Four sustainability and transformation plan regions have failed to raise mental health spending as mandated by national leaders, HSJ can reveal.

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.

STP responses

A spokesman for Oxfordshire CCG said its proportion of mental health spending had gone down because it had not managed to match the seven per cent allocation growth for 2016-17.

He added: “In October 2015 the new mental health outcomes based contract commenced which was a negotiated agreement around improved mental health outcomes for a flat cash envelope.

“As we were only six months into this contract [in April 2016] there was no need to invest further into this. There were funding increases in out of scope of OBC mental health services but obviously this wouldn’t equate to a seven per cent uplift in total for mental health.”

James Murray, programme director for Northamptonshire STP, said: ”Based on the submitted STP in October and supporting templates, there is no intention on reducing spending on mental health in Northamptonshire”

A Dorset STP spopeswoman said: ”Dorset CC) would like to emphasise that although the percentage of our total allocation spent on mental health may have gone down, it doesn’t necessarily mean that our mental health spend has gone down. It could equally mean that we have invested heavily in another area which simply changes the proportions.”

Milton Keynes, Bedforshire and Luton STP were approached for comment.

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

STP/CCG area (STP area in bold)Percentage change in planned mental health  spend as proportion of overall CCG allocation from 2015-16 to 2016-17Mental health investment standard achieved in 2016-17
Milton Keynes, Bedfordshire and Luton -1.55%  
Bedfordshire -4.21% No
Luton 0.13% No
Milton Keynes 2.19% Yes
Dorset -0.76%  
Dorset -0.76% No
Buckinghamshire, Oxfordshire and Berkshire West -0.28%  
Oxfordshire -5.35% No
Ayelsbury Vale 4.19% Yes
North and West Reading 2.11% Yes
South Reading 2.38% Yes
Newbury and District 1.68% Yes
Wokingham 2.31% Yes
Chiltern 2.68% Yes
Northamptonshire -0.15%  
Corby 1.61% Yes
Nene -0.28% Yes
South East London 0.90%  
Bexley 0.24% No
Bromley 1.92% Yes
Greenwich 0.91% No
Lambeth 0.77% Yes
Lewisham 0.55% Yes
Southwark 1.56% Yes
Hertfordshire and West Essex 1.10%  
Herts Valleys 1.61% Yes
West Essex -0.82% No
East and North Hertfordshire 1.57% Yes
North West London 1.32%  
Hammersmith and Fulham 0.68% Yes
Brent 2.51% Yes
Ealing -4.78% No
Harrow 5.31% Yes
Hillingdon 3.34% Yes
Hounslow 5.14% Yes
Central London (Westminster) 6.25% No
West London -0.46% Yes
Staffordshire 1.36%  
North Staffordshire 4.13% Yes
Stafford and Surrounds 4.25% No
Stoke on Trent 0.24% No
Cannock Chase 5.52% No
South East Staffordshire and Seisdon Peninsula -4.95% No
East Staffordshire -1.60% No
North Central London 1.63%  
Barnet -0.81% Yes
Camden 2.37% Yes
Islington 1.30% Yes
Enfield 5.63% Yes
Haringey 0.85% Yes
Mid and South Essex 1.66%  
Thurrock 1.96% Yes
Castle Point and Rochford 8.08% No
Basildon and Brentwood -1.84% No
Southend 0.62% Yes
Mid Essex 1.63% Yes
Bristol, North Somerset, South Gloucestershire 1.73%  
Bristol 0.93% Yes
North Somerset 2.05% No
South Gloucestershire 2.94% Yes
Bath, Swindon and Wiltshire 1.81%  
Bath and North East Somerset 5.67% Yes
Swindon 0.60% Yes
Wiltshire 0.68% Yes
Cornwall and the Isles of Scilly 1.86%  
Kernow 1.86% No
Frimley Health 2.01%  
Bracknell and Ascot 3.23% Yes
North East Hampshire and Farnham 2.52% Yes
Slough 1.78% Yes
Surrey Heath 1.19% Yes
Winsor, Ascot and Maidenhead 0.82% Yes
Suffolk and North East Essex 2.42%  
Ipswich and East Suffolk 5.03% Yes
West Suffolk 1.04% Yes
North East Essex 0.24% No
Devon 2.46%  
South Devon and Torbay 0.23% No
Northern, Eastern and Western Devon 3.06% No
Norfolk and Waveney 2.53%  
North Norfolk 1.88% Yes
Norwich 1.88% Yes
South Norfolk 4.23% Yes
Great Yarmouth and Waveney 2.40% Yes
West Norfolk 2.47% Yes
Kent and Medway 2.61%  
Ashford 7.98% Yes
Canterbury and Coastal 5.14% Yes
South Kent Coast 3.20% Yes
Thanet 4.95% Yes
Dartford, Gravesham and Swanley 0.61% No
Medway 1.00% Yes
West Kent 0.86% Yes
Swale 2.08% Yes
South West London 2.67%  
Croydon 3.00% Yes
Kingston 1.17% Yes
Merton 2.10% Yes
Richmond 2.15% No
Sutton 5.22% Yes
Wandsworth 2.52% Yes
Somerset 3.35%  
Somerset 3.35% Yes
Surrey Heartlands 3.44%  
Guildford and Waverley 4.23% Yes
Surrey Downs 5.97% Yes
North West Surrey 1.15% Yes
Cambridgeshire and Peterborough 3.47%  
Cambridgeshire and Peterborough 3.47% Yes
West, North and East Cumbria 3.58%  
Cumbria (crosses 2 STPs) 3.58% Yes
Northumberland, Tyne and Wear 3.74%  
Northumberland 6.96% Yes
Newcastle and Gateshead 0.89% Yes
North Tyneside -4.47% No
South Tyneside 0.34% Yes
Sunderland 11.22% Yes
Coventry and Warwickshire 3.78%  
Coventry and Rugby 1.00% No
Warwickshire North -1.23% No
South Warwickshire 12.31% Yes
Greater Manchester 3.98%  
Bolton 2.86% Yes
Central Manchester 2.58% Yes
North Manchester 0.32% Yes
South Manchester 0.07% Yes
Stockport 2.93% Yes
Trafford 2.36% Yes
Wigan Borough 10.82% Yes
Oldham 10.46% Yes
Salford 3.49% Yes
Bury 2.17% Yes
Tameside and Glossop 2.90% Yes
Heywood, Middleton and Rochdale 1.83% Yes
Sussex and East Surrey 4.00%  
Crawley 1.61% Yes
East Surrey 3.16% No
Brighton and Hove 1.70% Yes
High Weald Lewes Havens 11.18% Yes
Horsham and Mid Sussex 0.82% Yes
Coastal West Sussex 5.42% Yes
Eastbourne, Hailsham and Seaford 9.72% Yes
Hastings and Rother 0.53% Yes
South Yorkshire and Bassetlaw 4.41%  
Barnsley 13.76% Yes
Doncaster 0.69% Yes
Sheffield 0.45% No
Bassetlaw 0.50% No
Rotherham 10.32% Yes
Coast, Humber and Vale 5.30%  
Hull 2.11% Yes
North East Lincolnshire 8.53% Yes
North Lincolnshire 2.03% Yes
East Riding of Yorkshire 2.52% Yes
Scarborough and Ryedale 9.97% No
Vale of York 8.95% No
Cheshire and Merseyside 5.64%  
Knowsley 11.64% Yes
Wirral 2.60% Yes
South Sefton -0.42% No
Southport and Formby 0.93% No
Eastern Cheshire 1.64% Yes
Liverpool 11.38% Yes
Halton 10.11% Yes
St Helens 11.85% Yes
South Cheshire 0.12% No
Vale Royal 2.18% No
Warrington 0.02% Yes
West Cheshire 2.37% No
Durham, Darlington and Tees, Hambleton, Richmondshire and Whitby 6.22%  
Durham Dales, Easington and Sedgefield 12.59% Yes
Darlington 2.20% Yes
South Tees 2.37% Yes
Hambleton, Richmondshire and Whitby 0.24% No
Hartlepool and Stockton-on-Tees 1.89% Yes
North Durham 12.35% Yes
Herefordshire and Worcestershire 6.43%  
Redditch and Bromsgrove 2.16% Yes
South Worcestershire 16.27% Yes
Wyre Forest 0.76% Yes
Herefordshire -0.12% No
West Yorkshire 6.54%  
Airedale 2.36% Yes
Bradford City 14.92% Yes
Bradford Districts 11.75% Yes
Calderdale 12.16% Yes
Greater Huddersfield 1.13% Yes
Harrogate and Rural District 15.79% Yes
Leeds North 1.86% Yes
Leeds South and East 0.82% Yes
Leeds West -0.07% Yes
North Kirklees 1.29% Yes
Wakefield 13.50% Yes
The Black Country 6.93%  
Dudley 10.89% Yes
Sandwell and West Birmingham 13.86% Yes
Walsall -3.81% No
Wolverhampton 2.00% Yes
Birmingham and Solihull 8.01%  
Birmingham and Crosscity 8.46% No
Birmingham South and Central 13.59% Yes
Solihull -0.48% No
Hampshire and the Isle of Wight 8.60%  
Fareham and Gosport 13.32% Yes
Isle of Wight 3.41% Yes
North Hampshire 1.21% Yes
South Eastern Hampshire 14.67% Yes
Southampton 0.23% No
West Hampshire 12.19% Yes
Portsmouth 11.27% Yes
Lancashire and South Cumbria 8.77%  
Blackpool CCG 14.71% Yes
Chorley and South Ribble 8.94% Yes
Fylde and Wyre 11.38% Yes
West Lancashire 1.61% Yes
Blackburn with Darwen 11.70% Yes
East Lancashire 8.33% Yes
Lancashire North 7.12% Yes
Greater Preston 9.75% Yes
Cumbria (crosses 2 STPs) 3.58% Yes
North East London 10.73%  
Barking and Dagenham 11.67% Yes
City and Hackney 1.44% Yes
Havering 11.16% Yes
Tower Hamlets 18.47% Yes
Waltham Forest 11.51% Yes
Newham 13.67% Yes
Redbridge 8.02% No
Gloucestershire 11.44%  
Gloucestershire 11.44% Yes
Shropshire and Telford and Wrekin 11.93%  
Shropshire 12.95% No
Telford and Wrekin 9.84% Yes
Lincolnshire 12.01%  
Lincolnshire East 10.95% No
Lincolnshire West 12.89% Yes
South Lincolnshire 10.61% No
South West Lincolnshire 14.39% Yes
Leicester, Leicestershire and Rutland 12.43%  
East Leicestershire and Rutland 13.67% Yes
Leicester City 12.02% Yes
West Leicestershire 11.84% Yes
Nottinghamshire 12.84%  
Mansfield and Ashfield 11.97% Yes
Newark and Sherwood 10.74% Yes
Nottingham City 15.21% Yes
Nottingham North and East 10.45% Yes
Nottingham West 10.81% Yes
Rushcliffe 14.55% Yes
Derbyshire 14.89%  
Erewash 13.70% Yes
Hardwick 9.74% Yes
North Derbyshire 11.41% Yes
Southern Derbyshire 19.00% Yes


Exclusive: Where mental health spending misses national target