Health board activity

RCPsych FOI requests for budget spend by specialism were only returned by one health board in 2018. Subsequent analysis of these budgets and spend suggested that where this particular health board was overspending it was predominantly on physical health, and where it was under spending it was on mental health. This experience was confirmed anecdotally by members who had managed services in Wales. We would like to see greater transparency from health boards in this regard and publishing allocated budgets and spend regularly by service and specialism would allow us to understand more about how financial parity can be achieved in the NHS.

Health boards have independent members from the third sector, local authorities, trade unions (etc.) who provide experience and expertise in their areas. This should be extended to include mental health to restore the inconsistent representation of mental health on health boards and ensure that health boards act on important issues that are raised and discussed. 

The College Centre for Quality Improvement (CCQI) work with 90% of mental health service providers in the UK but very few of these are in the devolved nations. CCQI help services work to the best standards designed by clinician and patient groups. Studies have demonstrated that low-secure services participating in CCQI trend towards greater improvement in the quality of the physical environment compared to non-participants*. These services were also better at managing events relating to assault, self-harm, verbal abuse, substance misuse and slips and trips. The Welsh Government have already committed to delivering services that meet the CCQI Perinatal Mental Health Standards and we are working with the Welsh Government.

*Aimola, L., Jasim, S., et al. 2018. Impact of a peer-review network on the quality of inpatient low secure mental health services: cluster randomised control trial. BMC Health Services Research

Ensuring parity in funding is not just a matter of principle. Welsh mental health services have not seen an increase in recruitment of psychiatrists to match the increase in population. The resulting pressures across services are plain to see. The Welsh Government should expand the mental health budget to allow for more psychiatry posts to be established and filled, as well as funding the additional infrastructure and sundries necessary for delivering services. Increasing the mental health budget to 13% and making the same adjustment to the budget for learning disabilities (from 2.4% to 2.8%) would allow the Welsh NHS to train and recruit more psychiatrists, to bring them in line with the rest of the UK and Europe.