• New report highlights drop in adult acute mental health inpatient beds and fall in community care provision
  • Centre for Mental Health calls for “urgent review” to address growing gap
  • Charity hopes implementation of the Five Year Forward View for Mental Health will bridge the gap

A drop in mental health inpatient beds coupled with a fall in community care provision is a “great concern” that requires an urgent review, a new report has said.

The Centre for Mental Health has today published a report using data compiled by the NHS Benchmarking Network focusing on adult mental health in England and Wales.

The report, shared exclusively with HSJ, said acute adult inpatient bed numbers fell by 15 per cent from a median of 23 per 100,000 population in 2012-13 to 19.6 in 2015-16.

The authors also found bed occupancy had risen from 91 to 94 per cent during the same period, while staff numbers had fallen. This is above the 85 per cent level recommended by the Royal College of Psychiatrists.

Lengths of stay rose slightly from 32 days on average to 33.4, while official figures show the number of people detained under the Mental Health Act rose from 48,600 in 2011-12 to 63,600 in 2015-16

But the charity said overall community mental health care provision fell with people on community caseloads dropping by 6 per cent and contacts by 7 per cent.

The report said the “growing gap” in adult mental health services created as beds close but community services do not expand needed “urgent attention” from national and local policymakers.

It said: “With bed occupancy levels rising year on year, and a growing reliance on leave to manage bed capacity, pressure on acute inpatient services can no longer be ignored. But it is the combination of reductions in inpatient care capacity and a fall in community care provision that is the greatest cause for concern from the data we have reviewed.

“Reducing bed numbers without expanding community support is not sustainable long term. Investing in high quality community and primary care is now imperative to bring about the changes outlined in national strategies that will be vital to put mental health on an equal footing to physical health across the country.”

The report found while acute adult inpatient bed numbers fell between 2012-13 and 2014-15, there was a rise from 2014-15 to 2015-16.

The CMH said it hoped that that the implementation of the Five Year Forward View for Mental Health, published last February, will balance the gap between inpatient and community care.

It added: “An absence of specific policy direction on the configuration of inpatient and community services has led to a wide range of approaches emerging across the country.

CMH chief executive Sarah Hughes said: “The Five Year Forward View for Mental Health in England sets out a clear ambition to improve community mental health services and increase investment in mental health care. Today’s report shows that this is a vital mission.”

But an NHS England spokesman said the data pre-dated the Five Year Forward View for Mental Health and overlooked a 3 per cent increase in community beds between 2015 and 2016 as well as a £574m funding increase for the sector this year.

He added: ”This report, based on historic data at least a year and a half old, pre-dates the Mental Health Taskforce investment. It also provides a misleading view based on accounting and service classifications that were abandoned several years ago, as it ignores the fact that community provision and the range of services have all increased and improved since 2015.”

The report said it remains to be seen whether the revision of the Mental Health Act proposed by Theresa May could tackle the increase in people being detained.

It added: “There is no current evidence that there are significantly more people with mental health problems. However, the reduction in community service capacity and high levels of bed occupancy may mean there are fewer alternatives to use of the act.”

 

This story was updated at 9.30am on Thursday, 28 September, to include the statement from NHS England.