A key opportunity to revolutionise mental health care could be missed because flagship NHS schemes are not doing enough to put it at the heart of services, according to a new report by The King’s Fund and the Royal College of Psychiatrists.
The report, Mental health and new models of care, looks at mental health in vanguard areas – flagship NHS schemes that bring services together. These include groups of GP surgeries working collaboratively to cater for up to 50,000 patients and NHS organisations coming together to deliver the full range of health care in their area.
There is strong evidence that addressing mental and physical health needs together is better for patients and can be more cost effective. The report finds that the approach to mental health in some vanguards has had a positive impact. In the Tower Hamlets Together vanguard in East London, for example, the number of bed days accounted for by people with dementia, serious mental illness and depression has reduced by 12.7 per cent.
But across all the vanguards, the report finds that mental health has not been a high enough priority and that service changes to bring mental and physical health together have not been ambitious enough. It calls for lessons to be learned as new ways of delivering services are rolled out across the country.
The report urges areas that are developing new ways of working – particularly through sustainability and transformation plans - to offer more mental health support in GP surgeries and in hospitals, and to consider mental health as a key part of their approach to public health.
Chris Ham, Chief Executive of The King’s Fund, said: ‘Some of the vanguards have made real progress on mental health, but overall we need to go much further. The approaches being developed in the vanguards are intended to be a blueprint for the future of the NHS, so mental health needs to be at their core.
‘Getting this right means better quality care, and could also help the NHS to meet the challenge of providing health care free at the point of use to an ageing population.’
RCPsych president Professor Sir Simon Wessely said: ‘These integrated care models offer a pathway to revolutionised health services in this country, but the report’s findings are worrying.
‘In addition to giving health providers greater incentives to fully integrate mental health into all their physical health services, we need to properly evaluate these models so we know what works and what doesn’t.’
Notes to editors:
Integrating mental and physical health is one of the three key priorities identified in NHS England’s five-year plan for mental health, and the NHS’s five year forward view delivery plan published in March set out the aim to ‘make the biggest national move to integrated care of any major western country’.
The five new care models in the vanguards are:
multispecialty community providers (MCPs) – groups of GP practices working together with a range of community health services to cover a patient population of between 30,000 and 50,000
primary and acute care systems (PACS) – single organisations that take responsibility for delivering a full range of primary, community, mental health and hospital services
urgent and emergency care models (UEC) – networks of local NHS services aiming to improve the co-ordination of urgent and emergency care services and reduce pressures on A&E departments
acute care collaboration models (ACC) – hospital networks that focus on developing co-ordinated approaches to specific medical areas such as cancer, orthopaedics, neurology and mental health
enhanced health in care home models – NHS services working with care home providers and local councils to develop new forms of support for older people.
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