Core mental health services in England ‘overwhelmed’

CREDIT: This story was first seen in OnMedica

Core mental health services are being overwhelmed by a combination of rapidly rising demand, workforce shortages, and the failure of funding to get through to the frontline, warns NHS Providers, in a new report* published today, OnMedica writes.

Core mental health services are being overwhelmed by a combination of rapidly rising demand, workforce shortages, and the failure of funding to get through to the frontline, warns NHS Providers, in a new report* published today.

The Prime Minister’s welcome commitment to tackling long-standing injustices faced by people with mental health problems is being undermined, it says.

The findings are based in part on the largest regular survey of NHS trust chairs and chief executives, and draw on responses from nearly two thirds of trusts that provide mental health services and more than half of all NHS trusts in England.

The report sets out how the provider sector is performing, the challenges trusts are facing, and the support they need in the face of another five years of constrained funding and rapidly rising demand.

The centrepiece of the report is mental health, a critical area of care for the NHS and other public services, and a growing concern for wider society.

The report acknowledges the strong and welcome commitment from government to address long-standing inequalities in care for people with mental health needs. This is starting to enable better service provision in the targeted areas. But trust leaders say the position of core mental health services is deteriorating.

The survey findings show that more than 70% of respondents expect demand to rise this year — rising to 90% of respondents in child and adolescent mental health services — outstripping their capacity to provide effective care to service users.

Fewer than one in three is confident they have enough staff to deliver existing services let alone extending or creating new ones. In particular, trusts are struggling to recruit enough mental health nurses and psychiatrists.

Just one in 10 say their local trust is managing demand and planning for unmet need for key mental health services, including those for children and young people.

Most (80%) say extra money intended for mental health at a national level is still not getting through to NHS mental health trusts operating frontline services.

The pressures on services are affecting the speed and quality of care for some people with mental health needs.

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Mental health services are not being given enough priority in planning for the future, in Sustainability and Transformation Partnerships, with only 11% of respondents confident that their local STP will lead to improvements in access and quality.

The report calls for: realism about rising demand and what is needed to meet it, recognising that increased focus on mental health and current societal pressures will generate more demand.

Ways must be found to guarantee that mental health funding reaches frontline services provided by NHS trusts, it says, adding that a robust workforce strategy combined with support at local level are needed to make it happen.

The director of policy and strategy at NHS Providers, Saffron Cordery, said the concerns raised in the survey pointed to a growing gap between the government’s ambition for the care of people with mental health needs and the reality of service provision.

“In some cases, core mental health service provision by mental health trusts is actually getting worse,” she said.

“Mental health trust leaders are struggling to find sufficient staff to deliver their current services, let alone find new staff to extend, transform or innovate services. And too often, trust leaders report that any extra funding is just used to fill existing gaps or to manage current demand, not improve service quality or access.

“Unless action is taken to address these areas of concern then the government’s ambitions for transforming mental health care will not be met,” she said.

Sean Duggan, chief executive of the Mental Health Network said that huge progress had been made in destigmatising mental health, but raised awareness increases demand for services that were already overstretched.

“The government has pledged to put mental health on a par with physical health but this needs to be reflected in investment and the continued progress of the Five Year Forward View for Mental Health. Securing a sustainable mental health workforce fit for the 21st century is a crucial part of this,” he commented.

Getting mental health services right will relieve pressure on other parts of the health system and we would urge the government to deliver on its promises and ensure mental health gets the equal status it deserves,” he added.