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Clarity over ‘parity of esteem’ definition and 5% annual spending increase needed for mental health services

The Institute for Public Policy Research (IPPR) has called for greater clarity over the definition of ‘parity of esteem’ between mental and physical health needs, and has published a number of financial recommendations for NHS mental health services.

The IPPR’s report, ‘Fair funding for mental health: Putting parity into practice,’ argues that the NHS long-term plan must clearly define ‘parity of esteem’ and be delivered by 2030. The lack of a clear definition has led to politicians “profess a commitment to it without being held accountable for specific deliverables.”

“People living with a mental health condition must have an equal chance of a long and fulfilling life as those with a physical health condition,” the IPPR said, recommending that the NHS should adopt it as its formal definition.

The report also called on the NHS to scale-up its access to— and improve its patient care of—mental health services.

This can be improved by investing more in early intervention measures for children and young people; scaling up access to treatment for more common conditions (e.g. anxiety, depression), including through Improving Access to Psychological Therapies (IAPT); providing universal community care for people with severe condition (e.g. psychosis); treating people in the community and intervening early to reduce hospital admissions; and setting up a Mental Health Innovation Fund to share best practice. 

That would mean mental health spending would need to increase from £13bn in 2017-18 to £16.1bn in 2023-24 and £23.9bn in 2030-31, a growth of 5% versus the 3.4% in the NHS budget up to 2023-24, and equivalent to 17% of the new NHS money by 2023.

To achieve parity of esteem, and separate to the other funding recommendations, the IPPR estimates that £500m per annum will be needed for workforce development and £400m for capital investment, as well as a £200m a year boost to prevention and public health.

The IPPR also called on the government to return social care budgets that effect mental health to the levels seen in 2010, which would require an additional £1.1bn by 2030; and to commission a ‘health in all policies’ strategy to address the social determinants of health, with 60% of health outcomes determined by factors outside the NHS (e.g. welfare, housing, criminal justice and schools). The report recommends this commission should be overseen by a cabinet committee and chaired by the PM, as laid out in the Darzi Review.

Sean Duggan, chief executive of the Mental Health Network (part of the NHS Confederation), commented: “This is a welcome report looking at the cost of implementing the government’s commitment to putting mental health on an equal footing to physical health and comes at the right time ahead of the long-term NHS plan. We were happy to support the letter to the prime minister calling for a 5% annual increase in the mental health budget, which we believe is realistic and absolutely necessary.

“Workforce development and capital budgets are also vital – while public health and social care, which are so closely allied to NHS services, will need funding uplifts if we are to support recovery and keep people well.”

Top image: ipopba 


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