This week, the independent Mental Health Taskforce published their report, The Five Year Forward View for Mental Health, setting out the beginning of a ten-year journey for the transformation of NHS mental health services in England. What follows is a short precis of the priority actions for the NHS as described in the paper.
For more detailed read, we recommend the Mental Health Network’s 10 page briefing.
PRIORITY ACTIONS FOR CHANGE BY 2020
24/7 mental health support
Mental health must be treated with the same importance as physical health, and people in crisis should have access to mental health support 24 hours a day, 7 days a week. The paper puts forward a target for a 10% reduction in suicide.
Integrated mental and physical health
By 2020/21, 280,000 more people with severe mental illness should have their physical health needs met through increased early detection and access to evidence based physical care assessment and intervention. The provision of psychological therapies for people with common mental health problems has expanded significantly in recent years, but still meets only 15% of need for adults. Evidence-based psychological therapies should be made accessible to meet 25% of need so that an additional 600,000 adults with anxiety can access care, focused on those living with long-term physical health conditions.
Care for mothers, children and young people
By 2020, 30,000 more women should have access to evidence-based healthcare during the perinatal period.
Fundamental changes in the commissioning and delivery of CYP services are required and 70,000 more children and young people should have access to mental health care when they need it. Future in Mind should continue to be implemented and local transformation plans refreshed, and integrated into forthcoming sustainability and transformation plans.
Care pathways and access standards
The NHS should complete work with Arm’s Length Bodies (ALBs) to publish and implement a comprehensive set of care pathways for the full range of mental health conditions incorporating physical health care interventions, clinical and non-clinical outcomes such as improved wellbeing and employment.
By April 2016, more than half of those experiencing a first episode of psychosis should have access to a NICE approved care package within 2 weeks of referral, rising to 60% by 2020/21.
Payment models
Payment models should incentivise swift access, high quality care and good outcomes, while deterring services from choosing to treat those deemed “easiest to treat”. NHS England should ensure that population-based budgets are in place by April 2017, enabling CCGs and local partners to collaborate on the commissioning of specialised services. This should be tested at scale and a revised payment system should be introduced by 2017/18, and for CYP services as soon as possible.
Acute and secure care
NHS England must plan with partners how standards are to be introduced for acute care services. Care should be provided in the least restrictive setting, as close to home as possible and the practice of sending people out of area for acute care should be eliminated entirely by 2020/21.
The Mental Health Act should be closely monitored at national and local level, and that rates of detention are reduced through early intervention. The over-representation of BME and other disadvantaged groups in acute care should be reduced.
Tackling inequalities
The Department of Health must address race equality in access and outcomes, and must appoint a new champion to drive this change.
Supporting employment
The NHS should play a greater role in supporting people to remain in or seek employment, and by 2020/21 up to 29,000 more people with mental health problems should be supported to find or stay in work via increased access to psychological therapies.
A data revolution
A “data revolution” is needed to improve transparency, drive improvement and inform decision making. A dashboard is to be created by NHS England by the summer of 2016, identifying the metrics for monitoring performance and outcomes data, so that national and local bodies can be held to account for the implementation of this new strategy.
Support for NHS Workforce
By the end of this year, a review should be undertaken to address training needs for both new and existing NHS funded staff.
NHS England should ensure that it is taking care of the wellbeing and mental health of its own staff, with the provision of occupational mental health expertise and effective workplace interventions from 2016. An incentive payment system relating to staff health and wellbeing should be introduced by 2017.
RECOMMENDATIONS TO GOVERNMENT
Mental Health Research
The Department of Health should publish a report in one year from now, setting out a ten year strategy for mental health research.
Department for Work and Pensions
The Department for Work and Pensions should ensure that funds are directed to commission evidence-based health-led interventions that are proven to deliver improved employment outcomes. It should ensure that protection is in place for people with mental health problems who require specialist supported housing.
Health and Criminal Justice
A complete health and justice pathway should be developed to deliver interventions in the least restrictive setting, appropriate to the crime which has been committed.
Digital
The Department of Health should ensure that significant investment is made in digital infrastructure to realise the priorities identified within the report and ALBs should optimise the use of digital channels to communicate key messages and make services available online where appropriate. NHS Choices should be expanded to raise awareness and direct people to effective digital mental health products.
Children and Young People
An expert panel should be established to examine how the needs of children vulnerable to developing mental health problems can best be met.
Tackling Stigma
Public awareness initiatives like Time to Change should continue to be supported, and mental health champions should be established within communities with the aim of improving attitudes to mental health by a further 5% by 2020/21.
What are your thoughts on the report and the recommendations? How do you feel about the access target for IAPT increasing to 25%? What impact do you think these changes will have on IAPT and the way care is delivered locally? Tweet us @iaptustweets or get in touch using our contact form. We would love to hear your thoughts.
