It is estimated that one in ten children and young people have mental health problems such as emotional or conduct disorders. Acute and chronic physical illnesses also have consequences for mental health and well being. In acute settings, physical health problems are well addressed but provision for mental health needs generally falls short of the holistic care that is necessary for optimum health. The Common Assessment Framework supports early identification of children's additional needs and provides for timely and co-ordinated support to meet those needs. However, it is not yet widely implemented in general inpatient settings. Staff need to work closely with child and adolescent mental health staff, addressing the challenges of information sharing and interagency working, if they are to provide more holistic care and support.