Exclusive: Variation in children's mental health spend 'seems unjustifiable'

New analysis from the Royal College of Psychiatrists has found vast differences in how much clinical commissioning groups are investing in young people’s mental health services.

The college also found that over a third of clinical commissioning groups – 70 out of 209 – spent less than planned on CYP and eating disorder services in 2016-17, and that 22 cut overall mental health funding in real terms from 2015-16 to 2016-17.

The analysis, shared exclusively with HSJ, found while four CCGs spent more than £100 per head of the population aged 0-17 in 2016-17, one spent less than £10 per child and young person in its footprint.

The median spend per child and young person across all CCGs was £50.13, and the range excluding the top and bottom and quartiles was £41.13-£59.83.

Tameside and Glossop CCG had the lowest spending per head at £9.69 per 0-17 year old, followed by Solihull at £10.12 and Enfield at £10.62.

South Tyneside spent the most per head with £136.32 for every child in its footprint.

Improving mental health services for children is one of prime minister Theresa May’s top health priorities. The Conservative Party’s 2017 election manifesto pledged a new green paper on young people’s mental health.

• Explore the data: The CCGs spending the most and least on child mental health

To identify the amount spent on children’s mental health, the college looked at the total spend on CYP and eating disorder services published in the latest update to NHS England’s mental health dashboard, which was released earlier this month. It then worked out the amount spent by head of the population based on Office for National Statistics population estimates.

The college said the variance “seemed unjustifiable” because of the 13-fold difference in spending between the top and bottom CCGs.

College president Professor Wendy Burn said the analysis suggested that money allocated for child and adolescent mental health services is not always reaching the front line, which she said was “deeply worrying”.

She said: “We cannot continue to live in a society in which mental health services favour those living in certain parts of the country, and continue to fail those living elsewhere.

“Our NHS will not withstand the long term strain such a system places on its patients and its staff, particularly at a time when not enough medical students are opting to choose psychiatry and provide those much needed services.”

A spokesman for Tameside and Glossop CCG said that its declared CYP spend in the dashboard did not include the amount spent on services for children and young people through its main block contract with Pennine Care Foundation Trust. He said the actual spend for 2016-17 was almost 10 times as much as the national dashboard data suggested.

The data from NHS England’s mental health dashboard, which launched last year, showed that mental health spending by CCGs rose to £9.7bn in 2016-17, from £9.1bn the previous year.

While most CCGs and sector overall managed to meet the mental health investment standard – raising their spending on the sector in line with their allocation growth – 32 failed to meet the national target.

Phil Moore, chair of the Mental Health Commissioners Network, part of NHS Clinical Commissioners, said CCGs were “serious and ambitious” about improving mental health services.

He said NHSCC had called for a planned extra £1.25bn for children’s mental health to be ringfenced.

An NHS England spokesman said £280m of extra funding a year was being committed to improve outcomes for young people, including 70 community eating disorder teams.

He said last year CCG spending on overall mental health was ”far in excess of the required spending to meet the mental health investment standard.”