HSJ’s fortnightly briefing covering safety, quality, performance and finances in the mental health sector. Mental Health Matters is now written by HSJ’s new mental health correspondent, Rebecca Thomas. Tell her what you think, or about issues she could write about, by emailing her in confidence at rebecca.thomas@wilmingtonhealthcare.com; or by sending a direct message on Twitter.

Rebalancing priorities

We’re in a new phase of planning for the NHS, and with it comes an opportunity to address the gaps left by the Five Year Forward View for mental health. 

Last week, Simon Stevens said there were three challenges the new long-term plan would need to tackle.

The first is the lack of integration between physical and mental health services, which has been talked about for years with too little action.

The second is for the NHS to be more assertive in making the economic case for increased investment for mental health. Having made the strong moral argument, Mr Stevens said the NHS must now show the government it is also a smart economic move.

The third challenge is the need to restrike the balance between new talking therapy services for patients with less severe conditions, and the “core services” for those with long term and severe mental health needs.

Mr Stevens admitted the latter services often “do not get the resourcing and workforce they need”, and even suggested the rise of IAPT services had come at the expense of core services.

This was a surprising admission from Mr Stevens, considering it was NHS England’s 5YFV for mental health which has spurred the spread of new IAPT services.

Recurring theme

The lack of attention for core services has been a recurring theme in my early conversations with people in the sector and was also emphasised in an all-party parliamentary group report last week, which called on NHS England to prioritise investment for adults with severe mental illness.

A good starting point, the report suggested, would be for NHS England to publish referral to treatment pathways for those services for which this has been promised. We still await many of these despite deadlines having already passed.

Speaking with several commissioners this week I found the most common bugbear was the pressure to invest in “shiny” services to hit newly mandated targets, which leaves services such as those for personality disorders neglected.

And according to the Sean Duggan, of the Mental Health Network, there is major concern that trusts are haemorrhaging staff in core services.

“We know that staff are being tempted by higher-paid exciting new roles in specialist areas,” he said.

If we really are seeing a migration of workforce from core services into newer services for less severe needs, this will be a tough issue for the long-term plan to address.

Honest evaluation

The improvement of IAPT and various specialist services is undoubtedly positive and something the sector can celebrate. But we’re now in a time of honest evaluation and sector voices are calling out for a bigger spotlight on core mental health services.

Mr Stevens’ comments suggest this could be achievable. Whitehall is in listening mode, and now is the time to get the balance right.

HSJ Regional Mental Health Network

HSJ’s regional mental health network is taking place on Tuesday 6 November and will be chaired by national mental health director for NHS England, Claire Murdoch.

It is free to attend for NHS and associated professionals, and brings together like-minded people from across healthcare, local authorities, the third sector and other relevant stakeholders who are involved in the commissioning and delivery of services to prevent, care for and support patients with mental health conditions. The meetings provide a platform for active discussion and exchange of ideas.

The next meeting in the series is the South East event, and will be held at Holiday Inn, Guildford. To book complimentary places for you and your colleagues, please register here or choose to be kept up to date about all future networks here.