• The mental health sector is facing a number of longstanding, historic challenges, which have come to a head at a critical time: the government is due to publish its 10-year health plan and conclude its first comprehensive spending review in the summer. Both provide a critical opportunity to secure the funding and focus the mental health sector requires to build on the work undertaken in recent years – and make further necessary improvements – to deliver sustainable, high-quality mental health services to the benefit of individuals and the wider system and society over the next decade.
  • Securing the right levels of national funding and focus for the mental health sector in upcoming strategic NHS decisions is also essential to supporting the breadth of mental health's role in delivering the three shifts (across treatment to prevention, hospital to community, and analogue to digital) and providing services to those with the most serious mental illnesses.
  • More individuals are accessing NHS mental health, learning disability and autism services than ever before, but there remains significant unmet need and challenges around the quality and safety of care. This affects children and young people as well as adults, and individuals with severe and enduring mental illness as well as those with mild to moderate mental health conditions. Pressures on services and the complexity and acuity of people's needs also persist, despite ongoing work by the sector to increase access and transform models of care within the resources available.
  • Critically, trusts from across the acute, mental health, community and ambulance sector have raised concerns about whether overall levels of funding for mental health services are enough and whether they are being appropriately prioritised locally and nationally, particularly services for individuals with severe and enduring mental illness. There is a growing perception of a waning political will and focus on addressing the systemic challenges facing the mental health sector and delivering the well-established principle of parity of esteem between mental and physical health care. There must be recognition of the economic and wider benefits derived from investing in the delivery of high-quality, timely mental health services for the full spectrum of needs that exist. Such investment can reduce healthcare costs, improve productivity and lead to better health outcomes for patients.
  • Mental health trust leaders are open to doing things differently and addressing the challenge of delivering sustainable, high-quality mental health services in partnership with others to better meet the full spectrum of need in their local communities as early and as close to home as possible. A lot of innovation has, and is, going on within the sector, providing helpful local and national learning – some of which we share in this briefing and we will be sharing more in the weeks and months ahead.
  • Providers of mental health, learning disability and autism services have been trailblazers in particular in working together with wider partners, both formally and informally, to improve the delivery of specialised services at scale through NHS-led mental health, learning disability and autism provider collaboratives. The benefits of this approach are evidenced in reduced inappropriate out-of-area placements, increased investment in community-based services and support, and enhanced patient experience and outcomes. As national policymakers set out their plans to shift services into the community, they should take learning from, and build on, the experiences of mental health provider collaboratives.
  • This briefing sets out the current state of the mental health sector and why there is a need to provide more clarity, coherence and alignment on what needs to be prioritised in the short to medium term to deliver high quality, sustainable mental health services in line with the government's three shifts. NHS Providers will be working over April and May to explore what needs to be prioritised, and how to deliver what’s needed in practice, further with trust leaders and stakeholders, and will share findings and recommendations with policymakers ahead of the comprehensive spending review concluding and the implementation of the 10-year health plan.