Inconsistent mental health service provision for 16-18 year olds
Department of Health and Social Care received 2 coroners' reports about this hazard between 9 Nov 2017 and 1 Oct 2019.
They came from 2 different coroners in 2 coroner areas. A similar concern was raised again 1 time after the first warning.
A published response was found for 1 of the 1 earlier reports, stating 2 specific actions.
The story, report by report
Spacing grows with the time between reports.
“Out of hour's provision for 16 to 18 years. (During working hours they are considered children and therefore are the responsibility of CAMHS,”
Original on judiciary.uk ↗ Department of Health and Social Care responded, stating 2 specific actions.Response (PDF) ↗Response (PDF) ↗
“SC NHS FT will work with local commissioners on the benchmarking exercise”
“the NHS in Sheffield has taken a number of measures to address the concerns raised. This includes training for staff on transitions; the opening of a Section 136 suite at Sheffield Children's Hospital; and the employment of a Mental Health Liaison Consultant to commence in January 2018. In addition, an information sharing agreement is to be drawn up between NHS organisations in Sheffield.”
Stated timescale: January 2018
- 1 year 11 months laterClosely relatedConfidence 0.80 · moderatea different coroner
“The inquest was told that the provision of mental health services post 16 varies widely across the country.”
Original on judiciary.uk ↗ The most recent report. A response may not be due or published yet.
- All reports to Department of Health and Social Care
Each row is one judged link between an earlier and a later report. Open a row to read both quotes, found word for word in the originals.
2017 → 2019Oliver Sharp1 year 11 months after Daisy French · different coronerClosely relatedConfidence 0.80 · moderate
Closely relatedConfidence 0.80 · moderateBoth reports highlight problems with mental‑health service provision for young people aged 16‑18, focusing on gaps in out‑of‑hours or transitional care.
Daisy French · 9 Nov 2017
“Out of hour's provision for 16 to 18 years. (During working hours they are considered children and therefore are the responsibility of CAMHS,”
Original on judiciary.uk ↗ Oliver Sharp · 1 Oct 2019
“The inquest was told that the provision of mental health services post 16 varies widely across the country.”
Original on judiciary.uk ↗
Stated action
“SC NHS FT will work with local commissioners on the benchmarking exercise”
Stated action · timescale: January 2018
“the NHS in Sheffield has taken a number of measures to address the concerns raised. This includes training for staff on transitions; the opening of a Section 136 suite at Sheffield Children's Hospital; and the employment of a Mental Health Liaison Consultant to commence in January 2018. In addition, an information sharing agreement is to be drawn up between NHS organisations in Sheffield.”
No published response from Department of Health and Social Care was found for this report. It is the most recent report, so a response may not be due or published yet.
- Each report's concerns were extracted by Nemotron 3 Nano on Nebius Token Factory, each with a quote copied from the report.
- Concerns from reports to Department of Health and Social Care at least six months apart were compared by meaning (Qwen3 embeddings) and wording (TF-IDF).
- The closest pairs were judged by Nemotron 3 Super with reasoning on. Only identical or closely related, with confidence of at least 0.70, are shown.
- Every quote was checked by code as an exact substring of the original text. Names of staff and family are redacted, and the deceased are named by report title only.
| Link | Meaning | Wording | Judge | Coroner |
|---|---|---|---|---|
| 2017 → 2019 | 0.78 | 0.35 | Closely related · 0.80 | different |
Judge model: nvidia/nemotron-3-super-120b-a12b. How Nemotron did the work · Full methodology.
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This shows that a similar concern was raised again after an earlier report. It does not say why, and it is not a finding about any organisation or person. To report an error, see the corrections route.