Long Term Plan for the NHS in England

In January 2019, NHS England published a Long Term Plan for the NHS in England. This set out how the NHS would allocate its funding and what its priorities would be for the next five to ten years.

Rolling out the Community Mental Health Framework: 8 key messages

We have prepared eight key messages to support planning and implementation of community transformation across England.

The Community Mental Health Framework for adults and older adults describes how the Long Term Plan’s vision for a place-based community mental health model can be realised, and how community services should modernise to offer whole-person, whole-population health approaches, aligned with the new Primary Care Networks.

What does the Long Term Plan say about mental health?

Some of the key funding and policy commitments relating to mental health are:

  • A growth in investment in mental health services faster than the NHS budget overall for each of the next five years.
  • Mental health will receive a growing share of the NHS budget, worth in real terms at least a further £2.3 billion a year by 2023/24.
  • Funding for children and young people’s mental health services will grow faster than both overall NHS funding and total mental health spending.
  • By 2020/21, the NHS will ensure that at least 280,000 people living with severe mental health problems have their physical health needs met. By 2023/24, a further increase in the number of people receiving physical health checks to an additional 110,000 people per year, bringing the total to 390,000 checks delivered each year including the ambition in the Five Year Forward View for Mental Health.
  • By 2020/21, all acute hospital have an all-age mental health liaison service in A&E departments and inpatient wards by 2020/21, and that at least 50% of these services meet the ‘core 24’ service standard as a minimum. By 2023/24, 70% of these liaison services will meet the ‘core 24’ service standard, working towards 100% coverage thereafter.
  • New and integrated models of primary and community mental health care will support adults and older adults with severe mental illnesses. This new community-based offer will include access to psychological therapies, improved physical health care, employment support, personalised and trauma-informed care, medicines management and support for self-harm and coexisting substance use. 
  • Increasing access to evidence-based care for women with moderate to severe perinatal mental health difficulties and a personality disorder diagnosis, to benefit an additional 24,000 women per year by 2023/24, in addition to the extra 30,000 women getting specialist help by 2020/21.
  • By 2023/24, at least an additional 345,000 children and young people aged 0-25 will be able to access support via NHS funded mental health services and school or college-based Mental Health Support Teams. Over the coming decade, the goal is to ensure that 100% of children and young people who need specialist care can access it.
  • By 2023/24, an additional 380,000 adults and older adults will be able to access NICE-approved IAPT services.

    Read our brief on the Long Term Plan 

How will these changes be implemented?

All local areas in England have been tasked with developing strategic plans by November 2019 to deliver this transformation in their local area.

Over summer 2019 NHS England and NHS Improvement published the NHS Mental Health Implementation Plan 2019/20 – 2023/24 to provide guidance for local areas on how to deliver the mental health ambitions within the Long Term Plan through the development and delivery of their local plans for the next 5 years.

The guidance is primarily aimed at the leaders of local STP/ICS (integrated care system) areas and sets out information on funding, transformation activities and indicative workforce numbers to support the development of plans, which are due to be completed by the end of this year.

It is crucial that all local areas take this guidance into account when devising their local plans. Please do take any opportunity to raise this guidance with colleagues in your local area.

What work is the College doing on the Long Term Plan?

To help shape the plan, we submitted our proposal for change to NHS England. This included a vision to achieve the biggest expansion in access to mental health services across Europe through integrated models of care, with equal attention given to people with severe and enduring mental illnesses as those with common mental health problems. Since the publication of the Plan, the College has been working to help make sure it is successfully implemented.

RCPsych proposals for the NHS LTP (PDF)

What were the College's proposals for reform for the Long Term Plan?

In our submission, we called on the Department of Health and Social Care (DHSC), other relevant government departments, NHS England (NHSE), the other ALBs of the NHS, and relevant organisations to:

  1. Commit to the biggest expansion in access to mental health services across Europe, empowering the disempowered with a much-needed focus on tackling inequalities, fit for a modern NHS. 
  2. Enable the NHS to become the safest, most effective, and transparent health system in the world with mental health trusts leading the way.
  3. Empower mental health leaders to develop the healthcare services of the future through Integrated Care Systems (ICS) and Providers (ICP). 
  4. Build a strong and resilient mental health workforce with 70,348 more staff on the ground by 2028/29 (excluding Mental Health Support Teams), of which 4,218 will be psychiatrists. 
  5. Invest an additional £6.198bn (£5.677bn revenue and £521m capital) in mental health services between 2019/20 – 2023/24 and a further £7.456bn (£6.520bn revenue and £936m capital) between 2024/25 – 2028/29.
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