Many mental health trusts lack funding for facilities’ repairs and upgrades

Author: Adrian O'Dowd

As many as two thirds of NHS mental health trusts will not receive the funding they need this year to invest in urgent repairs or upgrade their facilities, according to a briefing paper published today.

The briefing from NHS Providers, Mental health services: meeting the need for capital investment, sets out findings from a survey of mental health trust leaders.

It warns that, although mental health services require a significant amount of capital investment in 2020-21, the majority of trusts will not be able to access enough capital funding to meet their needs.

The situation means that patient safety standards at being put at risk, leaving many still being cared for in inappropriate dormitory-style wards, said NHS Providers.

The survey, which contains 37 responses from the 54 trusts providing mental health services in England, also found that:

  • for 27% of mental health trusts, funding allocated for capital investment would not even meet half of their current need
  • two thirds of trusts estimated that they needed between £50m and £150m of capital investment over the next five to 10 years
  • one trust requires more than half a billion pounds to address maintenance and transform services to meet patients’ needs.

In the last three years, more than a fifth of trusts have faced enforcement action from the Care Quality Commission (CQC) over the condition of facilities and the impact on quality and safety of patient care, said the report authors.

However, a number of trusts were unable to access the funding required to make these improvements. Two trusts in the new survey warned that they were unable to meet more than 70% of the costs necessary to address CQC's safety concerns.

There are still 350 dormitory-style wards in use across the NHS in England which CQC has warned do not support people’s privacy or dignity and should not be used for patient care in the 21st century.

Mental health trusts urgently need access to sufficient capital investment to modernise care, address safety issues, and reduce out-of-area placements, said NHS Providers.

In addition, the survey findings illustrated concern among mental health trusts about access to capital funding in the long-term, as well as current restrictions on trusts spending their income on these projects and effectively planning capital projects across systems in the future.

NHS Providers said it was calling on the government to fix the current system of capital investment within the NHS by setting a multi-year capital settlement which roughly doubles the current budget, and ensuring all parts of the system are able to access funding based on need.

Deputy chief executive of NHS Providers, Saffron Cordery said: “While we have seen some very welcome additional investment from the new government, this to date has overwhelmingly been focused on the acute hospital sector. This is a troubling oversight when there is such a clear need for capital investment in the mental health sector.

“We have warned repeatedly of the risks of neglecting investment in NHS mental health facilities. Vulnerable patients are being placed at increased risk because the facilities they need are no longer fit for purpose to deliver the specialist care they deserve.”

The British Medical Association’s mental health policy lead Dr Andrew Molodynski said: “It is unacceptable that across the country, many mental health patients are being treated in inadequate, run-down and even unsafe care settings that are detrimental to their health and recovery.

“Many of these facilities are not fit for a 21st century health service as patients, many of whom are extremely vulnerable, and indeed the staff who look after them, deserve to be in an appropriate clinical environment.”