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Care services minister, Norman Lamb MP, has urged mental health leaders to refrain from accepting financial settlements from clinical commissioning groups that result in mental health “losing out”

Speaking to a gathering of senior mental health leaders at the annual conference of the NHS Confederation's Mental Health Network recently (26 March), Mr Lamb urged delegates to be resolute and hold commissioners to the obligations of the NHS Mandate.

“If the Mandate is ignored, it is a very significant issue,” he said.

He made the comments in reference to NHS England and Monitor’s decision on the tariff deflator, which recommends funding for mental health services is cut by 20 per cent more than acute providers.

‘Flawed decision’

Labelling the deflator “a flawed decision which cannot be defended and is not evidence based”, he questioned how it can be argued that safe staffing is more important in acute services than in mental health.

The minister told delegates that since the decision was taken, NHS England had written to area teams regarding commissioning plans and setting budgets, saying they will need to pay particular attention to parity of esteem.

He urged mental health leaders not to accept financial settlements from clinical commissioning groups that would result in mental health “losing out”.

Cajole, challenge and demand fairness

He explained that his role is to cajole, challenge and demand fairness on behalf of mental health. He will scrutinise plans and challenge NHS England if he believes parity is not being applied, he said.

The minister told delegates that in his own county, he has written to the CCG as he had been told that mental health was losing out disproportionately.

‘Existential challenge’

Mr Lamb made the comments in a keynote address in which he discussed the current and future state of mental health, his priorities and the challenges facing the sector.

The minister spoke of four big shifts that need to happen as the health service is facing an “existential challenge”:

1. a fundamental shift from repair to prevention
2. a move away from a “horribly fragmented system” to one that meets the needs of the individual
3. a move away from a paternalistic system to one that is “acutely personal”
4. a move away from an exclusive system to one that is richer in collaboration with the wider community.

On the current state of mental health, he praised the sector for making efficient use of resources and its excellent examples of “amazing practice”.

But he said he was acutely aware the system is under financial strain and there is institutional bias, “which is most potent at the moment”.

Priorities and challenges

He spoke of his specific priorities, which include:

• The continued roll out of liaison and diversion services, saying it is the “scandal of our time that in the prison system there are people there that need not be” and those with learning difficulties.
• The Closing the gap action plan, which introduces access standards into mental health for the first time.
• The transition from child to adult services, saying there is a “cliff edge at age 18”.
• The combination of commissioning for recovery and better use of data.
• The new Care Quality Commission inspection regime.
• The Crisis care concordat.

Commenting on challenges to be addressed, he said too much is spent on secure care, and made a plea that the sector consider how it uses resources, as well as ensuring mental health services get their “fair share".

He also identified integrating mental health into primary care as a much-needed approach.