The must-read stories and debate in health policy and leadership.

Don’t ask, don’t get

The long-awaited review of the Mental Health Act was published this week. While it did not “rip up” the current legislation, as the prime minister had originally suggested it would, it did include significant – in both quantity and quality – recommendations to improve how the Act is used to detain patients with mental health problems.

Of the recommendations contained within the 300-page report, many focussed on improving patients’ choice and power over their own care. Indeed the review’s chair, eminent psychiatrist Sir Simon Wessely, said during a press briefing earlier this week that, if he had to pick which out of the 150 recommendations the government would act upon, it would be those based on patient choice.

Although the review did not offer any cost figures itself, a number of the recommendations will require the government and/or NHS to pony up significant funding. One of the clearest calls on the government pocket was for a multi-year capital investment programme to improve mental health estate, which the review claimed is some of the ”worst estate the NHS has”.

Two other recommendations which will require cash are to build places of safety in healthcare settings by 2023-24 (to avoid people being detained in police cells) and buy bespoke ambulance vehicles, so detained patients don’t have to ride in police cars.

There’s no guarantee Sir Simon will get everything he’s asked for but it’s a good time to ask – mental health is a prime ministerial priority (for whatever that’s worth mid-Brexit chaos) and the NHS is currently negotiationg a capital funding deal as part of next year’s spending review.

Redundancy packages

NHS England has launched an independent investigation into how two clinical commissioning group managers were given redundancy payments which appear to have breached the maximum allowed, we have reported.

Tony Bruce, former accountable officer of East Staffordshire Clinical Commissioning Group, and Wendy Kerr, the CCG’s former chief financial officer, both left the organisation in March when a combined management team was set up to cover all of Staffordshire’s CCGs.

The CCG’s annual report said Mr Bruce was given a payment for loss of office of £259,689 – nearly £100,000 above the £160,000 maximum allowed for very senior managers. Ms Kerr was paid £202,183.

Beyond this, nothing has been proven, and both NHS England and the CCG said little more than confirming the review was taking place.

With huge turbulence among CCG senior leadership – including sharing accountable officers, merging groups, and new senior system roles – there will no doubt be questions about the costs of change more widely, too.