Four in five managers charged with implementing the national service framework for mental health are not convinced it can be done without extra money, according to a survey of health authorities and trusts.

The survey reveals a mismatch between faith in the standards themselves - 57 per cent of HAs and trusts described the framework as 'definitely' worth waiting for - and confidence that they can be achieved on current funds.

Primary care standards and 24-hour access were flagged up as 'real problems' in the survey by consultants Mental Health Strategies, a subsidiary of MJM Ltd.

Director Tom McCarthy said many believed that without extra cash the national service framework was 'just a bundle of good practice in a document'.

Roger Pedley, chief executive of Avon and Western Wiltshire Mental Health Care trust, said the figures were 'no surprise' and reflected a widely held view that 'it is going to be a real struggle' to implement the framework.

He said it would be 'very disappointing' if the framework's 10-year timescale was used as an excuse to 'take the foot off the pedal' in transforming services.

Just over 70 per cent of respondents felt their organisations had only 'partial' skills and resources to deliver the agenda - evidence, said Mr Pedley, of the need for 'very energetic strategic leadership' that was often lacking. He flagged up the need for mental health management to be promoted as a 'more attractive' career option.

The Department of Health is due to announce membership of its review of mental health workforce planning 'very shortly'.

Barry Day, joint strategic development manager at Northamptonshire HA and Northamptonshire county council, said that while money was 'always welcome', some solutions might be found in service configurational change. But he was dubious about attempts to measure current services against framework standards, which were vague.

Bob Quick, national project manager of the Community Mental Health Team Management Association, called on health secretary Alan Milburn to 'put his money where his mouth is' following the description of mental health as one of the government's key priorities.

Dr Matt Muijen, director of the Sainsbury Centre for Mental Health, highlighted the 'massive resource implications' of targets to cut bed occupancy to 95 per cent, and end mixed-sex wards, suggesting it would cost 'about£1bn annually' to meet all the framework standards.

The Mental Health National Service Framework: an ambition too far . 0161-727 9419.

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See community spirit, page 20; feature, pages 26-27.

Shadows of doubts 59 per cent of HAs and trusts were 'doubtful' that framework standards could be met within current resources and the£700m modernisation fund.

19 per cent were 'not at all confident' this could be done.

No-one was 'completely confident' the standards could be met without new cash.

Just 2 per cent claimed their current services complied with framework standards.