Evaluating the provision of paediatric liaison psychiatry services in England

Liaison psychiatry provision for children and young people in England is poorly evaluated.

We sought to evaluate paediatric liaison psychiatry provision and develop recommendations to improve practice.

The liaison psychiatry surveys of England (LPSE) cross-sectional surveys engage all liaison psychiatry services in England. Services are systematically identified by contacting all acute hospitals with emergency departments in England. Questions are developed in consultation with NHS England and the Royal College of Psychiatrists' Faculty of Liaison Psychiatry, and updated based on feedback. Responses are submitted by email, post or telephone. Questions on paediatric services were included from 2015 (LPSE-2), and we analysed data from this and the subsequent four surveys.

The number of acute hospitals with access to paediatric liaison psychiatry services increased from 29 (15.9%) in 2015 to 46 (26.6%) in 2019, compared with 100% provision for adults. For LPSE-4, only one site met the Core-24 criteria of 11 full-time equivalent mental health practitioners and 1.5 full-time equivalent consultants, and for LPSE-5, just two sites exceeded them. Acute hospitals with access to 24/7 paediatric liaison psychiatry services increased from 12 to 19% between LPSE-4 and LPSE-5. The proportion of paediatric liaison psychiatry services based offsite decreased from 30 to 24%.

There is an unacceptable under-provision of paediatric liaison psychiatry services compared with provision for adults. Number of services, staffing levels and hours of operation have increased, but continued improvement is required, as few services meet the Core-24 criteria.