• Every CCG required to hit the “mental health investment standard” from 2018-19
  • 32 CCGs failed to meet the standard in 2016-17
  • Royal College of Psychiatrists raises concerns that more CCGs may be missing the standard this year
  • College welcomes new requirement

Every clinical commissioning group in the country will be required to increase its mental health spending at least as fast as its overall allocation from next year.

The requirement, which has been revealed today in 2018-19 NHS planning guidance, means that every CCG in the country must meet the “mental health investment standard”.

The MHIS, which was originally introduced in 2016-17, currently only applies at a national level, rather than for every CCG.

It came as the Royal College of Psychiatrists raised concerns that an increasing number of CCGs may be failing to hit the standard this year compared with 2016-17.

The 2018-19 refresh of the NHS planning guidance does not set out sanctions for CCGs which fail to increase mental health spending sufficiently. However it does say: “CCGs’ auditors will be required to validate their 2018-19 year-end position on meeting the mental health investment standard.”

HSJ understands the majority of CCGs which have failed to hit their mental health investment targets are in deficit. An NHS England finance board paper published this afternoon says the £400m commssioner sustainability fund available in 2018-19 will return CCGs to finanial balance, and therefore makes it possible for all CCGs to hit the MHIS.

This, the paper adds, “will support further expansions next year in children and adolescent mental health services, crisis and emergency mental health care, talking therapies, and a range of other improvements.”

According to NHS England data 32 CCGs fell short of delivering the standard in 2016-17.

NHS England has not yet released comparable CCG-level data for 2017-18. However Royal College of Psychiatrists president Wendy Burn said: “In 2016-17, when commissioners had to meet the MHIS, 15 per cent of them failed to do so. The situation may have worsened this year when this policy was relaxed. If the situation has got worse, reinstating the obligation to meet the standard, if properly enforced, should help reverse that trend.”

She added: “This is very welcome news which the RCPsych believes will benefit people with mental illness.

“If we are to realise our ambition to treat a million more people with mental illness, then we need to make sure that money is spent on frontline services.

“That means commissioners need to be held to account for their decisions and the communities they serve must easily be able to see where money is being spent.”

NHS England chief executive Simon Stevens told the health select committee as recently as October: “There’s not a requirement on every single CCG to meet the mental health investment standard, the requirement is that across England in aggregate we meet the MHIS and our expectation is the vast majority of CCGs should do so.”

The new spending requirement for CCGs comes with a set of expectations for improved access to mental health services. These include more children and young people receiving treatment from community services; progress on waiting time standards for eating disorder services; more use of psychological therapies; and increased access to perinatal mental health services.