More than half of CCGs 'need to improve mental health services'

The national body has published rankings of CCGs based on the quality of mental health care for the first time, along with a new “dashboard” showing how each commissioner performs on a set of finance and performance measures.

The controversial CCG improvement and assessment framework, published by NHS England, ranked 127 of the 209 CCGs as either “needs improvement” (106) or “greatest need for improvement” (21).

Only 13 commissioning groups managed to secure the rating of “top performing”, while 69 were judged to be “performing well”.

The new rankings published on the MyNHS site are based on how well CCGs perform against the early intervention in psychosis and improving access to psychological therapies targets.

NHS England national mental health director Claire Murdoch, who is also chief executive of Central and North West London Foundation Trust, told HSJ there are plans to expand the ratings with three new indicators on:

• children’s mental health;
• physical health for people with severe mental illnesses; and
• out of area treatments.

She stressed that the data used to draw up the list came from January and March this year, so some CCGs will have already improved.

Ms Murdoch added: “This has been a work in progress and it still is.

“We know that CCGs have improved their performance and are moving forward.

“We hope together the [CCG ratings] and dashboard will be a means to help CCGs understand how they are benchmarked against others and shine a light on that.”

CCG Name	Overall Rating	IAPT Recovery Rate	EIP 2 Week Wait
NHS NORTH LINCOLNSHIRE CCG	Top performing	67.60%	100.00%
NHS SOUTH WEST LINCOLNSHIRE CCG	Top performing	61.20%	100.00%
NHS STOKE ON TRENT CCG	Top performing	59.10%	78.30%
NHS NEWBURY AND DISTRICT CCG	Top performing	55.80%	100.00%
NHS DORSET CCG	Top performing	56.10%	94.50%
NHS SOUTH CHESHIRE CCG	Top performing	58.90%	100.00%
NHS TRAFFORD CCG	Top performing	55.30%	82.60%
NHS BATH AND NORTH EAST SOMERSET CCG	Top performing	59.80%	90.00%
NHS HORSHAM AND MID SUSSEX CCG	Top performing	58.10%	85.70%
NHS WOKINGHAM CCG	Top performing	55.90%	100.00%
NHS NOTTINGHAM WEST CCG	Top performing	55.10%	80.00%
NHS NORTH DERBYSHIRE CCG	Top performing	56.80%	75.00%
NHS SOUTH READING CCG	Top performing	55.00%	100.00%

CCG Name	Overall Rating	IAPT Recovery Rate	EIP 2 Week Wait
NHS BURY CCG	Greatest need for improvement	47.50%	33.30%
NHS BIRMINGHAM SOUTH AND CENTRAL CCG	Greatest need for improvement	46.40%	22.00%
NHS DARTFORD, GRAVESHAM AND SWANLEY CCG	Greatest need for improvement	47.60%	30.00%
NHS DURHAM DALES, EASINGTON AND SEDGEFIELD CCG	Greatest need for improvement	43.90%	48.50%
NHS HEYWOOD, MIDDLETON AND ROCHDALE CCG	Greatest need for improvement	43.90%	25.00%
NHS STOCKPORT CCG	Greatest need for improvement	44.00%	0.00%
NHS BIRMINGHAM CROSSCITY CCG	Greatest need for improvement	45.50%	16.00%
NHS BARNET CCG	Greatest need for improvement	43.60%	48.40%
NHS MANSFIELD AND ASHFIELD CCG	Greatest need for improvement	47.60%	7.10%
NHS LEWISHAM CCG	Greatest need for improvement	43.50%	36.40%
NHS DARLINGTON CCG	Greatest need for improvement	41.90%	25.00%
NHS HARROGATE AND RURAL DISTRICT CCG	Greatest need for improvement	43.10%	0.00%
NHS DUDLEY CCG	Greatest need for improvement	42.60%	46.20%
NHS TAMESIDE AND GLOSSOP CCG	Greatest need for improvement	39.10%	11.10%
NHS HULL CCG	Greatest need for improvement	42.90%	38.50%
NHS SCARBOROUGH AND RYEDALE CCG	Greatest need for improvement	37.00%	33.30%
NHS SHEFFIELD CCG	Greatest need for improvement	41.10%	48.20%
NHS EAST STAFFORDSHIRE CCG	Greatest need for improvement	37.10%	33.30%
NHS TELFORD AND WREKIN CCG	Greatest need for improvement	42.40%	33.30%
NHS SOUTHWARK CCG	Greatest need for improvement	35.40%	28.60%
NHS NORWICH CCG	Greatest need for improvement	40.80%	31.60%

NHS England has also today published a mental health dashboard, which shows how commissioners fare against a set of finance and performance indicators including:

• mental health spend as proportion of a CCG’s allocation;
• planned mental health spending;
• length of stay in secure inpatient care;
• number of patients placed in police cells as a place of safety; and
• whether the CCG is hitting access and waiting time standards.

Ms Murdoch said the dashboard will show whether a promised £3.97bn investment in mental health was reaching frontline services.

She said NHS England will work with CCGs to drive up standards if they need improvement, but stressed the new information was meant to help the whole system.

Ms Murdoch said: “This is not just for mental health trusts or CCGs, this for the entire system to deliver more modern and effective treatment.

“The whole purpose of the dashboard is both to drive improvement and enable the public to hold us to account for delivering these improvements.

“Transparency is paramount. We are deadly serious about investment getting to the front line.”

Former Mental Health Network chief executive Stephen Dalton told HSJ 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.

Ms Murdoch has previously stressed that NHS England will intervene if areas fail to invest new funding properly.

The new ratings are part of the CCG improvement and assessment framework, announced by health secretary Jeremy Hunt at HSJ’s annual lecture last October.

Under his proposal NHS England was due to employ the Ofsted style terms also employed by the Care Quality Commission, but this was dropped in favour of the less blunt termsafter opposition from CCGs and within NHS England, as HSJ revealed in July.

The dashboard will be updated every quarter starting from January, while the CCG ratings will be refreshed annually every June.