Focus on acutes has left mental health facing ‘significant uncertainties’ say trust leaders

Tees, Esk and Wear Valleys Foundation Trust expects demand for its services to be 20 per cent higher than pre-covid levels, but says uncertainties around funding could “impede” progress and “wider service sustainability”.

In TEWV’s latest board papers, published in late February, a report by finance director Liz Romaniak said: “Whilst significant national funding will be targeted to effect elective recovery [acute provider] from April 2022, no similar provision has been confirmed for mental health.

“These significant uncertainties have the potential to impede progress to deliver long-term plan priorities and wider service sustainability by diluting real-terms growth. Discussions continue, including through local partnership boards, to agree immediate and future investment priorities.”

The government has allocated an extra £8bn for elective waiting list recovery over the next three years, in addition to the long-term plan settlement. Elective waiting-list backlogs have grown substantially during the pandemic.

The last major pledge for mental health was made in the long-term plan, which pledged to increase mental health funding by £2.3bn per year by 2023-24. However, the sector is now expecting far higher demand than previously envisaged.

In an interview with HSJ last week, TEWV’s chief executive Brent Kilmurray said: “Quite often, we are facing the challenge of trying to find beds and meet demand. What we’ve seen is an increase in occupancy and an increase in length of stay. And we are relating that to an increase in acuity.

“We really welcome the investment that goes into the long-term plans on the specialist services that are coming through. [But] what we want to do with our work is give greater transparency to the backlogs that have developed and some of the additional pressures.

“There isn’t necessarily the financial headroom and that is a pressure. And I think by giving that transparency, we can start to have discussions around prioritisation. We’re really keen that we lobby and pursue further financing on this.”

Lord Stevens, the former NHS England chief executive, is pursuing an amendment to the government’s health and care bill which would force greater transparency over mental health funding.

Asked about the trust’s actions to address multiple concerns around safety and quality, Mr Kilmurray said staffing had improved in forensics, although the vacancy rate is still higher than the trust average, and that a leadership development programme is aiming to improve the culture of the organisation. He said he hopes the CQC “would see significant improvement” when they are inspected again.

He added that “a lot has changed” since the high-profile deaths of two teenagers under the care of the trust, which are subject to an ongoing inquiry

He said: “We will be able to build on the legacy of those young women in terms of the learning that we want to embed within the organisation.”

The Department of Health and Social Care said in a statement: “We are making every effort to ensure everyone can access the support they need. We’re investing to expand and transform mental health services under the NHS long-term plan, which will see an additional £2.3bn going to services by 2023-24.”

It added that an additional £500m of covid spending had been made available for mental health services during 2021-22.