NCS | Cash to boost children's mental health not getting through

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Money to improve struggling children’s mental health services is often not reaching the NHS frontline despite soaring rates of self-harm among young people, new figures reveal.

Half of England’s clinical commissioning groups (CCGs) are using their share of the £1.4bn ministers allocated to improve NHS care of troubled young people for other purposes, it has emerged.

Freedom of information requests by the charity YoungMinds show that only 50% of CCGs, the GP-led bodies which decide how NHS budgets are spent locally, have increased their child and mental health services (CAMHS) budget this year, even though all of them received extra money specifically for that purpose.

The diversion of funds by the other 50% means that the “significant improvements” to CAMHS care that both the coalition and current government promised may not happen, according to YoungMinds.

The findings raise serious questions about whether the government’s intention to “transform” CAMHS by 2020 will be achieved. Jeremy Hunt, the health secretary, has identified the care received by children with psychological and psychiatric problems as the health service’s biggest failing and pledged to push through major improvements.

Sarah Brennan, the charity’s chief executive, said: “While some CCGs have made big increases in their spending, it’s deeply concerning that so many others are using some of the new money to backfill cuts or to spend on other priorities. “Jeremy Hunt has described CAMHS as the single weakest area of NHS provision, so it is vital that all the new money is spent where it was intended, on creating better services with a greater focus on early intervention.”

She said that despite huge public concern about children’s mental health, CAMHS accounted for just 0.7% of NHS spending, and about 6.4% of mental health spending.

The 50% who did spend the money on CAMHS was well up on the 33% who did so in 2015-16, according to the responses from 199 of England’s 209 CCGs, although not all provided enough data to enable comprehensive comparisons.

A series of reports by MPs, the children’s commissioner and charities stretching back to 2014 have criticised NHS care of troubled under-18s as inadequate. Young people struggling with anxiety, depression, eating disorders and other conditions often face long waits to access care and 28% are denied any treatment because they are deemed to be not unwell enough to qualify. Demand for CAMHS care is rising, with social media, including online bullying, widely cited as a key factor.

Data collected by YoungMinds shows that Central Manchester CCG is spending £476,151 less on CAMHS this year than it should be, but spent £611,213 in 2015-16, the first year in which CCGs got the extra cash. Similarly, Horsham and Mid Sussex CCG is spending £397,182 less this year than it has been allocated for CAMHS and it underspent by £297,827 last year.

In contrast, Blackburn with Darwen CCG in Lancashire is putting £107,437 more than its allocation into CAMHS this year and also invested an extra £82,471 last year.

Labour MP Luciana Berger, a former shadow minister for mental health, said: “Waiting times to access support are unacceptable, children are being turned away because their condition isn’t considered serious enough and, in some parts of our country, there is no help available whatsoever.

“For Jeremy Hunt to claim that he is overseeing a ‘transformation’ in child and adolescent mental health services is disingenuous at best. He is failing our next generation.”

The Department of Health made clear that all CCGs should be investing all of their share of the £1.4bn fund, which includes £150m to improve eating disorders services.

Meanwhile, new research by NHS Providers, the association of NHS trusts, shows that the government’s pledge to give mental health “parity of esteem” with physical health services is at risk because many CCGs are not boosting their investment in mental health care in line with increases in their overall budgets. Its survey of NHS mental health trust bosses found that 63% thought their CCG would not comply with that obligation, which is set out in the Mental Health Investment Standard, often because the cash was being given to local acute hospitals instead.

The director of policy and strategy at NHS Providers, Saffron Cordery, said: “It is very disappointing that, despite repeated commitments to ensure parity between mental and physical health, the public commitments to increase mental health funding will not be delivered on the ground. “Another year of failing to fully meet the public commitments on mental health will undermine the ability to invest in new access standards and other improvements that have been set out in detail by NHS England and strongly supported by both the prime minister and the secretary of state for health. “When taken together with reduced funding for local government, and the damaging knock-on effect for social care, this can only exacerbate pressures on the wider NHS which translate into delays and distress for patients and service users.”

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