Spotlighting Parity of Esteem for mental health patients

By Martin McShane, national clinical director for long term conditions, NHS England:

Right from the start NHS England has shone a spotlight on mental health. We are committed to Parity of Esteem – making sure mental health gets treated the same way physical health does.

To this end, a raft of work has been undertaken by NHS England to close the gap between the access to physical and mental health services

Our programme of work has been about focussing our efforts and resources on improving clinical services and health outcomes by addressing five major areas:

  • Improving Information – so we know where we need to improve care.
  • Improving crisis care – so that people with acute mental health problems get the sort of care people with physical health problems take for granted.
  • Improving physical health care – to tackle the risk of premature death which people with mental illness face.
  • Improving the way we plan and invest in mental health – so that commissioners give it the right attention and investment.
  • Improving services – establishing networks across the country with leaders who are passionate about improving care.

This major programme of work has been set up to deliver the commitments in the NHS Mandate and also change the conversation and the culture right across the NHS.  The challenges are huge but NHS England is determined to deliver the changes required and change  traditional thinking about mental and physical health.

Someone recently described the problem to me as professional monocularism – we tend to view people through one eye at a time. One eye for physical health problems or one eye for mental health problems. It is time the NHS developed binocular vision. We need to value the importance of mental health on a par with that of physical health.

We recognise the issue of parity is an historic institutional problem which will take some time to change but we fully intend to get the wheels in motion.

Commissioners told us that best practice, tools and guidance, data and information and clear clinical leadership were important elements to support them in helping to deliver the national ambitions. After hearing this we’ve been striving to give them as much support as possible and published resources to this effect to help shape their five year plans.

NHS England also illustrated how patients with severe mental illnesses such as schizophrenia and bi-polar disorder will on average be at risk of dying many years earlier than the general population, and made a pledge to prioritise addressing this issue. These patients, we depicted, are dying of the same conditions as the general population but have the life expectancy of people living in the 1950s.

A key step towards tackling issues from a partnership stance came in February with the signing and welcoming of the Government’s Closing the Gap and Mental Health Crisis Concordat, a joint agreement which describes how police, mental health services, social work services and ambulance professionals should work together to help people going through a mental health crisis.

The concordat is an important step in delivering better care and outcomes for people in the midst of a mental health crisis. It is important that we address mental health as we would physical health problems; effectively, safely and with a positive patient experience; with ‘parity of esteem’.

Next year’s plan will see an intensive leadership programme for Clinical Commissioning Group (CCGs) mental health commissioners rolled out. It will also see an official launch of the ‘Parity of Esteem’ Programme which aims to engage with the public and key stakeholders.

And along with Public Health England we will be working on providing CCGs with revolutionary new profiles of the levels of need, access to services and opportunities to implement best practice.

This is the beginning of the journey. We will not get everything right from the start but we will endeavour to listen, learn and make the progress people have told us they want.

Dr Martin McShane was previously National Clinical Director for Long Term Conditions, since the publication of these blogs he has left NHS England.