Exclusive: Where mental health spending misses national target

Data analysed by the Royal College of Psychiatrists, shared with HSJ, shows that mental health funding has dropped in four STP footprints as a proportion of the total allocations given to the clinical commissioning groups in each patch between 2015-16 and 2016-17.

The regions are:

• Milton Keynes, Bedfordshire and Luton: -1.55 per cent.
• Dorset: -0.76 per cent.
• Buckinghamshire, Oxfordshire and Berkshire West: -0.28 per cent.
• Northamptonshire: -0.15 per cent.

The data comes from NHS England’s mental health dashboard, which was published last year to show how commissioners fare against finance and performance indicators.

Nine more STPs have increased their investment in mental health by less than 2 per cent and a total of 15 have done so by less than 3 per cent.

Increasing mental health spending at least in line with increases CCGs’ overall budgets is NHS England’s key measure for assessing whether commissioners are upholding the policy of “parity of esteem” for mental and physical health.

The royal college has called for CCGs to make sure the cash promised by NHS England last year for new mental health services is used to provide them.

College president Professor Sir Simon Wessely said for the STPs to succeed, mental health funding will have to increase in line with national guidelines.

He said: “I am deeply concerned that without further dedication to mental health investment, those areas falling behind will risk losing out on future funding, and will end up in a downward spiral of worsening care for those most in need.

“I would urge that STPs use this data to take note of those areas on an upward trajectory of investment, who can share notes on how they have met the standards for mental health care investment.”

While none of the individual CCGs in the four STPs were actually decreasing their total mental health spending, the college’s analysis shows that many of them were failing to increase their spending as mandated by national guidance.

The 2017-19 planning guidance, published last September, said commissioners and providers must hit access and quality standards and increase baseline spend on mental health.

The analysis follows HSJ revealing that more than a fifth of commissioners were failing to raise their mental health budgets from 2015-16 to 2016-17 by the same percentage as their overall allocation increase.

NHS Clinical Commissioners’ mental health network chair, Phil Moore, stressed commissioners are “serious and ambitious” about improving mental health services and achieving parity of esteem but there are cases where they are under pressure to invest resources in the acute sector.

Dr Moore, who is deputy clinical chair of Kingston CCG, added: “Their commitment towards improving mental health and the investment that [CCGs] are making is real but it is a fact that they are working in an incredibly financially challenged climate.

“The range of high priority and competing demands that CCGs have on their budgets can make it difficult to deliver transformation, in spite of their clear desire to do so.”

Table: Changes in planned mental health spending by STP area