NHS trusts providing mental health and learning disability services have been playing a critical role during the pandemic, adapting and innovating to maintain services and support the health service's response to COVID-19.
As our new briefing sets out, their achievements have been significant. They have been quick to adapt to support the acute sector, providing intermediate care wards for those recovering from the virus, and set up mental health A&Es and 24/7 emergency service access lines. They have also accelerated discharges in partnership with community services, reduced avoidable admissions with enhanced crisis care, and moved many home treatment models and clinical services online.
Trusts' efforts during the pandemic have taken place against a backdrop of changing demand for mental health services, including increased numbers of people needing urgent and emergency care. There are growing concerns that many who need help and support are not accessing services until they reach a crisis point, and a significant amount of pent up demand has built up during the lockdown. All the while, activity in many mental health services has either not reduced as significantly as in other areas of the NHS or has been met through new forms of support often in the community.
Mental health services will continue to face pressures in the weeks and months ahead, given a predicted surge in demand for mental health care as lockdown eases. Indeed, mental health providers are already beginning to report a significant increase in demand and the severity of new referrals.
The size and complexity of the challenge facing mental health trusts, as they seek to meet pent up demand and the predicted surge in new demand, cannot be underestimated and will require effective and careful prioritisation. Trusts also need support to model the likely future demand and capacity requirements for services, and effectively evaluate what changes prompted by the pandemic have added value and need to be locked in, and where recovery and restoration of services is needed.
Mental health services will continue to face pressures in the weeks and months ahead, given a predicted surge in demand for mental health care as lockdown eases.Policy Advisor
Key to meeting the extra demand for mental health services created by the pandemic will be ensuring that the required expansion in service provision is fully and promptly funded, on a sustainable basis. This funding must reach the frontline services that need it most, including core community mental health services, social care and key services provided by the voluntary sector.
Ensuring the sector receives its fair share of capital investment in forthcoming capital funding decisions is also fundamental to enable trusts to make the required investments in wards and innovations prompted by the outbreak. The current pressures have only served to reinforce concerns that the mental health estate is not fit for purpose, following years of underinvestment.
A further area mental health trusts will need support around is personal protective equipment (PPE) and testing. Their needs for PPE and testing must be adequately prioritised, as government continues to focus on getting a fit for purpose test and trace regime fully up and running, and a consistent and reliable flow of PPE to all trusts.
Ensuring the sector receives its fair share of capital investment in forthcoming capital funding decisions is also fundamental to enable trusts to make the required investments in wards and innovations prompted by the outbreak.Policy Advisor
Last but not least, a new workable strategic national plan for the mental health workforce needs to be accelerated, given the pandemic has exacerbated the significant workforce challenges trusts were already facing – particularly with regards to overseas recruitment and training. In the immediate term, a balance must be struck between trusts reaping the benefits of the rapid innovation prompted by the outbreak with ensuring staff get the time they need to rest and recover given the toll the pandemic response has taken on them.
Despite substantial progress, with new services and higher levels of investment, we know there was a significant care deficit in mental health before this pandemic. Government and national policy makers must give mental health trusts, and the wider sector, the support they need in the weeks and months ahead to avoid the impact of COVID-19 making the current care deficit in mental health provision even greater.
This blog was also published in the HSJ.