- New data shows more than a fifth of commissioners are not raising mental health funding as much as directed by NHS leaders
- 46 of the 209 CCGs have failed to achieve the “parity of esteem” mental health budget increase
- Eight CCGs have cut planned mental health spending over the same period
- The new data was published as part of NHS England’s new mental health dashboard
More than a fifth of commissioners are failing to raise mental health spending by as much as directed by NHS leaders, with eight actually reporting cutting their budgets, HSJ can reveal.
New figures analysed by HSJ show 46 of the country’s 209 clinical commissioning groups have failed to raise their mental health budgets from 2015-16 to 2016-17 by the same percentage as their overall allocation increase.
Increasing mental health spending at least in line with 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 new figures, published by NHS England, also reveal that eight CCGs have cut their planned mental health funding in cash terms this year (see CCGs in bold in the table below).
Nationally 163 commissioners achieved the “parity of esteem” measure, also known as the mental health investment standard.
The figures are part of NHS England’s new mental health dashboard, which was published last week to show how commissioners fare against a set of finance and performance indicators.
NHS Confederation chief executive Stephen Dalton said in July that making sure the money pledged in the sector’s implementation plan reached the front line would be the “acid test” for the plans.
But Mr Dalton, previous chief executive of the Mental Health Network, said the new dashboard data posed questions about regional variation in services, quality and finances which needed to be addressed.
He added: “Nobody is claiming, at this stage, that this is a perfect science, so it’s important we do not allow our serious and justified concerns about funding to spill over into excessive scepticism about this important project.”
The new dashboard forms part of the national implementation plan for mental health, which pledged nearly £4bn for the sector over the next five years and sets out how CCGs are performing against a number of performance and financial targets.
The 2017-19 planning guidance, published in September, said commissioners and providers must hit access and quality standards and increase baseline spend on mental health.
NHS England has sent out guidance to commissioners and providers to help meet the implementation plans and also has an “intensive support team” going out to work with organisations to help them improve.
NHS England national mental health director Claire Murdoch told HSJ that even if CCGs are hitting their targets she still wants them to continue to increase mental health investment in line with the increase in their baseline allocations.
She stressed that CCGs could not choose which services to provide and which not to and added: “Even if you’re hitting all your targets we are saying put the additional money in anyway.
“The mental health investment standard isn’t pick and mix. This is the beginning, not the end, of a major sweep of improvements.
“This is an agenda for the whole system, it’s not a campaign for parity, it’s for improving quality and providing modern treatment which is evidence based.”
CCG responses
South East Staffordshire and Seisdon Peninsula CCG said its mental health spending had been reduced due to a ”one-off investment” being made within 2015-16, while Warwickshire North CCG said that the reduction was a mistake due to its spend in 2014-15 being overstated by £2.5, which had now been corrected.
A spokesman for Warwickshire North CCG added: “The total spend on mental health conditions in 2015-16 was £33.78m which includes specialist mental health providers, prescribing and community services.
”However, CCG spend in 2014-15 has been overstated by £2.5m and this is reflected in the CCG’s restated accounts for 2015-16. Taking this into consideration, the CCG has actually met its parity of esteem target for 2016-17.”
The CCGs not achieving parity of esteem
| CCG | 2015-16 planned spend as a proportion of allocation | 2016-17 planned spend as a proportion of allocation | Mental health outrun 2015-16 (000) | Mental health planned spend 2016-17 (000) | Cash difference 2015-17 to 2016-17 (000) | Parity of esteem |
|---|---|---|---|---|---|---|
| North Tyneside CCG | 14.81% | 14.15% | £44,607 | £41,412 | -£3,194 | No |
| Walsall CCG | 15.45% | 14.86% | £58,732 | £57,020 | -£1,712 | No |
| South East Staffs and Seisdon and Peninsular CCG | 10.16% | 9.66% | £22,553 | £20,976 | -£1,577 | No |
| Warwickshire North CCG | 15.21% | 15.03% | £34,763 | £33,690 | -£1,073 | No |
| Vale of York CCG | 10.65% | 11.60% | £46,662 | £45,861 | -£801 | No |
| Central London (Westminster) CCG | 18.28% | 19.43% | £55,027 | £54,431 | -£597 | No |
| Ealing CCG | 13.49% | 12.84% | £63,560 | £63,103 | -£457 | No |
| Shropshire CCG | 9.22% | 10.41% | £38,850 | £38,784 | -£66 | No |
| Herefordshire CCG | 15.93% | 15.91% | £36,400 | £36,484 | £84 | No |
| Richmond CCG | 12.17% | 12.43% | £28,514 | £28,626 | £112 | No |
| Stafford and Surrounds CCG | 9.86% | 10.28% | £14,839 | £14,958 | £119 | No |
| South Devon and Torbay CCG | 8.28% | 8.30% | £33,357 | £33,498 | £141 | No |
| Basildon and Brentwood CCG | 12.30% | 12.08% | £39,450 | £39,663 | £213 | No |
| Redbridge CCG | 8.99% | 9.71% | £32,984 | £33,242 | £258 | No |
| South Sefton CCG | 10.29% | 10.24% | £24,629 | £24,902 | £273 | No |
| West Cheshire CCG | 6.97% | 7.13% | £23,473 | £23,756 | £283 | No |
| Bassetlaw CCG | 13.12% | 13.18% | £20,794 | £21,082 | £288 | No |
| East Staffordshire CCG | 13.60% | 13.38% | £19,983 | £20,280 | £297 | No |
| Hambleton, Richmondshire and Whitby CCG | 10.82% | 10.85% | £20,207 | £20,533 | £326 | No |
| Cannock Chase CCG | 9.65% | 10.18% | £14,165 | £14,525 | £360 | No |
| Vale Royal CCG | 12.78% | 13.06% | £16,767 | £17,159 | £392 | No |
| Scarborough and Ryedale CCG | 10.83% | 11.91% | £18,941 | £19,348 | £407 | No |
| North Somerset CCG | 9.44% | 9.63% | £24,783 | £25,212 | £429 | No |
| Southport and Formby CCG | 11.50% | 11.60% | £20,561 | £21,001 | £440 | No |
| South Cheshire CCG | 10.18% | 10.19% | £22,361 | £22,858 | £497 | No |
| Dartford, Gravesham and Swanley CCG | 10.03% | 10.09% | £30,958 | £31,505 | £547 | No |
| South Lincolnshire CCG | 10.85% | 12.00% | £23,996 | £24,559 | £563 | No |
| East Surrey CCG | 12.88% | 13.29% | £24,442 | £25,026 | £584 | No |
| Castle Point, Rayleigh and Rochford CCG | 8.99% | 9.72% | £21,930 | £22,705 | £775 | No |
| Oxfordshire CCG | 10.33% | 9.78% | £72,777 | £73,577 | £800 | No |
| Solihull CCG | 17.26% | 17.18% | £50,159 | £50,975 | £816 | No |
| Greenwich CCG | 14.45% | 14.58% | £52,799 | £53,739 | £940 | No |
| Bedfordshire CCG | 16.05% | 15.37% | £72,209 | £73,289 | £1,080 | No |
| Lincolnshire East CCG | 12.38% | 13.74% | £45,961 | £47,053 | £1,092 | No |
| Bexley CCG | 9.91% | 9.94% | £28,481 | £29,669 | £1,188 | No |
| Stoke on Trent CCG | 13.43% | 13.46% | £50,671 | £51,895 | £1,224 | No |
| Kernow CCG | 16.64% | 16.95% | £121,814 | £123,041 | £1,227 | No |
| North East Essex CCG | 11.15% | 11.18% | £49,710 | £51,214 | £1,504 | No |
| Sheffield CCG | 18.03% | 18.11% | £135,207 | £137,088 | £1,881 | No |
| Luton CCG | 14.99% | 15.00% | £34,392 | £36,447 | £2,055 | No |
| West Essex CCG | 11.27% | 11.18% | £40,538 | £42,659 | £2,121 | No |
| Dorset CCG | 15.57% | 15.45% | £160,173 | £162,334 | £2,161 | No |
| Southampton CityCCG | 14.12% | 14.15% | £43,607 | £45,879 | £2,272 | No |
| Coventry and Rugby CCG | 15.68% | 15.84% | £91,635 | £94,139 | £2,504 | No |
| Birmingham CrossCity CCG | 13.45% | 14.59% | £133,031 | £135,820 | £2,789 | No |
| North, East, West Devon CCG | 16.95% | 17.47% | £184,251 | £187,706 | £3,455 | No |
8 Readers' comments