Exclusive: Spend on 'vital' community services cut by a fifth

The average spend by trusts on their community teams decreased from £6.2m per 100,000 people served in 2012-13, to £5.3m in 2016-17. This is a 15 per cent reduction in cash terms. Once inflation is considered, the cut was 20 per cent.

The analysis, from a report by the organisation NHS Benchmarking, is based on figures from 28 of the 56 mental health trusts. 

The news comes following the publication of the NHS long-term plan, in which NHS England has indicated it will introduce access targets for adult community mental health services and support local areas to “redesign and reorganise” core community mental health teams.

NHS England data suggests commissioners’ spending on mental health services as a whole increased from £10bn in 2015-16 to £11.9bn in 2017-18. The long-term plan said it will continue to grow, by £2.3bn over five years, but does not specify how much of this will go into community services.

The graph below, shared with HSJ, shows the average spend across 28 mental health trusts on community health teams, according to an NHS Benchmarking report. 

Andrew Moore, member of the Royal College of Psychiatrists’ general adult faculty, told HSJ the findings echoed staff’s experience in the services. “In community services it’s a case of gradually fewer staff doing more,” he said.

He said staff were “squeezing as much as you can out of the sponge”, and added: “You can do that to a certain extent but then things like your waiting list times go up and staff burn out becomes a problem.”

He said “some” areas of mental health were “getting new investment but at the cost of other areas getting less”. Those losing out were the “core” areas like community services, he said.

Miriam Deakin, director of policy and strategy at NHS Providers, said: “It is worrying to see that community mental health teams are not benefiting from much needed investment in wider mental health services. This is unsustainable at a time when referrals to mental health crisis teams in the community are actually going up.

“Mental health teams in the community are a vital part of the service and ensure that people who need it can receive treatment early and avoid the need for crisis care away from home.”

An NHS England spokesman said: “The key fact is that overall spending on mental health has gone up year on year in real terms and every local area is now required to go through an independent audit to show beyond doubt that funding is reaching front line services.

“What is more, any analysis of funding which looks only at spending by specialist mental health trusts will overlook around one third of investment in mental health services.”

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