There has been significant public and political interest in access to inpatient beds for children and young people during the last two years. Media stories about young people in police cells, and children travelling many miles from home to receive hospital care, have generated concern about access to help for children and young people in mental health crisis. However, it is not just a lack of beds that has been in the spotlight; the staffing, skill mix and quality of care provided in inpatient child and adolescent mental health services has also been called into question. This article discusses some of the challenges facing the nursing profession and makes some key recommendations for hospital managers, health service commissioners, professional bodies and organisations responsible for commissioning and providing nurse education. Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai