NHS Confederation warns over risk to mental health improvement plans

9 Mar 2012 02:05 PM The head of the NHS Confederation has warned that plans to improve the nation's mental health are at risk as the basic building blocks are not yet in place to make them a success.

Mike Farrar, the Confederation's chief executive, spoke out one year on from the publication of the mental health strategy "No Health Without Mental Health".

The strategy aims to ensure that, for the first time, mental health is given the same priority across government as physical health. It will tackle stigma against mental illness so people feel free to come forward earlier with mental health issues.

It will also make services prioritise early intervention and tackle the underlying causes of mental ill health. This should mean, for example, that more people with mental illness can find and stay in work.

Every year, poor mental health costs the UK economy almost as much as the entire NHS budget. Almost one in five people in the UK have a recognisable common mental disorder - a rise from just over one in seven in 1993.

Mr Farrar is clear that leaders of organisations offering NHS-funded care across the system are up for the challenge, even in the face of increases in demand as the economic situation remains gloomy and substantial cuts to local authority services that the NHS relies on to keep people out of hospitals.

Mr Farrar praises the Government for getting a strategy in place early and involving the mental health sector in implementing it. But, he says the way forward to successful implementation requires progress in three key areas:

Paying for care: The new payment system for mental health services is not ready yet and is unlikely to be ready by the deadline of the financial year 2013-14. The Department of Health must be realistic in either postponing implementation more than it already has or spending more money to get it right. Otherwise, public money risks being wasted.

Commissioners: NHS leaders are optimistic that new clinical commissioners, who work in primary care where 90 per cent of NHS activity takes place, have great potential to help spot mental health problems early just as they currently do with physical health. The National Commissioning Board needs to set up a program of help so they can achieve this potential as they take on their mental health commissioning role.

 Holding services to account: Outcome measures by which patients and the public will hold services to account are not in place. For example, the strategy prioritises recovery but there are no effective recovery measures in place.

Mr Farrar said:

"Good mental health is vital for our patients and for the health of our economy. It matters right across public services. Getting the strategy right is vital for the health of the nation and UK plc.

"The Government should be commended for making such a clear and early commitment to mental health in its strategy.

"But, it is in danger of snatching defeat from the jaws of victory if it does not do more to put the basic building blocks of its plans in place as soon as possible. The Department of Health is working closely with the NHS Confederation's Mental Health Network on implementing its mental health strategy but we need ministers and senior officials to ensure the foundations are in place to turn aspiration into reality.

"What is frustrating for NHS leaders is that lessons for the challenges ahead are readily available in recent NHS history.

"We know from the acute tariff what happens if not enough time is spent on developing a reliable payment system. We know that if our commissioners are not given the support to deliver on their potential then quality will become patchy. We also know that while focusing on outcomes is the next step for the NHS, services need robust and reliable ways to measure them.

"We have to be honest with ourselves that we are not there yet with putting these fundamental building blocks in place. The Department of Health and Commissioning Board needs to spend time and resources to develop a functioning mental health tariff, to produce robust outcome measures and to invest in the obvious potential future commissioners have.

"As the strategy heads to the implementation phase, we have to start looking realistically at how we are going to sort these problems out now or we will risk doing a disservice to the millions of people who need mental health services."


Francesca Reville
020 7074 3312

Niall Smith
020 7074 3304

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