Children and adults with conditions such as psychosis, depression and anxiety will be among the first to benefit from improved services as work starts on a major transformation programme for mental health care.
‘Implementing the Five Year Forward View for Mental Health’, published today, outlines the changes people will see on the ground over the coming years in response to the Mental Health Taskforce’s recommendations to improve care.
In the foreword to the document, Claire Murdoch, NHS England’s national director for mental health, said: “The costs of mental ill health – whether to the individual, their family or carer, the NHS or wider society – are stark. So today we’re kick starting national action to overhaul and expand this long neglected part of the NHS.”
Intended as a blueprint for the changes that NHS staff, organisations and other parts of the system can make to improve mental health, the plan also gives a clear indication to the public and people who use services what they can expect from the NHS, and when.
The report details how new funding, pledged in response to the Five Year Forward View for Mental Health, rising to £1 billion a year by 2020/21 in addition to the cumulative £1.4 billion already committed for children, young people and perinatal care, will be made available for clinical commissioning groups (CCGs) year-on-year. It also shows how the workforce requirements will be delivered in each priority area and outlines how data, payment and other system levers will support transparency.
Initially, 4 areas will see action to improve services. Firstly, there will be a £72 million investment over two years to better integrate physical and mental health services. This will include expanding psychological therapies in up to a third of CCGs through building ‘Integrated Improving Access to Psychological Therapies (IAPT)’ services – co-located in and integrated with physical health services – to improve health for people with mental health and long-term physical health problems or persistent unexplained medical symptoms. In 2016/17 £17.8 million and up to £54 million in 2017/18 will go on training new staff and delivering new ‘early implementer’ integrated services.
In addition, a new £1.8 million pilot, initially directed at 6 sites, will test new approaches to delivering mental health care. This will see budgets put in the hands of local providers and commissioners to drive the design of new approaches to delivering secure mental health services and children and young people’s mental health services, with a focus on reducing admissions and lengths of stay, and bringing those people placed out-of-area closer to home.
There will also be clear plans for how the £365 million allocated for specialist perinatal mental health services over the next five years will help 30,000 more women per year. This includes a proposal to set up a perinatal community development fund during 2016/17 to invite bids from local areas to begin to develop specialist teams and to improve quality, with a particular focus on areas of under-capacity. Bids will be invited in the autumn for investment over up to 3 years as the size of the fund grows. From 2019/20, this will be mainstreamed into CCG allocations.
Finally, there will be a £12 million roll-out over next 2 years of liaison and diversion services, for people who may have mental health needs and find themselves in the court system or police services. Services will be available nationwide by 2020.
This will build on the 16 existing teams around the country specifically designed to serve around 50,000 people a year who need a mental health assessment following arrest – about 70% of who go on to require support. The new money will ensure this service can be rolled out to all people who need it by 2020.
“This roadmap for implementing the Five Year Forward View for Mental Health will improve access and outcomes, reduce inequality and deliver efficiencies across the local health and care economy,” Murdoch said.
“As well as setting out our expectations of the NHS, we have outlined how national partners will work together to provide the right enabling structures and frameworks, to support and help drive improvements in mental health over the coming years.
“Other organisations who have a role to play such as social care, employers, schools are also paramount to the success of this work. The need for action cannot be ignored. It is now up to all of us to make this a reality.”
Paul Farmer, chief executive of mental health charity Mind and independent chair of NHS England’s mental health taskforce, welcomed the implementation plan. “As chair of the Advisory and Oversight Group I will be keeping a close eye on progress and helping to make sure that the services and government departments involved are on track,” he said. “The implementation plan is a step in the right direction, but we cannot afford to become complacent. The job is just beginning and we must all play our part.”
President of the Royal College of Psychiatrists, Professor Sir Simon Wessely, added: “To provide the best care our profession first needs to take better care of its own; to ensure that the needs of the mental health workforce are met. NHS staff are having a tough time at the moment, and we know that staff morale and wellbeing directly impacts on patient care.
“We are pleased therefore to see the health and wellbeing of the NHS workforce being taken seriously. Funding to support the development of plans to improve mental health support for NHS staff is money well spent.”
Stephen Dalton, chief executive of the NHS Confederation, said the additional funding was “vital”, adding: “It’s essential that we now receive further clarity about how we can be assured that promised investment reaches the frontline. Theresa May demonstrated a clear commitment to mental health in her first speech as Prime Minister and can help end the delays in funding reaching those in need.
“The goal of achieving greater efficiency is still a major challenge for mental health services and their staff, who are stretched to capacity. It is clear that to achieve the ambitions set out in the plan, mental health must be an intrinsic part of every decision that's made about local services. The newly-announced support from NHS England and national partners, will we hope, provide the opportunity for these vital services to play a key role in reshaping healthcare."
Dr Maureen Baker, chair of the Royal College of General Practitioners, said the money and plans are a “step in the right direction” to mental health achieving parity of esteem with physical health, if they are implemented efficiently.
“What is essential is that general practice is recognised. GPs and our teams are often the first port of call for patients with mental health problems, and it is vital we have access to the appropriate resources and services. NHS England’s GP Forward View included a pledge to ensure every GP practice has access to a mental health worker who can deliver services and treatments that can really benefit our patients, and we would like to see this implanted as a matter of urgency.
“The College will be holding NHS England to account on this, and the other pledges in the GP Forward View, to ensure that they are implemented in the best interests of general practice and our patients.”