A vulnerable child with complex behavioural disorders spent more than two months in an A&E department because no suitable care placement could be located, according to a distressing new report. The child endured over 70 days in the accident and emergency unit at Queen's Hospital in Romford, east London, while another young patient remained in the department for more than 30 days. Both children had previously been in council-arranged care, such as foster homes, but those placements collapsed, leaving them without anyone prepared to provide appropriate care.
Hospital Leaders Express Grave Concerns
Matthew Trainer, chief executive of Barking, Havering, and Redbridge University Hospitals Trust, told the Health Service Journal that these cases represent some of the longest waits the trust has ever witnessed. He highlighted that in 2022, The Independent revealed a child had waited 26 days in A&E at the same trust, indicating a worsening trend. Trainer emphasised that hospitals are increasingly being used as a "place of safety" for children and young people grappling with mental health issues and challenging behavioural needs.
"This means several young people have experienced long waits for the right support in A&E," he stated. "It's unacceptable and distressing for both patients and our staff, and something we've been discussing for several years."
Systemic Pressures and Financial Strain
The trust's board papers have raised serious alarms about the prolonged waits for mental health patients in A&E. According to documents published in March, the trust allocates approximately £6 million annually to fund registered mental health nurses, additional healthcare assistants, and security guards specifically to manage patients with mental health needs. Despite this investment, patients often languish in A&E for extended periods before being transferred to specialised mental health providers where their conditions can be properly addressed.
Local commissioner North East London Integrated Care Board warned that children with autism constitute the largest group admitted to A&E under a "mental health diagnosis." This trend may be linked to mounting pressures on local children and adolescent mental health services, coupled with a rising number of children's care homes in the Havering area.
Common Reasons for A&E Admissions
Data on admissions reveals that the most frequent reasons children and young adults with mental health conditions present at A&E departments include self-injurious behaviour, bizarre behaviour, anxiety, physical aggression, and hallucinations. The board noted that A&E departments are increasingly viewed as a last resort for children who have complex mental health needs, neurodiversity, or behaviours that challenge, especially when their residential placements break down.
"There is currently an out-of-area care-experienced young person who has spent over 50 days in a side room at Queen's Hospital A&E department, following a breakdown of his placement," the board reported.
National Crisis in Mental Health Care
The latest NHS data for February underscores a broader national crisis, showing that 3,511 mental health patients out of 38,517 waited more than 24 hours in A&E departments across England. This statistic highlights systemic failures in providing timely and appropriate care for vulnerable individuals, particularly children, who are caught in a cycle of inadequate social care and overstretched mental health services.
The situation at Queen's Hospital exemplifies a growing emergency where A&E units, designed for acute medical emergencies, are being forced to act as temporary shelters for society's most vulnerable young people. This not only strains hospital resources but also inflicts significant emotional distress on patients and staff alike, calling for urgent policy interventions and increased funding for mental health and social care infrastructures.
