment or treatment. Of 182 young people who were waiting for initial telephone triage, 26 had been waiting 18 weeks to a year and 3 had waited more than 1 year.

Of 823 young people waiting for initial assessment, 348 had been waiting 18 weeks to a year, 12 people for 1 to 2 years and 1 person over 2 years. This was in excess of the 6-week standard set for community CAMHS. Staff told us that although the waiting lists had reduced, the average wait was 16 months for a routine initial assessment and 3 months for urgent.

The waiting times for treatment exceeded the 18-week NHS standard and the service did not demonstrate that it had an effective plan to meet the needs of this patient group. Seven hundred and eighty five young people were waiting for treatment, with 361 (46%) waiting over 18 weeks. At the time of our inspection, the service did not report the individual waiting times of the young people waiting for treatment over 18 weeks, and did not collect data on what treatment they were waiting for. The leaders told us this was because the treatment pathways were under review.

Staff and parents/carers we spoke with shared concerns about the waiting lists. One staff member described them as “ridiculous”. Carers told us about the damaging impact of the long waiting times on theirs and young people’s mental health and quality of life. One carer said: “There was a long and difficult wait”. Another told us: “We waited over three years. It’s been a long battle, an uphill struggle”; they added that the impact of this long wait on the young person was the feeling of “being written off”. Carers also shared concerns about poor communication from the service while waiting. One said: “It took 7 months to get a telephone call to accept the referral. They said we would get a face-to-face appointment but I’ve heard nothing since. There’s been no indication of timescale.” Another told us: “We have not had an acknowledgement if the referral is even in the system.” One carer said they did not receive support while waiting: “Nothing from CAMHS. We were referred to social services. I’d love to work but because of my situation, I can’t.”

Caseloads varied across pathways and were highest among staff working in triage. Some staff we spoke with said the service did not have enough staff and their caseloads were not manageable. They said they had to work over their hours and this extra work was not always recognised. Staff reported individual caseloads over 90 and one said theirs could reach 110. Some staff told us they were not able to provide adequate interventions to patients.

These were breaches of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.