21.04.16
Government warned mental health targets could be missed
Mental health improvement targets risk being missed owing to the fragmented nature of health services, the National Audit Office (NAO) has warned.
The NAO report says that implementing the government’s commitment to improve access and waiting times for mental health treatment will be made more difficult because mental health service provision varies by CCG, and because the £120m additional funding the NHS and Department of Health (DH) have provided to CCGs in the past two years is not ring-fenced.
The report also said that the cost of improving services may be more than current estimates. For example, the DH estimate that providing adequate access to early intervention in psychosis services will cost £137m more every year, but the NHS only provided £40m last year.
Sir Amyas Morse, head of the NAO, said: “The Department of Health has recognised that mental health has been treated as a poor relation relative to other health needs for many years.
“This recognition, the goal of ‘parity of esteem’ and the setting of new standards for access and waiting times are all bold and impressive steps forward. It is important that these steps are supported by implementation in a reasonable timescale if they are not to be a cause for disillusionment, and this looks challenging in current conditions.”
The report also says that there is a lack of data measuring how well NHS England is meeting its targets, and that this varies between CCGs.
Although the standard for referral to Improving Access to Psychological Therapy (IAPT) is being met nationally, with 79% of people starting treatment within six weeks of referral against a 75% target, it had not been met in 83 out of 211 CCGs.
The latest NHS performance figures included mental health targets for the first time, on treatment for psychosis patients, but the data was incomplete. Additionally, only 7% of acute trusts have a 24-7 psychiatry service, despite this being a minimum requirement for each trust.
Saffron Cordery, director of policy and strategy at NHS Providers, and a member of NHE’s editorial board, said the report showed more data was needed on NHS mental health provision.
“We welcome this excellent report from the NAO, which shines a light on how much still isn't known about the levels of investment in mental health and the extent to which money actually reaches service users,” she said. “Investment in data gathering, and a commitment to greater transparency is critical if we are going to be successful in tracking funding, where the current information available is very limited. This only hampers making the case for spending on mental health.”
Cordery added that it was also necessary to end the division between physical and mental health services, which the King’s Fund recently called unaffordable.
Dr Phil Moore, Chair of the NHSCC Mental Health Commissioners Network and Deputy Chair of Kingston CCG, said: “Meeting the recommendations set out in the recent Mental Health Taskforce Report and achieving true parity of esteem will be challenging – but we know that not giving it our best will be even more costly in both economic and human terms.”
A DH spokesperson said: “We are well aware of the challenge ahead - our ambitious goals for mental health are backed by an additional £1bn funding by 2020.
“We have made big improvements in mental health data, publishing more statistics than ever before and launching the first national survey of children and young people's mental health since 2004. We will publish a five year plan for mental health data by the end of this year — as recommended by NHS England's Independent Mental Health Taskforce in February.”
(Image c. Dominic Lipinski from PA Wire)