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Risk and reward

HSJ revealed a few important things on Monday:

  1. If clinical commissioning groups hit the mental health investment standard, funding for the sector will grow by 8 per cent by 2020-21; and
  2. 24 CCGs are forecasting reducing mental health spending for 2017-18 and 21 are predicting they will not hit the standard.

It is worth stressing that things are – on paper at least – moving in the right direction. CCG mental health spending has increased in both 2016-17 and 2017-18. Only 21 CCGs are predicting they will not meet the mental health investment standard this year.

The Five Year Forward View for Mental Health requires CCGs to invest an extra £1bn a year by 2020-21 from the 2015-156 baseline.

If they all hit the investment standard they will have increased mental health spending by £1.6bn in this period. This would be an 18 per cent increase, outstripping overall CCG allocation growth of 14 per cent over the same period.

Coupled with the forecast £744m of national savings the plans are meant to produce across improving access to psychological therapies, liaison psychiatry and crisis care, this creates a potential cushion of around £1.3bn.

So much now depends on this investment standard. This might be why NHS England mandated it in the 2018-19 planning guidance last month.

But there are risks and HSJ’s forecasts only apply to a perfect world where everything goes to plan. With CCGs struggling to meet the standard and some even cutting spending, this is unlikely to be the case.