• CCGs may face regulatory action if they fail to meet the the mental health investment standard in 2019-20
  • NHS England will require commissioners to grow the share of spending in children and young people services next year
  • STPs and mental health providers to sign of CCGs’s investment plans
  • Commissioners required to invest £1.50 per head of population on primary care networks in 2019-20

NHS England is set to increase rules for clinical commissioning group spending on mental health services and implement stricter controls on those failing investment standards, new planning guidance has revealed.

In its preparing for 2019-20 guidance, NHS England has said CCGs must increase spending on children and young people’s services and warned those failing the mental health investment standard could face “regulatory action”.

According to the guidance, published today, in the next financial year CCGs will have to increase the share of investment in both front line mental health provision and children and young people services, as a proportion of their overall mental health spend.

The document added that any CCGs which have historically underspent on children and young people’s services will be “required to make good on this shortfall”.

Commissioners’ investment plans for MH will need to be signed off by both their sustainability and transformation partnership leads and main mental health provider; while any CCGs which fail to achieve the mental health investment standard will face “appropriate regulatory action, including in exceptional circumstances imposing directions”.

For 2019-20 the investment standard will require CCGs to increase their spend on the sector by the same rate as the growth in their overall allocations, plus an additional percentage increase to reflect the uplift in mental health funding given to each CCG. The minimum mental health uplift for each commissioner will be published in early January, according to a timetable included in the guidance.

The news comes following promises made by the chancellor in November that spending on mental health would increase as a proportion of the NHS’s total budget over the next five years.

NHS England has said it will start examining mental health spend per head for each CCG, though not specified whether this data will be published.

In the NHS standard contract for 2019-20, NHS England has included incentives for trusts to improve the physical health of mental health patients. This was previously included in CQUIN incentives; while for the first time NHS England has included CYP eating disorder targets in the contract.

Royal College of Psychiatrists president Professor Wendy Burn said: ”It’s great that this guidance will strengthen the mental health investment standard, which means the increase in spending by commissioners on mental health services should be greater than on health services overall.

“To ensure mental health care improves, it is essential that there is complete transparency and accountability about how services are run and that the money pledged for those services reaches the front line.”

Today’s guidance also repeats the “prime minister’s commitment that funding for primary medical and community health services should grow faster than the overall NHS revenue funding settlement”.

It also continues the requirement for CCGs to invest £1.50 per head of population in primary care services for 2019-20. However, commissioners will now be required to dedicate this funding to the development of primary care networks.

STPs and integrated care systems are required to develop new primary care strategies by April 2018, which will have to include:

  • Details of their local investment and areas identified as a priority;
  • A primary care network development plan;
  • and a local workforce plan

Areas will also have to ensure their primary care network are provided with new data around their populations “to allow primary care networks to understand in depth their populations’ needs for symptomatic prevention programmes, including screening and immunisation services.”

Meanwhile, the draft NHS standard contract includes a new requirement on community services providers “to ensure that their services are organised and delivered in such a way as to integrate effectively with the local configuration of primary care networks”.

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