Will the Mental Health Taskforce report make it off the shelves? 

Dubbed ‘The five year forward view for mental health’, the much-awaited report from the independent Mental Health Taskforce chaired by Paul Farmer is an important document.

It gives an honest diagnosis of current shortcomings in mental health care in England, and a detailed analysis of how best to target available resources in the future. It follows hot on the heels of last week’s report from the Commission on Acute Adult Psychiatric Care, which gave a similarly frank assessment of the need for improvement.

A particularly encouraging message in the taskforce report is the call for mental health care to be embedded much more deeply within the wider health care system. There are welcome proposals for investment in liaison psychiatry, perinatal mental health services, physical health screening for people with mental health problems, and trialling of other service models that straddle the boundary between mental and physical health. Our forthcoming research and conference on integration of mental and physical health care will provide further evidence on the importance of this and examples of how it can be achieved in practice.

Inevitably, much of the commentary on the taskforce report has centred on one question: is it realistic? My view is that most or all of the recommendations could be achievable if the government and NHS leaders have the will to make this a priority. But it certainly won’t be easy, and one of the most significant challenges will, of course, be the money.

As has been widely remarked, the commitment to increase spending on mental health by £1 billion a year by 2020/21 comes from funding already allocated to the NHS in last year’s Spending Review. In effect, the commitment made by NHS England is that mental health services should expect to receive a proportionate share of the £8 billion pledged by the government in their 2015 election manifesto (the NHS currently spends around £1 in every £8 on mental health).

There are three significant issues that might prevent this commitment from being delivered in practice. First, in 2016/17 (and quite possibly beyond) much of the increase in NHS England’s budget will be needed to stabilise services in the short term and cover rising deficits among NHS providers (predominantly in acute trusts rather than mental health providers). This raises the prospect of most of the new money for transforming mental health services being phased in later in this parliament. It is worth remembering that the £8 billion requested by the NHS was the minimum required, leaving little headroom for investment in new service improvements.

Second, the detail behind the Spending Review settlement reveals that the £8 billion increase in the funding received by NHS England by 2020/21 will be partially paid for by reduced spending elsewhere in the health system, particularly public health, education and training. The recommendations made by the taskforce put significant emphasis on increasing investment in preventing mental illness and promoting mental health, and on placing greater priority on preventing physical ill health among people with mental health problems. There are also important recommendations for professional education and training. It is not clear how much capacity there will be to act on these recommendations in parts of the system that are set to see their budgets fall in real terms over the next four years.

Third, there is the question of whether adequate forms of oversight exist to ensure that the money gets to where it’s needed, and to hold local commissioners to account for achieving the vision that the taskforce describes. It has always been notoriously difficult to track spending on mental health services with any degree of precision, and even harder to measure outcomes. Proposals made by the taskforce for increased transparency in relation to spending by clinical commissioning groups, accompanied by a ‘data revolution’ in mental health, are therefore an indispensable part of the plan.

The last of the 58 recommendations made by the taskforce is that by summer of this year, NHS England, the Department of Health and the Cabinet Office should ‘confirm what governance arrangements will be put in place to support the delivery of this strategy’, including ‘arrangements for reporting publicly on how progress is being made’. If the work of the taskforce is to make it off the shelves and into practice, that final recommendation is arguably the most important one to watch.

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#545794 Pearl Baker
Independent Mental Health Advocate and Advisor/Carer

I have done some considerable research, and discovered that much of what is on offer will be at the demise of another service. The 'Better Care Fund' is an example £5.3 Billion half of this comes from somewhere else in the System! (health & social care) and only £2 Billion Extra. 'Robbing Peter to pay Paul'.

I now come to NHS trusts. 'To ensure the continued delivery of affordable, safe, and quality service, regulatory action can be taken to provide trusts with support, and where necessary to define compulsory action to bring the organisation back to a stable position as soon as possible.

I have campaigned for a number of years regarding those patient's placed into 'supported un-regulated accommodation' to be protected from NEGLECT.

The System of regulation provides for those patients placed into Registered accommodation i.e 'Care Homes' and similar accommodation, and no other individuals.

The CQC are NOT interested, the DOH know perfectly well what is going on, but do nothing. Thousand are out in the 'community' with no support and that will not change until there is regulation that protects them from 'NEGLECT'. these people might as well be 'dead' because as far as the system is at present, they are 'invisible'.

The trusts! well if in financial difficulty they will be supported until they are back on their 'feet', however ALL trusts are expected to sign up to a set of conditions aimed at delivery efficiencies across their services as quickly and safely as possible, and to develop sustainable plans for the future'.

Summary so far: trusts to make efficiencies savings across all services, at the same time of making services safe and deliver a quality health service, at the expense of those thousands of Mentally Ill 'invisible' to a system that has let them down, and will continue to do so.

My LA has a 44% cut in Central Government spending, so now hope here.

The CQC could help the situation by ensuring all those subject to section 117 receive all their entitlements under the LAW to include 'Care Plans' this would be 'monitored' from the Trusts records, and GP Inspections, then the 'truth' will be revealed.

My idea of all patients suffering from a LTC have a 'hand book' this will hold all relevant information on their mental health status, who and when they were seen, recorded and signed each time they are visited. Carers would have access to this and write down any concerns they have, with information of who they should contact in emergency, this is the basic idea, apparently used in Camden CCG is one of the first to provide this service, and called 'integrated digital records' not exactly how I would like to see this implemented, it should be available for Carers Comments and patients comments, and relevant contact details available to those who need it in emergency. Not as 'holistic' as I would like.

My answer to the report is too many LTC will go undetected and continue to lead an 'isolated' life as so many do at present. there is nothing in this Report that shows that any of my concerns for those in the community who do not come under Regulation will be 'Protected' from 'Neglect'.

If we can't 'protect' those placed into Regulated accommodation, there is absolutely no way it will help any others, outside the system.

The system needs a complete overall. I would like to see a new debate in how GPs provide a better service, and this is it. GPs would contract out to NHS Trusts, they would be entitled to choose what service they are interested in delivering, that way we would have a GP who is now becoming an expert in their chosen 'subject' funding would follow where it needs to be, identify problems, and ensure their patients receives their entitlements for a better and improved health and social care system.

#545795 Joanne Osmond
Healthcare Project Manager

I completely agree that the last recommendation is by far the most important if this report is to be worth the paper its written on! Why do we need to wait until summer, and does this mean start or end of summer? This is a desperate situation facing people with mental health issues, they can't wait until summer to find out how these recommendations are to be addressed.

#545801 tom mccarthy
managing director
mental health strategies

Transparency on investment and delivery was the basis of the national service and financial mapping initiative that tracked the implementation of the national service framework for mental health. It gave a very clear picture at national, commissioner and trust level of what was being spent and how to enable strategic priorities to be delivered. The initiative was stopped a few years ago at a point when the analysis began to show a decline in real terms investment in services.

The framework can easily be used to again track mental health's progress if there is a political will to shine a light on what's actually happening in the field.

We are also aware that the initiative was very much welcomed and its output used by commissioners to set plans for investment and by trusts to assess how they compared to others.

The transparency problem has a ready made solution.


While i live in hope not only as director of cic helping MH recovery for s/users but I am also a s/user who really knows whats happening on the ground ---Lancashire is suffering from cuts made at the beginning of 2009 during that time we have seen BED occupancy in Hospitals cut to unbeleavable levels along with the loss of experienced staff to early retirement if this extra money becomes available it will need to fund MH care to what it was at the beginning of 2009 before it makes any in roads to modern mh care and soc care --the NHS TRUSTS have been forced to sell off property now needed to properly accommodate talking therapies of which there are several types
The lack of talking and listening to s/users will not help move MH SOC CARE and hospital care onwards ---once again it will be a lost opportunity and likely to be money wasted again --I hope NOT !!!!

#545874 George Coxon
Various inc Chair of the MHNA & Specialist MH advisor for Cogora

Stirring stuff as ever from the Kings Fund & another excellent blog from Chris Naylor. I rarely go anywhere these days without one KF report or another. I chaired a conference stream at the Olympia centre this week at the ever popular CommissioningLive conference series I first heard Sir Muir Gray in his customary fabulous inimitable style say MH care receives c£11b of the c£113b NHS funding pot. I then chaired a high emotion session with KFs own Fellow in MH policy, Helen Gilburt and Dr Geradine Strathdee national clinical director for MH at NHS England. I'm taking this blog with me to an MHNA symposium in a few weeks to share with the several thousand MHNA members and will do me bit to highlight the work of the Taskforce for whom we have high hopes as well as the points Chris makes here. I will also make sure our MHN journal features themes too. Many thanks and keep these points and recommendations coming

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