NHS England’s Five Year
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
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
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
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
- 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
- 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
- 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
- The College campaigned for the bidding process for
digital exemplars to be open to Mental Health Trusts as well as
- 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
- NHS England will review and redevelop the mental health content
of www.nhs.uk 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
- 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
- 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
Parity through legislation
- The College advocated for health care legislation to
extend rights equally to people experiencing mental health
- 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
- 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
- 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.