This briefing provides a summary of the findings and recommendations of Old Problems, New Solutions: Improving Acute Psychiatric Care For Adults In England, the final report of the commission to review the provision of acute adult inpatient psychiatric care for adults.

National and local data is a consistent theme. To incentivise whole-systems collaboration across government, the final report presents the findings and conclusions of the independent commission, established in January 2015 by the Royal College of Psychiatrists and led by Lord Nigel Crisp, to:

• describe the purpose and value of inpatient services as part of the wider system;
• propose how to identify the size and scope of safe and therapeutic inpatient services; and
• make recommendations for improvements and propose an implementation plan.

The commission’s work has been undertaken in close cooperation with the NHS England Mental Health Taskforce – the recommendations are intended to align with the Taskforce’s whole-system focus and not duplicate work performed as part of its analysis of mental health funding and expenditure. Key points to take from the report:

• Patients with mental health problems should have the same rapid access to high quality care as patients with physical health problems.
• Access to acute care for severely mentally ill adults is inadequate nationally and, in some cases, potentially dangerous.
• Major problems both in admissions to psychiatric wards and in providing alternative care and treatment in the community are intimately connected and need to be tackled together.
• There are many good services around the country and enormous scope for dramatically improving others, a great deal of good practice to build on and new opportunities for innovation.
• New, firm targets for improvement must be combined with new approaches to quality improvement, data management, innovation and investment.

There are 12 recommendations that touch on all parts of the mental health system and aspects also of broader health and social care for people with serious mental illness. Most build on existing good practice cases within the NHS and these are featured throughout the report as exemplars for replication across the system or as models to be adapted locally with partners as needed and appropriate. Most also emphasise greater collaboration with local partners and in particular between providers and local commissioners.

See our blog from Lord Crisp and our press statement responding to the report.