• BSMH FT CEO says mental health specialised commissioning will be devolved to providers
  • John Short says £1.9bn budget should be run by regional collaboratives
  • Trust examining devolved commissioning for tier 4 CAMHS services

Mental health specialised commissioning will be fully devolved to providers within the next three years, according to the chief executive of a major mental health trust.

Birmingham and Solihull Mental Health Foundation Trust chief executive John Short told HSJ he expected NHS England’s £1.9bn specialised commissioning budget would be devolved to provider collaboratives. 

“I think within two-and-a-half to three years all the £1.9bn of NHS England mental health spec comm will be run by collaboratives. That ambition is Simon Stevens’ ambition”, he said.

Mr Short said he sat on an NHS England advisory board set up to examine how more of this budget, which includes forensic adult mental health, inpatient child and adolescent mental health, and eating disorder services, can be shifted to groups of providers.

He said: “We are having some fantastic conversations and it really is about saying, ‘Actually, what we want to see is provider collaboratives’.

“We are talking about the selection criteria, not tendering or procurement, for provider collaboratives and how they would come together and take responsibility for commissioning specialised mental health services in their patch.”

About £640m of the specialised mental health budget has already been handed over to groups of providers in 17 areas as part of the pilot into new models for mental health.

Birmingham and Solihull MHFT leads one of these partnerships, Reach Out, which holds the devolved forensic adult mental health budget for the West Midlands. 

Several pilots, including Reach Out, have reported profits in their first year running, and that money has been reinvested into improving services.

Mr Short said he was also in discussions with other trusts in the region about creating more “collaboratives” to run specialist mental health budgets, including inpatient CAMHS.

“Collaboratives have to be really focused on outcomes, really focused on sharing information,” he said. “They have to challenge the service, and be prepared to decommission one of their own services.”

Mr Short will retire next March after six years as chief executive at the trust. He will be replaced by Roisin Fallon-Williams.

Speaking to HSJ, he said, while mental health service had improved immensely in the decades since he started working in the sector, big challenges remained.

“There is still, despite all the publicity, a massive stigma around health,” he said. “The real focus is on young people and resilience but when you then say, ‘We actually need services for people that have bipolar, dementia and the homeless’, it’s like, ‘I suppose so’.

“Even within a mental health service, there is a lack of parity of esteem.”

An NHS England spokesperson said: “Following the success of the new care model programme the intention is for specialised mental health services to eventually be planned and delivered by partnerships of providers and NHS England, as well as local commissioners, in all parts of the country.

“This is in line with a wider drive to join up care – and the timing of implementation will vary according to the maturity of services and local health systems.”