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The Royal College of Psychiatrists Improving the lives of people with mental illness

NHS England’s Five Year Forward View

In October 2014, NHS England published its Five Year Forward View. This set out how the NHS needs to adapt to ‘take advantages of the opportunities that science and technology offer patients, carers and those who serve them’ and how it needs to evolve to meet the new challenges of people ‘liv[ing] longer, with complex health issues’.

The RCPsych Policy Unit produced a briefing outlining the main elements of the plan that relate particularly to mental health: RCPsych Policy Unit - Summary briefing on NHS E Five Year Forward View Nov 2014


Overview of Government’s response to the Five Year Forward View for Mental Health, assessed against College priorities for the Strategy

The government published its response to the Five Year Forward View for Mental Health on 9th January. This came on the same day as the Prime Minister spoke on children and young people’s mental health and announced a forthcoming joint Department for Health and Department for Education green paper on children’s mental health, mental health first aid training for teachers and trials of closer working between schools and NHS services.

View the President’s response to these announcements

The Government’s decision to accept all the recommendations of the Five Year Forward View and its commitment to improving mental health which was set out in the Prime Minister’s speech is strongly welcomed by the College. This page sets out some of the key items which the College has campaigned for and the corresponding government responses.

The College will continue to monitor and engage with government activity in relation to these commitments as appropriate, and continue to advocate for further action where necessary.

View the recommendations of the Five Year Forward View

View NHS England’s implementation plan for the Five Year Forward View


Transparency and accountability on funding allocation

  • The College sought commitment from DH that they will hold the NHS to account for ensuring the full allocation of additional resources for mental health services and that is spent by CCGs.
    • Department of Health have committed to ‘taking steps’ to hold the NHS to account for ensuring the full allocation of additional resources for mental health services in the NHS. This builds on NHS England’s introduction of indicators with the CCG Improvement and Assessment Framework and requirements in the guidance for developing Sustainability and Transformation Plans so that CCGs demonstrate they are doing this. This pledge is extremely welcome. Clarity is now needed on what levels DH will use and how they will be applied.


  • The College sought DH commitment to taking action to improve the availability and transparency of mental health data.
    • The DH has committed to working with NHS Digital, NHS England, NHS Improvement and MyNHS to improve the availability and transparency of mental health data.
    • The Mental Health Five Year Forward View Dashboard was published in October 2016 and will help us to monitor how their programmes are helping to improve mental health services across the country. This is welcome but there have been flaws with early data returns to the dashboard. This needs to be improved in order for CCGs to be held accountable for their spending on mental health services. The College is working closely with NHS England to ensure that future data returns to the dashboard are accurate.
  • The College called for a five-year data plan for the NHS.
    • NHS England, NHS Improvement, Public Health England (PHE), Health Education England (HEE) and NHS Digital, together with the DH, are developing a five-year data plan to address the need for substantially improved data on prevalence and incidence, access, quality, outcomes, prevention and spend across mental health services. DH expect to publish an update on progress against each of the data recommendations in early 2017.
  • The Commission on Acute Adult Psychiatric Care (CAAPC) recommended the DH lead a review of the Mental Health Services Data Set (MHSDS) to ensure it is fit for monitoring and evaluating acute care pathways. It was also recommended that the MHDS be converted into publicly available performance measures that enable local and national analysis of the state of acute mental healthcare and outcomes. The CAAPC also recommended that available information to be brought together into a single resource to support local operational management.
    • DH have introduced a new annual schedule of updates to the MHSDS to ensure that the dataset is capturing all relevant data items to accurately measure performance and delivery.
    • Collaborative work is underway, under the auspices of the Mental Health Data and Information Programme Board, to ensure the right information is reported nationally and is being fed back to providers and commissioners in a useful manner, and that local systems are able to make the data flow effectively.
    • Mental health has been chosen as the pilot for developing more sophisticated data presentation on the My NHS website (, and in particular to show changes in performance over time, so it will be easier for the public to access and understand local mental health data.

    NB. the College expects NHS England to issue a response to the recommendations of the Commission on Acute Adult Psychiatric Care in Spring 2017.

  • The College called for a minimum service expectation to be agreed between DH, NHS Digital and key stakeholders for 2016/17, including agreed changes to Version 2 of the Mental Health Services Data Set (MHSD).
    • This has been accepted and the process for agreeing 2017/18 service expectations and Version 3 of the MHSD began in November 2016.
  • The College wanted the establishment of a new children and young people’s mental health prevalence survey.
    • This has been commissioned and is on track for reporting in 2018.


  • The College sought a commitment to GPs receiving additional training on mental health.
    • HEE is working with NHS England and the Royal College of General Practitioners on improving and extending the training available.
    • The Government is also supporting the expansion of programmes that train people to qualify as social workers and contribute to ensuring the workforce is ready to provide high quality social work services in mental health. This includes investing over £10m to support the fast track Think Ahead programme – which aims to increase the number of mental health social workers by at least 300.


  • The College campaigned for the bidding process for digital exemplars to be open to Mental Health Trusts as well as acute trusts.
    • Six Mental Health Trusts will now take the role of Global Digital Exemplars. These trusts will be selected to focus on improving informatics and technology with the aim of providing higher quality, safer care. Their innovations can then be shared with other Mental Health Trusts, enabling them to rapidly benefit from improvements in the use of information technology.
    • DH will also develop six digital tools, most with a particular focus on children and young people’s mental health, for inclusion in an online library of digital apps for health to be launched by April 2017. The College welcomes this; however, would want to ensure that evaluation is undertaken into the effectiveness, quality, patient satisfaction and safety of these apps.
    • The mental health content on NHS 111 will improve, with a dedicated module clinical triage for mental health, for use by NHS 111 advisers and clinicians to improve diagnosis and referral into care when people contact NHS 111 with a mental health condition.
    • NHS England will review and redevelop the mental health content of and enhance the site’s signposting to services so that the public can access up-to-date information to support their mental health.


  • The College called on the DH to work with PHE and local authorities to ensure that every local area has a multi-agency suicide prevention plan in place by 2017.
    • To date, DH have worked with local authorities to improve this position and a survey by PHE in 2016 showed that 95% of local authorities now have a multi-agency suicide prevention action plan in place or in development.


  • The College wanted a 10-year Strategy for Mental Health Research to be developed and for mental health research to be given funding parity with other areas of health research funding:
    • DH is leading the development of the 10-year Strategy for Mental Health Research with a steering group which the College participates in. The Strategy is due to be published in spring 2017.
    • A new Policy Research Unit for Mental Health, to commission, fund and manage leading research to support policy makers, will be established in 2017, the bids and proposals for which are currently under consideration. The successful institution will be announced shortly.

Parity through legislation

  • The College advocated for health care legislation to extend rights equally to people experiencing mental health problems.
    • The DH states it is working consistently to ensure that health care legislation extends rights equally to people experiencing mental health problems and we will always consider opportunities to improve it further in the interest of patients.
    • The Policing and Crime Bill, when enacted, will reduce the time that mentally ill people can spend in detention after a Section 136 from 72 hours to 24 hours.
  • The College wanted a comprehensive health and justice strategy in order for mental health service providers to respond to the criminal justice system, providing treatment requirements in a timely way.
    • The Department of Health and the Ministry of Justice are working together to develop a strategy to ensure that mental health issues are addressed as part of community sentencing and early intervention programmes.


  • The College continues to work to tackle the stigma against mental health and to call on Government to take action to secure further progress in reducing stigma:
    • The DH has awarded a further £12.5m to the national Time to Change anti-stigma campaign up to 2020/21 to improve the attitudes of people towards mental health. Investment up to 2020/21 will be more than £20m. To date, Time to Change have reported improved attitudes to mental health in over 3.4 million people. The DH continues to monitor the implementation of the Time to Change programme to ensure it achieves further improvements in attitudes towards mental health.
    • Continued focus on tackling stigma in the public is important and welcome. But as numbers of doctors training in psychiatry have dropped 10% between 2012 and 2015 it is crucial that stigma is also tackled among other medical professionals and in medical students. The College continues its campaign, “Ban the Bash”, against stigmatisation of psychiatric careers.


  • The College has campaigned for more funding to be allocated to addictions services.
    • The Cabinet Office is allocating £30 million for outcome-based interventions to tackle alcoholism and drug addiction through proven approaches. This requires local areas to demonstrate how they will integrate assessment, care and support for people with co-morbid substance misuse and mental health problems.
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