Summary
In 2011, the government acknowledged a large treatment gap for people with mental health conditions and sought to establish ‘parity of esteem’ between mental and physical health services. From 2016, the Department of Health & Social Care (DHSC) and NHS England made specific commitments to improve and expand NHS-funded mental health services. NHSE, working with the Department and other national health bodies, set up and led a national improvement programme to deliver these commitments.
This report by the House of Commons Public Accounts Committee assesses progress made in delivering these commitments. The report acknowledges that NHS England has made progress in improving and expanding mental health services, but says this was "from a low base."
Content
Conclusions and recommendations
- Workforce shortages are constraining the improvement and expansion of NHS mental health services. Recommendation: In six months’ time, NHS England should write to the Committee setting out what targeted interventions are envisaged for the mental health sector under the plan to ensure it can get the doctors, nurses, therapists and other clinical and non-clinical staff that the service needs, and who will be responsible for delivering them.
- Data and information for NHS mental health services still lags behind that for physical services. Recommendation: In six months’ time, DHSC and NHS England should write to the Committee, setting out how they will: improve the quality and completeness of the data on mental health services, including cost of services and patient outcomes, ensure these data are shared appropriately to support integrated care systems to improve services locally, including tackling inequalities and improve the evidence base on the cost-effectiveness of their investments, for example, on the roll out of mental health support teams in schools.
- New integrated care boards and partnerships could struggle to prioritise mental health services and support, in the face of funding pressures and the need to reduce backlogs for physical health services. Recommendation: NHS England and DHSC should evaluate how well the new integrated care boards and partnerships are supporting mental health services and how well their own support arrangements work to address variation between, and poorer performance in, local areas.
- There is still no clear definition of the end goal of ‘parity of esteem’ 12 years after the government first set out its ambitions. Recommendation: In its update to the Committee in six months, DHSC should also set out what achieving full ‘parity of esteem’ between mental and physical health services means in practice, for example, comprehensive access and waiting times standards and outcomes, timescales, funding and workforce requirements.
- DHSC and NHS England have still not committed to rolling out waiting times standards to all mental health services. Recommendation: In its update to the Committee in six months, DHSC and NHS England should set out their plan for implementing the new service standards.
- Preventive and public health services for mental health have not had the same priority and focus on improvement as NHS mental health treatment services. Recommendation: The Major Conditions Strategy must clearly set out how preventive and public health services for mental health will be improved and expanded, including how the right workforce will be secured.
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