• More than one in 10 CCGs are predicting their mental health spend will fall from 2016-17 to 2017-18
  • HSJ analysis finds 23 of 172 CCGs were forecasting mental health spending to drop in cash terms
  • Only 12 cut mental health spending from 2015-16 to 2016-17
  • Twenty-one were also predicting they will miss the mental health investment standard for 2017-18

The proportion of clinical commissioning groups whose mental health spending will fall in cash terms is predicted to double this year to one in 10, HSJ can reveal.

New data, compiled through freedom of information requests to every CCG in country, shows the majority are predicting they will raise mental health spending this year. But 23 of the 172 that provided full data for 2015-16 to 2017-18 say they will reduce it (see first table).

CCGs reducing mental health spending from 2016-17 to 2017-18

CCG2016-17 actual (£’000)2017-18 planned (£’000)
Kernow 137,000 121,200
Leicester City 75,700 58,900
Central London 59,000 52,646
Tower Hamlets 53,253 46,987
Telford and Wrekin 23,816 18,260
Hammersmith and Fulham 40,377 36,269
Northumberland 90,800 86,700
Croydon 56,233 53,146
West London 71,000 69,005
Warwickshire North 36,200 34,400
Sunderland 71,772 70,546
North Tyneside 44,000 43,000
Isle of Wight 27,319 26,569
Castle Point and Rochford 25,234 24,538
Thurrock 18,880 18,387
Fylde and Wyre 27,810 27,380
Eastern Cheshire 40,001 39,575
Wokingham 16,744 16,375
South Warwickshire 38,581 38,223
Slough 17,360 17,166
Fareham and Gosport 31,200 31,090
Bradford City 14,549 14,441
South Gloucestershire 31,100 31,000

This is double the 12 that cut mental health spending between 2015-16 and 2016-17. Kernow and Isle of Wight were the only CCGs to reduce their mental health spending in both years.

HSJ has excluded CCGs that have merged or split so that the data is comparable.

Some CCGs said they had included learning disability and dementia funding in their mental health spending, while others specified they had not. Some CCGs did not specify what they defined as mental health spending.

Where a CCG directed HSJ to itsgoverning body papers, we used the most up to date planned spending on mental health where possible.

Sunderland CCG said the basis of how mental health spend was calculated had changed, so previous years were not comparable to its 2017-18 spend.

Kernow CCG told HSJ that it is now forecasting to end 2017-18 with a total mental health spend of £121.2m.

In a statement it said that this was not comparable with previous years because it included ”other significant costs” for mental health needs including continuing healthcare and prescribing which are not included in its 2017-18 forecast.

It added: ”These are included in the figure we provided for 2016-17, so comparing the two against each other is not an accurate reflection of where we are. In fact, our reporting on the mental health standard for NHS England shows an increase in spend from £120.7m during 2016-17 to a forecast of £121.2million.”

Tower Hamlets CCG said mental health was a top priority for it and that the 2017-18 figure was not a true reflection of its total investment because it did not include learning disabilities and demenita.

A spokeswoman added: “If we take into account these areas, the overall 2017-18 projected spend is £55.4m. This is an increase spend of £2m compared to 2016-17.”

A spokesman for north Tyneside said the data for 2016-17 included non-recurrent funding to mental health providers which ”artificially inflated” its outturn figure.

He added: ”The CCG is committed to ensuring high quality provision of mental health services in North Tyneside.

”The CCG’s financial plan demonstrates that the CCG is achieving the mental health investment standard requirements.”

The largest increase in mental health spending was Vale of York CCG, which is predicting to spend nearly £65m on mental health in 2017-18, up by £18.8m from 2016-17.

HSJ’s analysis also found that 21 CCGs were predicting they would not hit the mental health investment standard, which specifies mental health spending should increase in line with their overall funding growth each year.

This is a reduction from the 32 which failed to meet the standard in 2016-17, according to NHS England data.

The standard was introduced in 2016-17, but NHS England made it a requirement for every CCG in the 2018-19 planning guidance last month.

The analysis revealed that of the 172 responses, 21 were predicting they will fail to hit the standard in 2017-18.

We also found seven CCGs missed the standard in both years – Herts Valley, Isle of Wight, Kernow, Richmond, Scarborough and Ryedale, South East Staffordshire and Seisdon Peninsular, and South Gloucestershire.

Tweleve CCGs cut spending from 2015-16 to 2016-17 but were predicting an increase in 2017-18. This meant they would hit the investment standard this year, despite spending less in cash terms than they were two years ago. but still spending less than they started with.

The CCGs reducing mental health spend from 2015-16 to 2016-17 and increasing it again in 2017-18 but still spending less than 2015-16

CCG2015-16 actual (£’000)2016-17 actual (£’000)2017-18 planned (£’000)
Southport and Formby £20,561 £15,744 £20,294
Hambleton, Richmondshire and Whitby £22,900 £19,700 £20,100
South Sefton £24,629 £21,300 £23,785
Barking and Dagenham £31,892 £28,208 £29,065
Redbridge £32,984 £29,336 £29,411
Southwark £69,000 £62,000 £64,548
Havering £33,234 £30,198 £31,133
Eastbourne, Hailsham and Seaford £23,100 £21,100 £22,900
East and North Hertfordshire £81,933 £75,924 £78,479
South East Staffs and Seisdon Peninsular £22,671 £21,322 £22,089
West Norfolk £1,745 £1,650 £1,663
East Staffordshire £12,222 £11,955 £12,132

An NHS England spokesman said CCG mental health spend had increased from £9.1bn in 2015-16 to £9.7bn in 2016-17, a rise of 6.3 per cent compared to allocation growth of 3.7 per cent.

He added: “More local areas than ever before are hitting the mental health investment standard and from April this year, every CCG will not only be required to meet the standard, but importantly will have to demonstrate to an independent auditor that funding has reached front line mental health services.”

Updated 28 March, 2018, to include response from Kernow CCG, and 29 March to include response from Tower Hamlets CCG.

This story was updated on 13 April to remove Richmond CCG from the list after it it was incorrectly included due to an error in HSJ’s data analysis.

Exclusive: The 23 CCGs predicting a cut in mental health spending