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‘No improvement’ in community mental health care

CQC calls on trusts to ‘reflect on findings’

Jo Carlowe

Thursday, 22 October 2015

There has been ‘no notable improvement’ in community care for patients with mental health problems, and in some cases provision has got worse.

This is the conclusion of the Care Quality Commission (CQC) taken from the results of a survey of over 13,000 people who were treated and cared for in the community for their mental health problems.

The regulator, who published the survey this week, is now calling for NHS trusts to reflect on their findings and improve their care.

The annual survey led by the CQC assessed people’s experiences of the care and support they receive from community mental health services run by NHS trusts in England, such as in clinics and in their own homes for conditions ranging from mild depression to psychosis. The survey does not cover the care people have received for their mental health problems from general practices.

When people were asked to rate their overall experience of their community mental health care on a scale of 0 to 10, a higher proportion of people reported a poorer experience compared to last year; 28% rated it as five or lower, compared to 25% in 2014.

Also, a slightly higher proportion of people than last year reported that they did not feel listened to by staff (7%, up from 5% in 2014), did not feel they were given enough time to discuss their needs and treatments (11% up from 9% in 2014), and did not feel they were treated with dignity and respect (7%, up from 6% in 2014).

While the survey has not shown improvement from last year’s results, there are many questions that people have responded to positively about their care and treatment. For example:

  • 96% of people reported that they knew how to contact the person in charge of organising their care and services, if they have a concern about their care
  • 70% reported that they ‘definitely’ felt listened to by the person or people they saw (2014: 73%)
  • 78% of people on long term medication reported that they had had this reviewed (the same as in 2014), although this means that 22% did not
  • 73% reported that they were ‘always’ treated with respect and dignity (2014: 75%)

    Dr Paul Lelliott, the CQC’s mental health lead, described the results as ‘disappointing’.

    “Overall it is disappointing that there has been no notable improvement from last year’s survey. In particular, the fact that over a quarter of people reported a poor experience of their care is worrying and must be acted on.

    “Community mental health services play a vital role in supporting people with their mental health problems without needing to stay in hospital.  It is imperative that the NHS gets this right. We urge all NHS trusts and in particular those that have performed poorly to reflect on what the survey tells them about what their patients think of their services act on the findings.”

    In response to the CQC’s Community Mental Health Survey, Vicki Nash, Head of Policy and Campaigns at Mind, said: “The survey results are among a number of alarming signs that services are under pressure. We know that NHS mental health services are really struggling at the moment as budgets have been cut at a time when demand is rising. The impact of these cuts is clearly falling squarely on the quality of care people are receiving and it just isn’t good enough. Community care is essential to keeping people well enough to stay at home and out of hospital but it is failing. Without good community care, people risk becoming more unwell and needing more intensive – and expensive – support further down the line.

    “We need to see urgent investment in mental health services so that people get the help they need, when they need it.”

    The community mental health survey is conducted every year by CQC. It represents the experiences of over 13,000 people who received specialist care or treatment for a mental health condition in 55 NHS trusts in England between September and November 2014.

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