Mental health and new care models

GPs need to prioritise mental health more, say experts. | Mental health and new models of care | Kings Fund | OnMedica

While some of the vanguard sites developing new care models report promising early results from adopting a whole-person approach, the full opportunities to improve care through integrated approaches to mental health have not yet been realised.
This Kings Fund report draws on recent research with vanguard sites in England, conducted in partnership with the Royal College of Psychiatrists. The report found that where new models of care have been used to remove the barriers between mental health and other parts of the health system, local professionals saw this as being highly valuable in improving care for patients and service users. But there remains much to be done to fully embed mental health into integrated care teams, primary care, urgent and emergency care pathways, and in work on population health.

The main vehicle for rolling out what vanguards are trying to achieve are England’s sustainability and transformation plans (STPs) and there are concerns, said the authors, that some STPs had limited content on mental health.

‘It is vital that STP leaders are encouraged to make mental health a central part of their plans, and that they are able to take heed of the emerging lessons from vanguard sites,’ says the report.

More mental health support is needed in GP surgeries, said the authors. They recommend strengthening mental health capabilities in the primary and community health workforce by improving the confidence, competence and skills of GPs, integrated care teams and others.

New publications from the NHS Confederation Mental Health Network

The NHS Confederation Mental Health Network has published two papers looking at the mental health workforce

The Future of the mental health workforce

The NHS Confederation Mental Health Network has published The future of the mental health workforce.  This discussion paper presents data on the current picture of the mental health workforce and looks at emerging findings from research to identify the challenges and opportunities that lie ahead for the mental health workforce. A final report will be published later in 2017.

Mental health and integrated care

Also published is Mental health and community providers: lessons for integrated care.  This briefing looks at how mental health and community provider organisations are exploring the multi-speciality provider model and how it can drive the delivery of integrated mental and physical healthcare.  The briefing presents key points and lessons learned.

Tackling culture change to transform mental health services

Mandip Kaur for the King’s Fund Blog | 16th March 2017

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Traditionally, mental health services are delivered by Children and Adolescent Mental Health Services (CAMHS) up until the age of 16 or 18 – or when a young person leaves school or college – at which point they’re expected to transition to adult mental health services. It’s long been recognised that this is a poor boundary for service transition, often having a further detrimental effect on mental health.

Forward Thinking Birmingham delivers mental health services for children and young people aged up to 25, combining the expertise of Birmingham Children’s Hospital, Worcester Health and Care Trust, Beacon UK, The Children’s Society and The Priory Group. The partnership’s vision is that Birmingham should be the first city where mental health problems are not a barrier to young people achieving their dreams. The transformational changes to the service were driven by the need to address disjointed and fragmented care provision, complicated service models, long waiting lists and rising demand. The service operates a ‘no wrong door’ policy and aims to provide joined-up care, focusing on individual needs, with improved access and choice for young people.

Read the full blog post here

5YfV for Mental Health: one year on

NHS England has published a report outlining the progress made in the first year of the Five Year Forward View for Mental Health | NHS Confederation

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Image source: NHS Confederation

The report sets out which areas are beginning to see improved access to care and outlines examples of good local practice in services. It also recognises the ongoing challenges, adding that there is more to do to “make a reality of the aspirations for transformation in mental health services”.

The report concludes by outlining that the infrastructure needed to sustain change has been put in place and in many areas people who use services are beginning to feel the benefits of the new and expanded services on offer. It cautions that this is a long term programme which goes beyond 2020/21, stating that further work will be needed beyond the first five years to continue to expand transformation of mental health services and meet the needs of the whole population.

Finally, the report acknowledges the hard work of staff and finishes by stating that “one year on, there is clear momentum behind this programme nationally and locally: the challenge now is to maintain and build on this to achieve next year and beyond”.

Highlights from year one:

  • Over 120,000 more people are expected to receive mental health care and treatment in priority services in 2016/17.
  • The Mental Health Investment Standard is planned to be met across England as whole in 2017/18 and 2018/19.
  • The first national access standards for mental health treatment have come into effect – with the waiting time targets met.
  • A new Mental Health Dashboard has been launched to provide unprecedented transparency of performance against key indicators.
    The first comprehensive all-age mental health workforce strategy has been co-produced for publication in April 2017.

The report also highlights that not all milestones have been met as planned with progress on workforce development taking longer than anticipated due to the complexities of delivering a strategy for such a diverse group of professionals.

Read the full report here

NHS Indicators: England, January 2017

The House of Commons library has published NHS Indicators: England, January 2017.

The full briefing paper looks at trends in the following areas:

  • Accident & Emergency attendance and performance
  • Ambulance demand and response times
  • Waiting times and waiting lists for routine treatment
  • Waiting times for cancer diagnosis and treatment
  • Cancelled operations
  • Delayed discharges and transfers of care
  • Diagnostic waiting times and activity
  • Waiting times for mental health treatment
  • Workforce numbers for doctors, nurses and other staff
  • Hospital activity, referrals and admissions
  • Bed availability and occupancy

Access the full report here

Doing justice to mental health in STPs

Claire Murdoch, the national director for mental health in England, recently argued that some sustainability and transformation plans (STPs) are failing to do ‘justice’ to mental health | Chris Naylor – The King’s Fund Blog

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Image source: Rowena Dugdale – Wellcome Images // CC BY-NC-ND 4.0

Ignoring the psychological aspects of health and wellbeing leads to some of the grossest inefficiencies in the health and care system. For example, we have estimated that in England, poor mental health drives up the annual cost of long-term physical health conditions by between £8 billion and £13 billion. The fact is – and it should hardly surprise us – that when people are struggling to deal with the social and emotional pressures in their lives, their physical health often deteriorates – and the impact of that is felt strongly in general practice, A&E and elsewhere. And yet all too often we act as if these issues should be of concern only to mental health professionals.

Leaders in some parts of the country are using the process of developing STPs as an opportunity to rethink the approach taken to mental health and wellbeing across their local systems, and are embedding mental health in every strand of their work. Those who haven’t yet done this risk missing a significant opportunity to use STPs to deliver better population health and better value.

Read the full blog post here

CCGs warned over withholding payments from mental health providers

NHS England & NHS Improvement | Published online: 8 November 2016

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Image source: NHS Improvement

This document provides technical guidance on how providers and commissioners can link locally agreed quality and outcome measures to payment. It has been developed to support mental health providers and commissioners to implement the new requirements under the 2017-19 local pricing rules. It is aimed at all those professionals in provider and commissioner organisations who need to work together to successfully link quality and outcome measures to payment – this includes clinicians, finance and contracting professionals and senior management.

Read the full guidance here