Health Service Focus

04.05.16

Why are we still waiting for progress on waiting times in mental health?

Liz Felton, CEO of Together for Mental Wellbeing, a national charity working alongside people with mental health issues, discusses the lack of progress on reducing mental health waiting times. 

The National Audit Office has reported that the government is unlikely to meet its pledge to bring waiting times for mental health in line with those for physical health. In fact, government officials “do not yet have a grip on how much the policy will cost”, five years after the original promise was made.  

This commitment and others, designed to bring mental health care in line with physical health care, have been enthusiastically lauded when announced. Described as ‘bold and impressive steps’ the assurances on waiting times rightly won the attention of individuals, organisations and campaigners when they were made in October 2014. The mental health sector applauded it as a significant step to eliminate an inequality that has kept mental health care behind the curve for decades. It finally felt like a sea change was imminent. 

But when it was revealed last week that little or no progress has been made towards the target, that officials don’t even know how much the policy will cost, the warning went largely unreported. It certainly wasn’t accompanied by an outcry to match the praise that preceded it. 

Of course it’s not the first time we have learnt of promises not being fulfilled, and perhaps this is why the news failed to get the attention it deserves. After all, we have seen it before. In the current economic climate, we half expect it. And as a sector, we have exhausted a portion of our outrage on service cuts and removal of benefits. 

The current situation amounts to yet another waiting game for people in need of mental health support. Politicians shouldn’t leverage public support by making popular commitments that they cannot resource or see through to completion. As a charity, we would be severely criticised for promising to achieve something that wasn’t founded on a solid plan with measurable delivery milestones. The NAO praised the government’s clear objectives and strong leadership as two areas where they are doing well. We know from experience this isn’t enough to make things happen. 

But we cannot let this go under the radar, and as a sector, we still have plenty of energy to see this ambition realised. We have to believe the government’s commitment to parity of esteem is genuine and achievable, and we have been busy fulfilling our part of the bargain. Mental health charities have been chipping away at the stigma that acts as a barrier to accessing care and support. We have taken steps to put services in more accessible community locations. We have done what we can to make it is as easy as possible for people to seek and receive help, by giving them the information they need and by delivering services that eliminate barriers. The NAO rightly pointed out that “improving care for people with mental health problems depends on action by many local organisations working together”. The third sector has displayed considerable leadership and maturity by combining its efforts and designing services that weave together the skills and resources of numerous agencies. 

CCG disparity is a cause for concern 

But the onus for achieving equality on waiting times cannot rest on third sector providers. And much as we want to see those seeking help being in charge of their own support and recovery, it cannot rest with them either. The NAO’s report identified the fragmented nature of mental health services as a factor in the government’s failure to meet its promise: not only does provision vary significantly between CCGs, their modes of data collection differ, meaning there is scant evidence on how the government is performing on its target. But perhaps most important is the NAO’s reminder that the additional £120m given to CCGs in the past two years for this policy is not ring-fenced. 

The disparity among CCGs is itself a cause for concern. Besides the burning question of why the funds haven’t been ring-fenced and whether they have been spent as intended, there are a number of other pertinent questions that rely for answers on a connected, united group of commissioners. For example, could CCGs commission services differently to bring waiting times down? What could change in the modelling of services to facilitate this? What are the responsibilities of statutory providers to ensure their services are outward-facing and emphasise early intervention? Third sector providers like ours frequently seek opportunities for conversations with commissioners about service design and the commissioning process for precisely this purpose, but it is not easy to do so when commissioners represent such a heterogeneous group. Not to speak of engaging those who use services in these conversations. 

And this unity needs to go even further still. By seeing physical and mental health provision as separate, competing parties – one dominant and the other lagging behind – we set up an opposition that only hampers progress. We know that physical health and mental health are interdependent and inseparable. We know that the climate is challenging and that targets are missed in physical health too. Only last month, the King’s Fund claimed that treating physical and mental health separately costs £11bn a year. By seeing the two instead as integral parts of one health system, we could take a jump towards efficiency and create an environment of being ‘in this together’ towards a common goal.

No one is in any doubt that the government needs to take ownership of this target and get to grips with the figures. As third sector providers, we will continue to see ourselves as having a role, and will remain committed to doing everything we can to creating an environment where people know what they are entitled to and are empowered to seek help. An open dialogue about commissioning led by a united and cohesive commissioning sector could be the catalyst for real progress, and would almost certainly have benefits reaching far beyond the realm of waiting times in mental health. 

Biog: Liz originally trained as a psychiatric nurse at Hollymoor Hospital, Birmingham and has worked in in-patient settings, including acute admissions and rehabilitation services. Before joining Together in 2006, she was Deputy Chief Executive of Rethink. 

At Together, her major aim is to shift thinking about mental health services away from something ‘done’ to people with mental health issues and towards a system ’built’ by individuals and their supporters, promoting quality of life, ambition and hope. 

Liz is currently Chair of Trustees at the Helplines Partnership, a board member of the Voluntary Sector Mental Health Providers Forum and sits on the NHS Confederation’s Mental Health Network as a representative of the voluntary sector.

Have you got a story to tell? Would you like to become an NHE columnist? If so, click here.

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

RCGP: Comprehensive plan for handling winter pressures ‘vital’

14/07/2020RCGP: Comprehensive plan for handling winter pressures ‘vital’

With annual winter pressures and a potential second wave of the coronavirus risking coinciding, the Royal College of GPs (RCGP) has called f... more >
Manchester University NHS FT health innovation campus takes forward steps

14/07/2020Manchester University NHS FT health innovation campus takes forward steps

A world-leading health innovation and precision medicine campus being established in Manchester, as part of a joint venture between Manchester Un... more >
NHS Confederation partner in new report to level up health in Yorkshire

14/07/2020NHS Confederation partner in new report to level up health in Yorkshire

NHS Confederation, Yorkshire & Humber Academic Health Sciences Network (AHSN) and Yorkshire Universities have combined their expertise to pub... more >

editor's comment

26/06/2020Adapting and Innovating

Matt Roberts, National Health Executive Editorial Lead. NHE May/June 2020 Edition We’ve been through so much as a health sector and a society in recent months with coronavirus and nothing can take away from the loss and difficulties that we’ve faced but it vital we also don’t disregard the amazing efforts we’v... read more >

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us th... more > more last word articles >

the scalpel's daily blog

NHS at 72: Managing mental health services going forward

03/07/2020NHS at 72: Managing mental health services going forward

Sean Duggan, Chief Executive of the Mental Health Network Let’s take this opportunity to reflect on the amazing achievements of our health system over the past few months. But as we recognise the best of the NHS and its response to the Covid-19 crisis we must not forget that for mental health the peak has yet to come. Covid-19 has placed enormous pressure on the entire health and care system. Despite the very real hardships f... more >
read more blog posts from 'the scalpel' >

comment

NHS England dementia director prescribes rugby for mental health and dementia patients

23/09/2019NHS England dementia director prescribes rugby for mental health and dementia patients

Reason to celebrate as NHS says watching rugby can be good for your mental health and wellbeing. As the best rugby players in the world repr... more >
Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Being on the receiving end of some “thanks” can make communit... more >
Nurses named as least-appreciated public sector workers

13/06/2019Nurses named as least-appreciated public sector workers

Nurses have been named as the most under-appreciated public sector professionals as new research reveals how shockingly under-vauled our NHS, edu... more >
Creating the Cardigan integrated care centre

10/06/2019Creating the Cardigan integrated care centre

Peter Skitt, county director and commissioner for Ceredigion Hywel Dda University Health Board, looks ahead to the new integrated care centre bei... more >
Helpforce to launch training programmes for NHS volunteers

10/06/2019Helpforce to launch training programmes for NHS volunteers

Kay Fawcett OBE, clinical advisor and education lead at Helpforce, and Lynn Twinn, talent development consultant, outline the new national traini... more >

interviews

Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

24/10/2019Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

Today, speaking at the Royal College of General Practitioners (RCGP) annual conference, Matt Hancock highlighted what he believes to be the three... more >
NHS dreams come true for Teesside domestic

17/09/2019NHS dreams come true for Teesside domestic

Over 20 years ago, a Teesside hospital cleaner put down her mop and took steps towards her midwifery dreams. Lisa Payne has been delivering ... more >
How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >
Duncan Selbie: A step on the journey to population health

24/01/2018Duncan Selbie: A step on the journey to population health

The NHS plays a part in the country’s wellness – but it’s far from being all that matters. Duncan Selbie, chief executive of Pu... more >