RCPCH response to “Making Wales a No Wrong Door Nation - how are we doing?” report by the Children’s Commissioner for Wales

In 2019-20, the Children’s Commissioner for Wales and her team visited every Regional Partnership Board (RPB) in Wales to find out how services were working together to support children with complex needs. RPBs bring together health boards, local authorities and the third sector to improve the well-being of the population and the ways in which health and care services are delivered in each area. 
Sign on building: Senedd Cymru | Welsh Parliament

As a result, the Commissioner called for a ‘No Wrong Door’ approach in each area “so that children and their families would not get bounced between services or get doors shut in their faces”. Today, she has published a follow up report looking at what progress has been made. 

Commenting on the report, Dr David Tuthill, RCPCH Officer for Wales said: 

I’m really grateful to the Children’s Commissioner and her team for their commitment to understanding how services are working together across Wales for children and young people. They have identified much good practice that I hope will be shared and scaled-up across Wales and have made recommendations for improvement where it’s required. 

It’s essential that services work in a joined-up way and that children and young people, particularly those with complex or ongoing needs, get the help they need when they ask for it without needing to be experts in navigating services that can be quite complicated. Care and services should take a holistic approach to prioritise the needs and complexities of each individual patient and their family .

It’s great to hear that every RPB now has a group dedicated to children’s issues. The Commissioner found that much progress had been made in listening to children and young people and involving them directly. We were pleased at the progress being made by RPBs in mental health. For example, many have improved how children’s mental health professionals support and train up other professionals in places like schools and social care. In several regions, children’s mental health crisis teams have extended their operations, with some operating 24/7. 

However, the Commissioner also highlights important barriers and ongoing issues. These hold back integration and result in children and young people still being told they have come to the wrong door when they reach out for support with their mental health, emotional or behavioural needs. In particular, it’s worrying that she finds that some RPBs are not in a position to deliver a 'whole system' approach for developing mental health, well-being and support services for babies, children, young people and their carers and families. The framework for doing that is called NEST / NYTH and the Commissioner thinks RPBs will need further support from the Welsh Government to get this vital work right.

We hope that RPBs and the Welsh Government will engage with this report, scale-up what is working and urgently address the things that are not.