Mental health and learning disabilities: The first 100 days of the new government

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Part of Health and social care under the new government

The new government has continued to emphasise the commitment to parity of esteem between mental and physical health that came to the fore under the coalition.

Ministers have stated that they remain committed to parity of esteem between mental and physical health. They have confirmed commitments made by the previous government, including the introduction of new waiting time targets for mental health, which will be implemented from April next year. These are positive signs, although there has so far been little evidence of new policy initiatives. A key early test of the government’s commitment will be whether it allows unspent money for child and adolescent mental health services from this year’s budget to be carried forward to next year.

In May, the Home Secretary, Theresa May, announced that measures to tackle the use of police cells to detain people under the Mental Health Act will be included in a new Policing and Criminal Justice Bill. The Bill was announced in the Queen’s Speech but has not yet been introduced to parliament.

Provisions in the Bill will put an end to the use of prison cells to detain people with mental health issues under the Mental Health Act, and reduce the maximum number of hours an individual can be detained for medical assessment. It will also increase the number of places that are designated as places of safety for people being detained under the Mental Health Act.

The Home Secretary indicated that up to £15 million of new funding would be provided to deliver additional health-based places of safety, although subsequent reports have suggested that the additional funding would be provided from existing budgets, and will only be available for 2016/17, after which clinical commissioning groups will have to provide funding.

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In early July, the new Minister for Community and Social Care, Alistair Burt, confirmed plans to introduce new waiting time targets for mental health services. These will come into effect from April 2016.

Plans to introduce the targets were set out by the coalition government towards the end of 2014, followed in early 2015 by guidance for clinical commissioning groups on implementation. The standards will require 75 per cent of people referred to the Improved Access to Psychological Therapies programme to be treated within 6 weeks of referral, and 95 per cent within 18 weeks of referral. They will also require more than 50 per cent of people experiencing a first episode of psychosis to receive treatment with a National Institute of Health and Care Excellence-approved care package within two weeks of referral.

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NHS England has published a Mental Health Staffing Framework which provides practical guidance on staffing in inpatient mental health settings. This will feed into the wider work being undertaken by the Mental Health Taskforce, one of three taskforces established by NHS England to support the NHS five year forward view. This work will be published at the end of the year.

The Framework was developed by an independent group of nursing directors, supported by Health Education West Midlands, and draws on a review of best practice evidence. Work is in progress to develop a similar framework for community mental health services.

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In early August NHS England distributed £30 million funding (recurrent for five years) for services for people with eating disorders. This is in line with the previous government’s 2014 Autumn Statement, which earmarked this funding to a central NHS England programme to improve access to specialist community child and adolescent mental health services (CAMHS) eating disorder services.

The funding will be used to improve community-based eating disorder services, with the aim that 95 per cent of patients will be seen within four weeks, and within one week for urgent cases. NHS England has also provided guidance for clinical commissioning groups (CCGs) on implementing plans to transform local mental health services for children and young people, including the development of eating disorder services.

This funding is in addition to the £1.25 billion funding for CAMHS over the next five years, which was pledged in the coalition government’s March 2015 Budget. £142 million will be allocated in 2015/16: NHS England has indicated that £133 million will be spent on improving children and young people’s mental health, of which £75 million will be given to CCGs to improve local services, and £58 million will be used to support other areas such as improvements to perinatal mental health care, workforce development and innovation. Health Education England will spend another £9 million.

This represents a smaller allocation for 2015/16 than was originally proposed in the March Budget. However, the government has confirmed its commitment to providing the total £1.25 billion over five years.

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In early June Simon Stevens, Chief Executive of NHS England, announced five ‘fast-track’ sites that will receive additional support for services for people with learning disability and/or autism and challenging behaviour or a mental health condition. This is part of the Transforming Care for People with Learning Disabilities programme which was initiated by the coalition government in early 2015.

The programme – which is being led jointly by NHS England, Local Government Association, the Association of Directors of Adult Social Services, the Care Quality Commission, Health Education England and the Department of Health – focuses on improving care for people with learning disabilities, in particular by shifting care out of hospitals towards community settings.

The fast-track sites – Greater Manchester and Lancashire; Cumbria and the North East; Arden, Herefordshire and Worcestershire; Nottinghamshire; and Hertfordshire – will receive technical support from NHS England to develop plans for transformation. From the autumn they will also have access to a £10 million transformation fund to support this work.

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