Despite progress over recent years to increase investment in NHS mental health services and tackle the stigma surrounding mental health, the sector is suffering from a ‘care deficit’ which leaves many seeking care not able to access it.

A briefing published today from NHS Providers, which represents all mental health trusts in England, warns that the provision of mental health services is not being prioritised across the whole of the NHS. This is despite the significant progress that has been made by the sector to innovate and transform services, and improve people’s access to care and the quality of care they receive.

The sector has welcomed a substantial cash injection in mental health services in recent years alongside a fully costed programme for mental health delivery with the five year forward view for mental health, which the NHS long term plan significantly builds on. But there remain significant challenges facing mental health provision that need to be addressed.

The sector has welcomed a substantial cash injection in mental health services in recent years alongside a fully costed programme for mental health delivery with the five year forward view for mental health, which the NHS long term plan significantly builds on. But there remain significant challenges facing mental health provision that need to be addressed.

   

The briefing Mental health funding and investment: A digest of issues sets out the concerns from mental health trust leaders which are contributing to the financial pressure on the sector this year and the wider care deficit in mental health. This includes:

• a growing demand for inpatient care, which is leading to both high use of out of area placements and delayed transfers of care
• increasing costs of recruitment and retention as to ensure that trusts are equipped with the staff to keep up with growing demand and to cover the costs of year three of the agenda for change pay uplift
• cash reductions in local authority public health contracts, which has led to the decommissioning of some mental health and community services such as substance misuse
• the frequency of retendering for mental health and community services means that there is less financial security over the long term
• access to capital investment to invest in modern mental health facilities. The number of reported patient safety incidents caused by infrastructure in 2018/19 was over 19,000 and eight never events were reported in 2018. 

 
The briefing highlights the impact of stigma on investment in mental health provision and explores how mental health services are commissioned, contracted and paid for, and how funding reaches the frontline. The briefing also sets out a number of solutions to financial problems mental health trusts face.

There are number of priorities and challenges that both mental health trusts and national bodies will need to consider in order to address these financial problems and to deliver for service users. These include:

• improved and transparent mechanisms that guarantee that mental health funding reaches frontline services that need it most
• meeting capital investment needs so that urgent improvements can be made to facilities
• greater understanding within local health and care systems of the mental health and wellbeing needs of local populations to ensure mental health service delivery is prioritised accordingly
• national policy must focus on increased support for both mental health and public health
• less fragmented approaches to commissioning and a reduction in the frequency of retendering.

NHS Providers deputy chief executive Saffron Cordery, said:

“Despite increased investment in the mental health sector, trust leaders are clearly facing financial pressures which must be addressed in order to deliver the best possible care to patients and service users.

“While the sector has welcomed this increased investment and focus on mental health services in recent years, we urgently need to see this national investment reach and stay in frontline services where it is needed most.

While the sector has welcomed this increased investment and focus on mental health services in recent years, we urgently need to see this national investment reach and stay in frontline services where it is needed most.

Saffron Cordery    Deputy Chief Executive

“Much like wider NHS services, the sector has also seen a significant squeeze on capital investment meaning trusts can not provide the modern and up-to-date facilities to meet the needs of those seeking care. We must see more capital investment prioritising mental health needs to ensure that patients are not put at risk.

“National bodies must also work to ensure less fragmentation in commissioning of these services and a renewed focus on mental and public health to ensure that services, which face huge demand pressures, can deliver care at the right place, at the right time.

“Without proper investment reaching these services it will be patients that feel the impact. We risk more patient safety incidents, higher use of out of area placements and delayed transfers of care, and more decommissioning of important mental health and community services such as for substance misuse.”