Increased funding and more beds may not be the solution to capacity pressures in mental health services, according to Lord Crisp who is heading up a new inquiry into the sector.
The former NHS chief executive and permanent secretary of the Department of Health is leading the Commission on Acute Adult Psychiatric Care set up by the Royal College of Psychiatrists.
In an exclusive interview with HSJ, Lord Crisp, who will chair the inquiry involving 14 commissioners from across the sector, said he believed solutions to capacity pressures in mental health would vary and involve a range of factors.
He said it was too simple to blame a lack of funding for problems, adding it was important to understand all the issues affecting the sector and that beds were just “one factor”.
The inquiry will “try and understand the dynamic and what seems to be the right mix”, he added. “I have heard an awful lot of comment about pressure on beds from staff and from patients, but what I am not hearing is people making the comment they just need more beds. It’s about how those beds are used and how they fit into everything else,” Lord Crisp said.
The inquiry, which is not looking at children’s services or specialist services such as eating disorders, has made a call for evidence, which will close on 18 March.
Lord Crisp said the commission would look to make relatively few recommendations, adding: “We want to say this is what inpatient beds are for, and these are the reasons for the current problems, and these are what we think needs to be done in order to provide better services to the standards we want for the people who need them.”
On achieving parity of esteem he said: “If something has developed over 40 or 50 years you don’t solve it in five minutes. There isn’t parity of esteem, and even if the rhetoric was followed through to the absolute maximum, you aren’t going to get parity of esteem for five or 10 years because it takes a long time.”
The Royal College of Psychiatrists set up the inquiry in response to concerns over whether the mental health sector has enough acute inpatient psychiatric beds for adults in England, Wales and Northern Ireland. The college said the number of patients in England travelling out of their local area for emergency mental health treatment more than doubled from 1,301 in 2011-12 to 3,024 in 2013-14. It also said the average inpatient ward bed occupancy figure in England was 101 per cent in August 2013 with some wards running at 138 per cent.
Sir Simon Wessely, president of college, said: “Throughout my career I have seen recurring crises in the provision of mental health beds, with wards running at full capacity and patients in crisis having nowhere to go.
“Now is the time to look at these crises more closely, identify the underlying causes and move towards finding practical and sustainable solutions.”
The 14 commissioners include:
- Paul Farmer, chief executive of Mind;
- Anne Campbell, former chair of Cambridgeshire and Peterborough Foundation Trust;
- John Bacon, chair of Sussex Partnership Foundation Trust;
- Martin Barkley, chief executive of Tees, Esk and Wear Valleys Foundation Trust; and
- Michael Brown, mental health coordinator at the College of Policing.
It also includes Mary Riddell, political columnist for The Daily Telegraph; Royal College of Nursing chief executive Peter Carter; and a number mental health service users.
The commission will produce its final report for publication in early 2016.