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Only a quarter have access to needed mental health services

NAO finds that meeting the standards will be ‘a very significant challenge’

Louise Prime

Tuesday, 26 April 2016

Only a quarter of people who need mental health services have access to them, according to the National Audit Office (NAO). The NAO found that meeting the standards set for improving access and waiting times will be “a very significant challenge”, as clinical commissioning groups’ existing budgets are squeezed ever more tightly.

The Department of Health (DH) and NHS England made a clear commitment, said the NAO, to improving mental health services for those who need them. In 2011, the Government said its ambition was for mental health to be valued just as highly as physical health; and in 2014 the DH and NHS England set out the first set of standards for how easily people can access mental health services when they need them, and how long they should have to wait for treatment.

In its latest report, Mental health services: preparations for improving access, the NAO said that although the DH and NHS England have begun to make progress to improve access and cut waiting times for people with mental health problems, much remains to be done.

It pointed out that many local organisations have to take action together to improve mental health care – but the full cost of implementing better access and shorter waiting times, as well as making long-term improvements in services, has been poorly understood. It said the DH estimated that achieving the commitments made in the first three areas – improving access to psychological therapies (IAPT), early intervention in psychosis and liaison psychiatry services – could be £160m a year more than the roughly £663m that CCGs spent on these services in 2014-15. But, it said: “Subsequent indicative analysis suggests that the cost of improving access further could be substantially higher, although there is considerable uncertainty around these estimates.”

The NAO pointed out that although the DH and NHS England had made available £120m of additional funding over 2014-15 and 2015-16, to support the implementation of access and waiting time standards for mental health, “most of the cost of implementing the new access and waiting time standards will be met from clinical commissioning groups’ existing budgets, at a time when the NHS is under increasing financial pressure.”

The NAO reported that meeting the standards will be “a very significant challenge”. It found that although access and waiting times for IAPT are already being met nationally, there is substantial variation in performance between different areas. It reported that last July, just 7% of acute hospitals had the level of service that NHS England considers will be beneficial to patients, i.e. at least a core liaison psychiatry service operating 24 hours a day, seven days a week.

Head of the NAO Amyas Morse said: “The Department of Health has recognised that mental health has been treated as a poor relation relative to other health needs for many years. This recognition, the goal of ‘parity of esteem’ and the setting of new standards for access and waiting times are all bold and impressive steps forward. It is important that these steps are supported by implementation in a reasonable timescale if they are not to be a cause for disillusionment, and this looks challenging in current conditions.”

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