September 25th, 2017
At this year’s NHS Health & Care Innovation Expo one topic in particular caught our eye, ‘The Two Doors of Mental and Physical Health: How the Five Year Forward View for Mental Health is Making it One Door for Both.’ This covered the progress made so far against the NHS’s Five Year Forward plan to treat mental health on a par with physical health, regardless of a patient’s primary presenting condition.
Significant Progress Made
During the first 18 months of this programme, emphasis has been placed on embedding the necessary infrastructure to deliver more sustainable change whilst also beginning to tackle gaps in access to treatment. Below we take a look at some of the key areas within the plan and the level of progress made to date in each of these areas.
Integration of Services
By 2020/21, it is expected that an extra 600,000 people with common mental health problems will access psychological therapies each year. In January 2017, 22 new ‘early implementer’ projects were launched across 30 CCGs with the objective of providing psychological therapies wherever people receive their physical healthcare. As part of this expansion 3,000 new therapists will be co-located in primary care. Over 1,000 people have already started treatment in these new integrated services.
These steps represent significant progress towards building a more holistic approach to patient care and helping to deliver better outcomes.
Expansion of and Access to Services
At least 120,000 more people are expected to receive mental health care and treatment via the priority service areas identified in the plan such as CYP services, perinatal and community mental health services.
Digitally Enabled Therapies
Digitally enabled therapies represent an opportunity to further broaden access and improve quality of services and is another key area chosen to support the ambitions of The Five Year Forward View for Mental Health. Over the past year, the NHS has developed the first digital strategy for mental health, bringing together investment of £67.7 million over three years.
Significant work is already underway including:
- The NHS 111 non-emergency helpline service is being transformed to provide a more intelligent clinical triage tool for mental health problems to help improve identification and advice.
- Embedding new routes of self-referral to psychological therapies through NHS Choices, to make it easier for people with common mental health problems to locate and access treatment.
- Digital Development Lab through which new digital tools can be tested, evaluated and endorsed by clinicians for wider use through a new library on NHS.uk. The first suite of six tools and apps are already being developed through this approach, which is expected to significantly improve access to new platforms for digital therapy.
SilverCloud Health’s online CBT programmes are featured on and endorsed by both NHS Choices and the Digital Development Lab.
Perinatal Services
£40 million funding has been granted for perinatal specialist community services. This funding has enabled the expansion of services with at least 750 more women expected to access specialist care in 2016/17 through the first wave of 20 chosen areas.
Adult Mental Health Services
In the first 12 months of the plan 972,000 people accessed psychological therapies – an increase of 72,500 on the previous twelve months. In terms of waiting times 87.8% of people entering treatment waited less than six weeks and 98.3% waited less than 18 weeks.
Equality of Access and Outcomes
Improving equality of access and outcomes for minority groups in services has also been identified as a priority area in the plan. As part of this NHS England has supported Age UK to run a campaign to encourage older people to access mental health services. This is supported further by the new mental health quality premium, which asks CCGs to focus and report on outcomes for people from black and minority ethnic groups, and access to services for older people.
Ensuring Sufficient and Transparent Investment in Mental Health
Across England as a whole additional funding has been fully allocated to support the programme. Furthermore, the new Mental Health Dashboard provides scrutiny and transparency of all funding allocation and spending in the plan.
Financial Incentives
NHS England and NHS Improvement have taken a number of steps to embed mental health within the frameworks and processes that drive quality and activity in the NHS. Consistent with the recommendations in the Five Year Forward View for Mental Health, 2017-19 local pricing rules for mental health now require commissioners and providers to link prices to locally agreed quality and outcome measures and achieving access and waiting time standards.
Conclusion
In summary, whilst our blog is only a snapshot of what has been achieved so far it is reassuring to see that significant gains have already been made in some of key areas within the first 18 months of this ambitious five year strategy. It seems that the infrastructure necessary to initiate and sustain change is being implemented and in many areas patients are already beginning to feel the benefits. We look forward to seeing what the next year holds.
