Investing in mental health services
NHS Providers surveyed mental health trust members about their experiences of the 2017/18 - 2018/19 contracting round. The survey was sent on Tuesday 13 December and closed on Thursday 15 December. We received 43 individual responses, representing 38 providers – which is 64 % of all mental health providers. All responses were from board members; primarily chief executives, chairs and finance directors.
Since 2012 there has been a sustained focus at a national level to address the lack of parity between mental and physical health services. The Five year forward view for mental health and the implementation plan both establish an ambitious and challenging agenda to deliver access standards for key mental health services as well as a range of improvements that need to be delivered, encompassed in a set of 58 recommendations.
Clearly this level of ambition is long overdue and everyone working in the sector welcomes it. However it needs to be matched by a funding framework that will mean it can be delivered on the ground. Since 2015 commissioners have been required to increase spending on mental health services at least in line with the amount by which their funding allocation has been increased overall. Research earlier in 2016 by NHS Providers showed that this year the funding allocation did not always reach frontline services, despite clear guidance from NHS England that this should inform the 2016/17 plans and financial allocations. Mental health trusts are now seeking to finalise their contracts with commissioners for both the next two years. This survey looks at both the extent to which guidance has been followed to ensure the Mental Health Investment Standard will be achieved, and the likelihood that mental health trusts will be able to conclude contracts with their commissioners, both locally and nationally.
- Mental Health Investment Standard - The majority of respondents (63%) are not confident that CCGs will deliver the Mental Health Investment Standard. Comments around this focussed on the financial pressures CCGs are facing and prioritisation of the acute sector.
- CCG financial position - Some respondents were sympathetic to the CCGs financial position, indicating they felt they would invest in mental health if they could.
- Finalising local contracts - 58% of respondents are confident they will reach agreement on their CCG contracts before the 23 December deadline, with just 5% believing they will go to arbitration.
- Prioritisation of other services – When asked about the challenges with CCG contract negotiations over half of respondents ranked prioritisation of acute services as the most challenging.
- Finalising national contracts - 61% of respondents are confident that they will agree their NHSE contracts before the 23 December deadline, with two indicating that their contract is already signed.
- National negotiations - Respondents generally commented that NHSE negotiations had gone well, with some concerns around lack of pace, and a few negative experiences, for example the transfer of significant financial risk.