Alongside other national partners, including the Department of Health and Social Care (DHSC), we have established access and waiting time standards for mental health in some service areas:

• NHS Talking Therapies, for anxiety and depression
• Children and Young People (CYP) with an Eating Disorder (ED)
• Early Intervention in Psychosis (EIP)

In 2024 we began to publish data on waiting times for all age (children, young people, adult and older adult) community mental health services.

NHS Talking Therapies, for anxiety and depression

NHS Talking Therapies, for anxiety and depression (formerly known as IAPT), was the first part of the national Mental Health programme to implement a referral to treatment waiting time standard in 2015/16.

To support commissioners and providers, we published guidance explaining how indicators for referral to treatment are constructed and confirming the data that needs to be submitted to NHS Digital.

For further details on this dataset visit the NHS England website.

All NHS Talking Therapies services should be providing timely access to treatment for people with anxiety disorders and depression.

• 75% of patients should have a first appointment within 6 weeks of referral.
• 95% should have a first appointment within 18 weeks of referral.

Children and Young People (CYP) with an Eating Disorder (ED)

In 2016 guidance was developed to support reporting against the access and waiting time standard (AWTS) for Children and Young People (CYP) with an Eating Disorder (ED).

The document explains how the referral to treatment waiting time element of the standard is constructed. It also confirms the data that needs to be submitted as part of the Mental Health Services Data Set (MHSDS) to measure progress and inform future development.

Until 2023, performance against the CYP Eating Disorder Access and Waiting Time Standard was reported using a bespoke Strategic Data Collection Service (SDCS) collection which was retired at the end of the 2022-23 reporting period.

The CYP ED access and waiting time standard is now monitored using the Mental Health Services Data Set (MHSDS).

The technical guidance for recording and measuring the CYP Eating Disorder Access and Waiting Time Standard is being updated alongside the commissioning guidance for CYP with an Eating Disorder and will be available in 2025; in the meantime, the existing guidance should be used.

The CYP ED standard is as follows:

• 95% of CYP with an urgent referral for eating disorder treatment should begin that treatment within 1 week of the referral being made.
• 95% of CYP with a non-urgent referral for eating disorder treatment should begin that treatment within 4 weeks of the referral being made.

For more information on how to submit to the MHSDS please see the MHSDS submissions webpage.

Early intervention in psychosis (EIP)

Implementing the early intervention in psychosis access and waiting time standard guidance aims to support implementation of the standard by commissioners and mental health providers, working collaboratively with service users and their families, carers and other partners.

The following technical guidance, published in 2022, supports teams to code EIP interventions correctly within the MHSDS dataset.

The EIP access and waiting time standard is ‘2-pronged’ and both conditions must be met for the standard to be deemed to have been achieved:

1. A maximum wait of 2 weeks from referral to start of treatment
   AND
2. Treatment delivered in accordance with NICE guidelines and quality standards for psychosis and schizophrenia in children and young people or in adults.

The Royal College of Psychiatrists College Centre of Quality Improvement (CCQI) published a baseline audit from 2014/15 showing variation among EIP services in delivery of NICE-recommended interventions; a core requirement of the EIP Access and Waiting Time Standard.

Since 2017/18, the Royal College of Psychiatrists has been running the National Clinical Audit of Psychosis (NCAP) on NHS England’s behalf to support the development of EIP services to deliver the full NICE-recommended package of care.

All NCAP reports are available on their website and sit alongside ongoing monitoring of the referral to treatment time strand of the EIP standard, which is published as part of routine monthly statistics from the MHSDS. 

Community mental health services – all age (children, young people, adult and older adult)

As part of the clinically-led review of standards in 2021, NHS England consulted on proposed definitions for additional mental health waiting times metrics (across both urgent & emergency care and community NHS-funded mental health services).

NHS England published a response to the consultation in February 2022, which set out broad agreement from stakeholders.

In community mental health, the focus has shifted from contact-based metrics (that is, counting the number of contacts a person receives) towards understanding what meaningful activity had taken place within those contacts.

The new waiting times metrics cover all age (children, young people, adult and older adult) community mental health services and measure the time to someone starting to receive meaningful help in the form of assessments; co-produced care plans; clinical and social interventions; and baseline outcome measurements. ​More detail on these metrics can be found on the NHS Digital website.

NHS England has published these metrics since April 2024 within the Mental Health Services Data Set (MHSDS) monthly statistics. Performance trends are available graphically via the quarterly MH dashboard.

Current work on community mental health waiting times is focused on improving national and local system understanding of waiting times, improving data quality, and addressing longest waits.

No specific waiting times standard for community mental health services has been set (that is, the length of time within which a patient should receive meaningful help) and further work would be required to determine appropriate performance thresholds.

In the meantime, systems are using the available metrics and data to support improvements in waiting times across their patient populations.

Urgent and emergency community mental health services – all ages

For urgent and emergency community mental health care the CRS introduced 3 access metrics that apply to all ages:

• Very urgent presentations should receive a face-to-face assessment within 4 hours.
• Urgent presentations should receive a face-to-face assessment within 24 hours.
• For people presenting to an emergency department (ED) with a mental health need, the expectation is that a liaison mental health team responds within 1 hour of referral.

4 and 24-hour standards apply to community-based crisis services accessed via NHS 111 ‘select mental health’, local SPA or Crisis Resolution Home Treatment Teams.

These align with the UK Mental Health Triage Scale which is widely used by services to determine clinical urgency at the point of triage.

While early support via phone or alternative services (such as crisis cafes, sanctuaries, etc) may resolve many presentations without escalation, these metrics ensure those requiring face-to-face intervention are seen within a safe and clinically appropriate timeframe.