Setting out how many children need in-patient care, who they are and how long they stay
Client and setting
An NHS children’s mental health in-patient provider collaborative, covering several trusts and local authority partners in a large urban area
The challenge
An earlier needs assessment had recommended better support for children and young people with a learning disability or autism. It did not say how many there were, whether they were admitted differently to other children, or what the next ten years might look like. The data sat with different trusts, diagnosis was recorded inconsistently, and small numbers made local comparison unreliable.
What we did
Estimated how many 5 to 18 year olds in the area have a learning disability or autism, using national profiles, school data and published prevalence, and cross-checked those sources against each other.
Analysed five years of admissions from the national case-mix dataset and trust records, about 1,700 admissions in all, suppressing small counts so individuals could not be identified.
Looked at length of stay, intensive care admissions, repeat admissions, ethnicity, sex and area of residence, rather than reporting admission numbers on their own.
Projected future need, setting out why simple trend extrapolation of autism diagnosis was not credible and using a prevalence ceiling instead.
The outcome
Children with a learning disability or autism made up about a fifth of admissions and stayed longer than other children: a median of roughly 70 days against 55, with about one in five in hospital for more than six months. A falling child population will not reduce demand. The collaborative had figures it could plan beds and community services around.
Timescale and team
About four months from start to final report. Three partners and a public health analyst, working with the provider trust’s population health lead.
