National Audit Office: Progress in improving mental health services in England (9 February 2023)

Summary

Many people will experience mental health problems in their lives. Around one in six adults in England have a common mental health disorder, and around half of mental health problems start by the age of 14. 

This report from the National Audit Office focuses on the implementation of NHS commitments as set out in the Five Year Forward View for Mental Health, Stepping forward to 2020/21: The mental health workforce plan for England and the the NHS Long Term Plan.

It examines whether the government has achieved value for money in its efforts to date to expand and improve NHS-funded mental health services by evaluating whether DHSC, NHSE and other national bodies:

• have a clear understanding of how much their work to date has reduced the gap between mental and physical health services
• met ambitions to increase access, capacity, workforce and funding for mental health services
• are well placed to overcome the risks and challenges, including the impact from COVID-19, to achieving future ambitions.

Content

Key findings

1. Introducing access and waiting time standards for mental health services was an important step towards parity of esteem with physical health services.
2. Overall, the number of people treated by NHS mental health services has increased, but some access targets are not being met. 
3. The NHS has achieved its waiting times standards, which aim to get people into treatment quickly, for talking therapy services and early intervention in psychosis services, but not yet for eating disorders services for children and young people.
4. NHS mental health services are under continued and increasing pressure and many people using services are reporting poor experiences.
5. NHS England’s ambitious plan for community-based mental health services is still at an early stage.
6. The impact of initiatives to reduce inequalities in mental health is not yet clear.
7.  Although the NHS mental health workforce has increased, staff shortages remain the major constraint to improving and expanding services. 
8. The share of funding for mental health services has increased slowly, reflecting the pace set by NHSE’s targets
9. Improvements to mental health data and information are taking longer than planned in many areas.
10. DHSC and NHSE have not defined what achieving full parity of esteem between mental and physical health services would mean.
11. Plans for service expansion up to 2023-24 still leave a sizeable gap between the number of people with mental health conditions and how many people the NHS can treat.
12. The national programme, led by NHSE, has maintained a consistent focus on expanding services. 
13. Increased demand and disruption following the pandemic mean it is likely to take longer for the NHS to close treatment gaps.