Robyn Skilton

From Maria Caulfield 
Parliamentary Under Secretary of State for  
Mental Health and Women’s Health Strategy 

39 Victoria Street 
London 
SW1H 0EU 

5 December 2022 

Penelope A Schofield  
Senior Coroner for West Sussex 
HM Coroner’s Office 
Records Office 
Orchard Street 
Chichester 
West Sussex 
PO19 1DD 

Dear Ms Schofield,  

Thank you for your letter of 7 August 2022, to the Secretary of State Steve Barclay, about 
the death of Robyn Skilton.  I am replying as Minister with responsibility for Mental Health, 
and I thank you for the additional time allowed.      

Firstly, I would like to say how deeply saddened I was to read of the circumstances of Ms 
Skilton’s death.  I can only begin to imagine how distressing her death will be for her parents 
and those who knew and loved her.  I offer my heartfelt condolences.  

It is vital that we take the learnings from what happened to Miss Skilton to prevent future 
deaths, and I am grateful to you for bringing these matters to my attention. 

I appreciate your concerns about access to child and adolescent mental health services 
(CAMHS) in West Sussex, and I would like to assure you that we are working nationally to 
support local areas to expand mental health services so that more people can access the 
care and support they need. 

The NHS Long Term Plan1, which we published in 2019, commits to increasing funding for, 
and access to, mental health services, with at least an additional £2.3billion a year being 
invested into these services by 2023/24.  This increased investment will allow an additional 
345,000 children and young people access to mental health services by then. 

A significant portion of this funding is provided through baseline funding to local 
commissioners (formerly clinical commissioning groups and now through the integrated care 
boards that replaced them).  This is supporting them to deliver on their responsibilities to 
commission healthcare services that meet the needs of their local populations and to expand 
mental health services in line with the aims of the Long Term Plan and the NHS Mental 
Health Implementation Plan 2019/20 – 2023/242, which provides the framework for local 
delivery. 

1 https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf  
2 https://www.longtermplan.nhs.uk/wp-content/uploads/2019/07/nhs-mental-health-implementation-
plan-2019-20-2023-24.pdf  

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Growth of the mental health workforce, as well as retaining and re-skilling our current 
workforce, is the key strategic priority to ensure we can deliver our commitments to expand 
services and increase access.  This is why, through the Plan we are committed to expanding 
the NHS workforce, with an aim of having an additional 27,000 mental health professionals 
by 2023/24, to deliver the expansion and transformation of mental health services, including 
those for children and young people. 

We are making progress: June 2022 figures show an increase of almost 6,900 more (a 5.4% 
increase) full-time equivalent staff in the mental health workforce compared to June 2021, 
and over 14,500 more (12.2% increase) since June 2010. 

Furthermore, we are aware that the pandemic has posed significant challenges to children 
and young people’s sense of wellbeing, and data from NHS Digital3 shows the prevalence of 
mental health issues in children and young people has increased from one in nine in 2017 to 
one in six in 2021/22.  

This is why, in 2021/22 we provided an additional £79million to expand children’s mental 
health services, allowing around 22,500 more children and young people to access 
community health services, 2,000 more to access eating disorder services, as well as a 
faster increase in the coverage of mental health support teams in schools and colleges. 
There are currently 287 mental health support teams supporting schools and colleges, 
covering 20-25% of the country, with 13 planned or in operation across the Sussex 
integrated care system. 

NHS England also announced a further £40 million in 2021/22 to address the COVID impact 
on children and young people’s mental health.  As part of this, £10 million capital funding 
was used to provide extra beds at units which provide care for young people with the most 
complex needs, as well as £1.5 million to ensure there are additional facilities for children 
under 13 years of age. 

With regard to children and young people’s mental health services in West Sussex, in 
preparing this response, Departmental officials made enquiries with NHS England (NHSE), 
as well as the relevant regulator in this instance, the Care Quality Commission.  

Officials inform me there is multiagency work across the Sussex integrated care system 
(which comprises East Sussex, West Sussex, and Brighton and Hove), under the leadership 
of the Directors of Public Health, to rapidly identify clusters of young people engaging in 
suicide ideation and self-harm, and to provide an immediate response to identify those at 
risk.  Local Authority Safeguarding and CAMHS teams are working in partnership to assess 
individual risk and vulnerability and are establishing care management plans to support the 
young person at home and at school.  

There are plans in place across the integrated care system to progress the Single Point of 
Access (SPOA) service, which will provide a simplified single route to access specialist 
emotional wellbeing and mental health support.   

The SPOAs are providing an access point for clinicians and professionals to refer children 
and young people to the full range of emotional wellbeing and mental health services, 
including CAMHS.  Young people and families may also self-refer and contact the SPOA for 
advice and guidance.  It is anticipated that signposting children and young people to the right 
service for their needs at the earliest point will result in a faster process. 

3 https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-of-children-and-
young-people-in-england/2021-follow-up-to-the-2017-survey  

 
 
 
 
 
 
 
 
 
 
 More broadly, NHS England consulted on the potential to introduce a range of new waiting 
time standards as part of its Clinically-led Review of NHS Access Standards4.  These 
include: 

•  For an ‘urgent’ referral to a community based mental health crisis service, a patient 

should be seen within 24 hours from referral, across all ages; 

•  For a ‘very urgent’ referral to a community based mental health crisis service, a 

patient should be seen within four hours from referral, for all age groups; 

•  Patients referred from Accident and Emergency should be seen face to face within 

one hour, by mental health liaison or children and young people’s equivalent service; 
and  

•  Children, young people and their families/carers presenting to community-based 

mental health services, should start to receive care within four weeks from referral. 

NHS England published in February the outcomes of its consultation on the potential to 
introduce these waiting time standards5 and we are now working with it on the next steps. 

Finally, we launched a public call for evidence on what can be done across government in 
the longer term to support mental health, wellbeing and suicide prevention.  We asked the 
public for their views on a wide range of questions, from prevention through to acute mental 
health care.  This is a key part of our commitment to ‘level up’ and improve unequal 
outcomes and life chances across the country.  The call for evidence closed on 7 July 2022.  
We are currently analysing the responses. 

I hope this response is helpful.  Thank you for bringing these concerns to my attention.  

Kinds regards, 

MARIA CAULFIELD MP 

4 https://www.england.nhs.uk/clinically-led-review-nhs-access-standards/  
5 https://www.england.nhs.uk/wp-content/uploads/2022/02/mental-health-clinically-led-review-of-
standards.pdf