Responding to the publication of a new report today (26 January 2017) on mental health care in general hospitals, Professor Tim Kendall, National Clinical Director for Mental Health, describes how the NHS is working hard to deliver priorities set out in the Five Year Forward View for Mental Health for changing the way in which mental and physical health have traditionally been viewed and treated.
‘Treat as One’, a report from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD)outlines the findings of a recent review of the mental health care provided to patients who are receiving treatment for physical health problems in UK general hospitals.
Mental and physical health are interdependent, and patients rightly expect care and treatment for both, whatever their primary presenting condition and through whichever door they first enter. We need to improve mental health support in general hospitals alongside bringing together mental and physical health care. This needs to happen inside hospitals, out in the community and in people’s homes – to break down the barriers, as we now say.
The NCEPOD recommendations echo almost exactly the priorities for integrating physical and mental health that we set out in our implementation plan for the Five Year Forward View for Mental Health.
Firstly there is new money available to CCGs from April this year to improve access to evidence-based physical health assessments and interventions for people with serious mental illnesses. We are supporting them in delivering this with new guidance and other implementation support so that by 2021, 280,000 more people with serious mental illnesses receive the care they need in both primary and secondary healthcare settings.
And secondly, I am very excited to report that there has been vast interest across the country in two new waves of transformation funding, for general hospital liaison mental health services and integrated psychological therapy (IAPT) services. Bidders across England have obviously been extremely hard at work on their applications over Christmas and the New Year, reflecting their passion and dedication. The bidding process for wave 2 funding for integrated IAPT services closes this week.
These services improve care and outcomes for people with common mental health problems and long term physical health problems, and also distressing and persistent medically unexplained symptoms. This new funding will help to develop sustainable integrated IAPT services at scale, giving 400,000 people access to them by 2021.
Bids for £30m to bolster general hospital liaison mental health services have also been coming in thick and fast this week.
In total there is £120m of central money earmarked over the next four years to help hospitals to provide 24/7 specialist on-site mental health expertise, to match the 24/7 opening hours of their A&E departments, so that at least half of English hospitals will be able do this by 2021.
Guidance for routine liaison care in physical health settings is currently in development, following our publication of guidance on the urgent and emergency functions of general hospital liaison services in November.
Along with indisputable evidence that these initiatives improve patient care while generating cost savings, the levels of interest in these bidding processes show that commissioners and providers share our appetite and impatience for implementing change. They understand the need for transformation, and are stepping up to the plate, which shows great promise for genuine action in 2017.
One last thought-provoking idea. At the moment, we still tend to first assess and treat our patients through one of two doors: the mental health door or the physical health door. But ours is a constantly-evolving, cutting-edge modern healthcare system – and one in which there are ever-increasing resource and demand issues. So maybe it’s time to think about a shift for the future model of care. Maybe patients just need one door to walk through, and to be treated seamlessly for all of their healthcare needs?