NHS Confederation - 'Hold your ground for a settlement that meets the NHS Mandate’, mental health leaders urged
28 Mar 2014 01:58 PM
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”:
- a fundamental shift from repair to
prevention
- a
move away from a “horribly fragmented system” to one that meets the
needs of the individual
- a move away from a paternalistic system to one that
is “acutely personal”
- 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.