Mental health care pathways

We develop guidance for NHS England and NICE to support delivery of the ambitions set out in The Five Year Forward View for Mental Health.

  • We set out evidence-based mental health care pathways that promote timely and equal access to effective treatment and health care
  • We provide guidance to commissioners and service providers on how the pathways can be implemented and the benchmarks achieved.

For each topic we developed detailed implementation guidance with accompanying appendices and helpful resources.

You can also access a short format guide, which provides a summary of the pathway and benchmarks, and an overview of the policy and strategic context for each topic.

Speech bubble with early intervention care comment

In response to the Mental Health Taskforce, there was a drive to make sure people experiencing first episode psychosis have timely access to evidence-based care.

The Implementing the EIP access and waiting time standard: guidance (PDF) describes in detail how commissioners and providers can implement the pathway for EIP services.

See also:

Speech bubble with dementia care comment

As set out in The Prime Minister’s challenge on dementia 2020 and the  Five Year Forward View, good evidence-based dementia care is of prime importance in order to increase the number of people being diagnosed and starting treatment, and improve post-diagnostic support.

You can find out more about the policy drivers and strategic context for transforming dementia care in our short guide to dementia care (PDF).

Our The dementia care pathway: full implementation guidance (PDF) outlines the pathway and associated benchmarks to support improvements in the delivery and quality of care and support, for people living with dementia and their families and carers. It accompanies, and builds on a shorter guide published by NHS England above and contains key commissioning and service development considerations.

The dementia care pathway: appendices and helpful guidance (PDF) includes a diagram of the full pathway, a summary of NICE recommended care for people along the Dementia Well Pathway, information on HEE’s Dementia Core Skills Education and Training Framework and on NHS England Dementia: Good Care Planning, guidance for recording dementia care pathway benchmarks in the MHSDS, recommendations for outcomes measurement and examples of services who are already providing high quality care and elements of the pathways and some helpful web-based resources.

The coding resource (xls) links to Section 4: Good Care Planning of the Dementia Care Pathway: appendices and helpful resources document above and has been developed to support this, as well as:

  • The D.E.M.E.N.T.I.A framework set out in Dementia: Good Care Planning: information for primary care and commissioners
  • The transition to SNOMED in primary care.

The coding resource spans the core components which constitute the minimum information that should be included in dementia care planning and offers a frame of reference and a view of the depth and breadth of the areas to address in dementia care planning.

Infographic of dementia pathway

Future in Mind and the Five Year Forward View for Mental Health made the case for promoting high-quality care for children and young people.

As part of this ambition, we developed a piece of guidance about eating disorders services:

The Five Year Forward View for Mental Health called for a 24/7 NHS for people with mental health problems, with high-quality urgent and emergency mental health care that is fit for purpose in a modern health care system, and accessible to people of all ages.

The following documents, covering a range of different services, set out how that ambition can be achieved:

Speech bubble with IAPT comment

The Five Year Forward View for Mental Health set out a commitment to expand IAPT services and improve quality further, with an ambition to increase access to psychological therapies for an additional 600,000 people with common mental health problems each year.

This will include those who have long-term conditions and medically unexplained symptoms.

The following documents provide practical advice about how to deliver that expansion and continue to improve quality:

The IAPT pathway for people with long-term physical health conditions and medically unexplained symptoms

The IAPT manual

We also developed the IAPT manual, which is for all commissioners, providers and clinicians of services that deliver psychological therapies. It serves as an essential manual for IAPT services, describing the IAPT model in detail and how to deliver it, with a focus on the importance of providing National Institute for Health and Care Excellence (NICE)-recommended care:

IAPT LTC Early Implementers Programme report

The following report was produced in collaboration with UCL and evaluates Wave 1 of the IAPT LTC early implementer sites:

We're also developing guidance on

  • Children and young people mental health service care pathway
  • Adult eating disorder pathway
  • Community mental health care for adults and older adults
  • Advancing mental health equality
  • Acute mental health care pathway
  • Urgent and Emergency Pathway: Blue Light, Community and children & young people
  • Children and young people's inpatient eating disorder pathway

We work with our College Centre for Quality Improvement to develop a self-assessment and improvement programme to support the delivery of the pathways.

Speech bubble with perinatal care comment

The Five Year Forward View for Mental Health highlighted a system of patchy care and fragmentation for women with perinatal mental health problems, and recommended that national clinical quality benchmarks and pathways could help to address this and support at least 30,000 more women to access mental health care during pregnancy and after giving birth. These pathways are described fully in these documents:

This guidance sets out the policy initiatives and strategic context for transforming perinatal mental health care. It explains why this transformation must be a priority for commissioners, providers and sustainability and transformation partnerships (STPs) and integrated care systems (ICSs).

This guidance provides detailed information on the pathway, what is important to people who use services, what perinatal mental health problems are and the treatments that should be provided, and the principles for delivering high quality, compassionate care.

This document includes NICE recommended care for perinatal mental health problems, recommendations for outcomes measurement and examples of services who are already providing high quality care and elements of the pathways.

Our Perinatal faculty has produced a template service specification for specialist community perinatal mental health teams. This can help commissioners to implement the perinatal mental health care pathways.


This graphic visual representation introduces the perinatal mental health care pathways.

Perinatal Self-Assessment Tool

Following the publication of the Perinatal Mental Health Care Pathways guidance, NHS England commissioned the NCCMH to develop a self-assessment tool to assist in measuring the provision of specialist community perinatal mental health teams in England.

Teams will be asked to complete an online self-assessment tool with questions on how the service operates and an audit of case notes. Self-assessment returns will be validated, and a national level report will be produced by the NCCMH. This will allow specialist community perinatal mental health teams identify strengths and weaknesses, and benchmark their performance against national averages. It will also offer providers and commissioners an indication of areas to target for service development and quality improvement.

The self-assessment will be open for teams to complete from 10 December 2018 – 29 January 2019. Specialist community perinatal mental health teams will be contacted on 10 December 2018 and given usernames and passwords which will allow teams to login and participate in the self-assessment tool. Clinicians working in the specialist community perinatal mental health team and/or the service manager will be asked to provide data for all women referred to the team between July and September 2018.

Teams will also be given a guidance document, which will provide information on what each question in the self-assessment tool is looking for. Teams will also receive a data collection sheet on 10 December which will assist services to gather data from their case notes. For a copy of the specialist community perinatal mental health team self-assessment tool and guidance document, please see below:

The NCCMH will provide advice and support throughout the process. If you have any queries or require your login username/password, please contact


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