The National Audit Office has published a report on progress in improving mental health services in England. The report focuses on the implementation of NHS commitments as set out in the Five Year Forward View for Mental Health (July 2016); Stepping forward to 2020/21: The mental health workforce plan for England (July 2017); and The NHS Long Term Plan (January 2019). It looks at whether the government has achieved value for money in its efforts to date to expand and improve NHS-funded mental health services.
Overall, the number of people treated by NHS mental health services has increased, but some access targets are not being met. 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. NHS mental health services are under continued and increasing pressure and many people using services are reporting poor experiences. Although the NHS mental health workforce has increased, staff shortages remain the major constraint to improving and expanding services.
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. Increased demand and disruption following the pandemic mean it is likely to take longer for the NHS to close treatment gaps.
The report recommends that the Department for Health and Social Care (DHSC) and NHS England (NHSE) should publish a detailed statement of what achieving full ‘parity of esteem’ between mental and physical health services encompasses. Either separately or as a distinct part of the overall NHS workforce plan due in 2023, DHSC and NHSE should publish a longer-term mental health workforce recruitment and retention strategy and a costed plan. NHSE, working with local Integrated Care Boards (ICBs) and providers, should improve its data and analysis to better understand the relative cost and cost-effectiveness of different services. NHSE, working with ICBs, should develop and issue guidance in 2023 on how the system will gain more transparency over capacity, activity, performance and outcomes in community mental health services, including improvements required to implement the proposed new clinical standards, as well as mental-health- related capacity and activity in primary care.
Meg Moss, Head of Policy & Public Affairs, says, "we have long been aware of the issues with waiting times and poor experiences within NHS Talking Therapies (previously known as IAPT). The solution to both of these problems lies within the counselling and psychotherapy workforce, which can provide the staffing levels needed to meet the demand as well as provide client-led care and support not currently found within the NHS Talking Therapies service. The Society has been campaigning on this matter for several years now, and will continue to do so until this is addressed."
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