Mandate: Mental health sector faces new challenges

The mandate, essentially the government’s instructions to the NHS Commissioning Board, has a large focus on making improvements to mental health services with some key aims during the next two years.

The document is littered with references to mental health being given parity of esteem with physical health services – something the coalition has long advocated.

The commissioning board will be required to measure levels of access and waiting times for mental health services and CCGs will be expected to address “unacceptable” delays and make significant improvements in access.

The mandate says the government will work with the board to “consider” new access standards, including waiting times for mental health services. It will also consider “the financial implications of any such standards”.

Increasing pressure on the mental health sector comes at a time when funding for the service has fallen in real terms for the first time in 10 years.

Providers will be under pressure to increase their service provision in the continuing tough financial climate.

The mandate says often those suffering mental health problems have worse outcomes for their physical health. Patients treated for physical conditions have mental health issues which go unrecognised.

An objective for the commissioning board “is to put mental health on a par with physical health, and close the health gap between people with mental health problems and the population as a whole”.

“By March 2015, we expect measurable progress towards achieving true parity of esteem, where everyone who needs it has timely access to evidence-based services,” it said.

According to the mandate, the government will want to see an extension to its Improving Access to Psychological Therapies programme, in particular for children and young people, and for those out of work.

The commissioning board has agreed that at least 15 per cent of adults with relevant disorders will have timely access to services, with a recovery rate of 50 per cent.

By 2015 patients will be also offered the choice of any qualified provider in community and mental health services, the mandate says.

Another large focus in the document is on dementia services – in line with the prime minister’s Dementia Challenge launched in March.

The mandate says: “The government’s goal is that the diagnosis, treatment and care of people with dementia in England should be among the best in Europe.

“The objective for the commissioning board is to make measurable progress towards achieving this by March 2015, in particular ensuring timely diagnosis and the best available treatment for everyone who needs it, including support for their carers.”

It says the commissioning board will need to work with CCGs to drive improvements in diagnosis with “a national ambition for diagnosis rates built up from local plans.”

The commissioning board will publish the expected level of diagnosis across the country through to March 2015.