Mental health network

Government response to Five Year Forward View for Mental Health

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Westminster

The Government has published its response to the recommendations outlined in the Five Year Forward View for Mental Health and has announced that it will accept all of them in full. 

The report focuses on the recommendations made to Government, which includes some for which responsibility is shared with NHS England and Arm’s Length Bodies.  The recommendations and responses in brief are as follows:

Recommendation No 1:

Implementing Future in Mind - including helping 70,000 more children and young people to access high quality mental health care when they need it. 
  

Response: 

  • In addition to local transformation plans covering all 209 CCGs which set out how local agencies will work together to improve children and young people’s mental health, the Government is looking at how to improve the mental health provision in schools (as laid out in the Prime Minister’s speech on mental health on Monday 9 January). 

Recommendation No 3:

Multi-agency suicide prevention plans in place by the end of 2017

Response: 

  • The DH is working with Public Health England and local authorities to ensure that every local area has a multi-agency suicide prevention plan in place by 2017.  
  • The DH has also published a progress report on the cross-government suicide prevention strategy, setting out ways in which they are strengthening the strategy in key areas for action.

Recommendation No 4:

New fund of up to £30 million for outcome-based interventions to tackle alcoholism and drug addiction 

Response: 

  • The fund launched in July 2016 and included a call out for social impact bond proposals linked in drug and alcohol dependency.  • £30m will be available for SIBs tackling addiction. 

Recommendation No 5:

By 2020/21 ensure that up to 29,000 more people per year living with mental health problems are supported to find or stay in work through increasing access to psychological therapies for common mental health problems and doubling the reach of Individual Placement and Support. 

Response:

The Government accepts this recommendation on the basis that there are a range of opportunities to commission the evaluation.  

  • The Government and NHS England has committed to increasing access to psychological therapies to reach 1.5m people each year (an additional 600,000 per year). 
  • The number of employment advisors in psychological therapy services is being increased and ‘Improving Lives – the Work, Health and Disability Green Paper’ sets out the Government’s proposals for improving work and health outcomes for disabled people and people with long-term health conditions.

Recommendation No 6:

Identify how the £40 million innovation fund should be used to support devolved areas to jointly commission more services that have been proven to improve mental health and employment outcomes.

Response: 

  • Using the Innovation Fund, the Government is working with NHS England to develop large-scale health-led trials that create partnerships between local health service commissioners and providers, Jobcentres and councils.  • They are also seeking views on the Work, Health and Disability Green paper.   

Recommendation No 7:

Commission more evidence-based health-led interventions that are proven to deliver improved employment outcomes and improved health outcomes. 

Response:

Accepted on the basis that there are a range of opportunities to commission the evaluation.

  • Better integration of health support is a priority and the Government will be challenging providers to deliver integrated support to customers with multiple barriers.
  • Providers have been given freedom in how they support claimants to move in to lasting work rather than specify particular services.
  • Over half of the £115m funding given to the Work and Health Unit will help those with mental ill health. 
  • A new partnership is being formed with employers to support mental health in the workplace ensuring that employers have the support and tools they need. 

Recommendation No 10:

Build the evidence base for specialist housing support for vulnerable people with mental health problems and explore the case for using NHS land to make more supported housing available for this group. 

Response:

  • The Department of Health is committed to delivering its targets to release surplus public sector land for housing.  • The Department of Health is committed to delivering its targets to release land for 26,000 homes and generate £2bn in capital receipts working closely with NHS Trusts and Foundation Trusts who own the majority of the estate. 
  • The Government is keen to see health, as well as other sectors, play an even greater part in supporting housing for vulnerable people with mental health problems, and is supportive of this aim.

Recommendation No 11:

Ensure the right levels of protection are in place for people with mental health problems who require specialist supported housing.

Response: 

  • A new funding model for supported housing will be introduced in April 2019. From this point, rent and eligible services charges will continue to be paid through housing benefit and universal credit up to the relevant local housing allowance rate.  • A separate top-up fund will be created to ensure that the supported housing sector continues to be funded at the same level it would otherwise have been in 2019/20. 
  • This funding will be devolved to local authorities ensuring that decisions on funding are made at the local level. 
  • A Green Paper on the top up model will be published in spring 2017. 

Recommendation No 12:

Support proven behaviour change interventions, such as Time to Change, to establish Mental Health Champions in each community to contribute towards improving attitudes to mental health by at least a further 5 per cent by 2020/21.

Response: 

  • The Department of Health awarded a further £12.5m to the national Time to Change anti-stigma campaign up to 2020/21 to improve attitudes towards mental health.
  • Phase 3 of Time to Change will focus on developing local Time to Change Hubs which will support and train people with lived experience to become mental health champions to influence change in attitudes and reductions in stigma in their local communities. 

Recommendation No 24:

Complete health and justice pathway to deliver integrated health and justice interventions in the least restrictive setting, appropriate to the crime which has been committed.

Response: 

  • Improvements are central to the reform of the criminal justice system, reducing offending and cutting crime.  • Cross-departmental work is ongoing to increase the uptake of Mental Health Treatment Requirements (MHTRs) and full roll out of Liaison and Diversion services is expected by 2020/21. 
  • The Department of Health and the Ministry of Justice are working together to develop a strategy to ensure that mental health issues are addressed as part of community sentencing and early intervention programmes. 

Recommendation No 26:

Mental health research – one year from now publish a 10 year strategy for mental health research. 

Response: 

  • To date a steering group has been set up including Mind, the Royal College of Psychiatrists, Arm’s length bodies and the major funders of mental health research. 
  • Four working groups have also been set up and are co-chaired by people with lived experience of mental health.
  • The strategy is due to be published in spring 2017. 
  • A new Policy Research Unit for Mental Health will be established in 2017, the bids and proposals for which are currently under consideration, and the successful institution will be announced shortly.

Recommendation No 28:

Expand work on NHS Choices to raise awareness and direct people to effective digital mental health products by integrating them into the website and promoting them through social marketing channels from 2016 onwards.

Response: 

  • NHS England has produced a strategy to improve mental health care through digital technology by 2020.  • Six Mental Health Trusts will take the role of Global Digital Exemplers. These trusts will be selected to focus on improving informatics and technology, leading to higher quality, safer care. 
  • An online library of digital apps for health will be launched by April 2017. The mental health content on NHS 111 will improve. The mental health content on the www.nhs.uk website will also be improved.

Recommendation No 29:

Ensure future updates to the Better Care Fund include mental health and social work services

Response: 

  • In 2015/16, £0.315bn of the planned expenditure from the BCF was on mental health. • At a local level, the BCF has funded initiatives relating to mental health and social work services.
  • The Government endeavours to keep nationally prescribed conditions and performance metrics to a minimum and would not consider asking for specific requirements relating to mental health or social work services.
  • Changes such as the council tax precept and the New Homes bonus will make available almost £900million of additional funding for adult social care over the next two years.

Recommendation No 36:

Ensure that by 2020 all GPs receive core mental health training

Response: 

  • All GPs already receive core mental health training as part of their initial education and qualification. Improvements are being made to training and a register of GPs with extended Scope of Practice in Mental Health is being developed.

Recommendation No 37:

Continue to support the expansion of programmes that train people to qualify as social workers

Response: 

  • Over £10m has been invested to support the fast track Think Ahead programme. In 2016, the Chief Social Worker for adults launched three new resources as part of a new initiative ‘Social Work for Better Mental Health’. • A Department of Health funded programme is underway to pilot new models of social work practice to deliver better outcomes for people with learning disabilities, autism and mental health conditions.

Recommendation No 39:

Develop a 5-year plan to address the need for substantially improved data on prevalence and incidence, access, quality, outcomes, prevention and spend across mental health services. 

Response: 

  • An update on progress on the five year data plan will be published in early 2017. 

Recommendation No 40:

Develop national metrics to support improvements in children and young people’s mental health outcomes

Response: 

  • There is a new children and young people’s mental health prevalence survey on track for reporting in 2018. • National data on children and young people’s mental health services has been included in the Mental Health Services Data set for the first time from January 2016.
  • The new integrated dashboard for mental health was published by NHS England in October 2016. 

Recommendation No 41:

Develop a Mental Health Five Year Forward View Dashboard 

Response: 

  • The Mental Health Dashboard was published in October 2016 and will help monitor how programmes are helping to improve mental health services across the country.
  • An initial rating for mental health for CCGs was published on MyNHS in October 2016, as part of the CCG Improvement and Assessment Framework for 2016-17. Mental health to be a pilot for developing more sophisticated data presentation on the My NHS website. 

Recommendation No 44:

Ensure rapid using and sharing of data with other agencies and set minimum service expectations for turning around new datasets by no later than summer 2016

Response: 

  • The Department of Health has agreed minimum service expectations with NHS Digital and key stakeholders for 2016/17.

Recommendation No 45:

Adopt data-rich Summary Care Records that include vital mental health information, where individuals consent for information to be shared by 2016/17.

Response:

Accepted in principle.  

  • The main focus of developments for SCRs over the next two years will be to drive delivery and use in scheduled and emergency care settings.
  • Around a third of CCGs are currently planning to roll out SCRs with additional information. Further extension will take time as patient consent is required.

Recommendation No 46:

Commission regular prevalence surveys for children, young people and adults of all ages that are updated at least every seven years.

Response: 

  • The last survey was carried out in 2004. The next survey will be carried out in 2017 and NHS Digital is on track to report in 2018. 

Recommendation No 50:

Publish data on levels of mental health spend, including for children and Adolescent Mental Health Services from 2017/18.

Response: 

  • NHS England has introduced indicators with the CCG Improvement and Assessment Framework and requirements in the guidance for developing Sustainability and Transformation Plans so that CCGs demonstrate they are doing this.

Recommendation No 51:

Review whether the Mental Health Act in its current form should be revised.

Response: 

  • Officials are currently exploring if any legal changes may be required to allow a person to be treated in the community for a mental health problem that would otherwise require a compulsory stay in hospital.
  • When the revised Mental Health Act 1983 Code of Practice was published in January 2015, the Department of Health committed to work with the CQC in carrying out an evaluation of the impact of the new Code once it had been embedded in working practices.

Recommendation No 52:

Identify disparities and gaps between provisions relating to physical and mental health services. 

Response: 

  • The Health and Social Care Act 2012 placed the principle of parity of esteem on a statutory footing. 
  • Since the 2012 Health and Social Care Act we have made significant progress by introducing access and waiting times standards for mental health services for all ages.

Recommendation No 54:

Introduce the regulation of psychological therapy sessions, which are not currently inspected unless they are provided within secondary mental health services

Response: 

  • The Department of Health has met with the CQC and other mental health stakeholders to consider the issues around regulating psychological therapy services and to explore how this may be achieved. 
  • A further update will be available later in 2017.

Recommendation No 56:

Ensure that the Healthcare Safety Investigation Branch include deaths from all causes in inpatient mental health settings and that there is independent scrutiny. 

Response: 

  • From 1 April 2017 the HSIB will be required to publish a set of principles on how investigations will be carries out including the nature of the events, circumstances, or outcomes that will be relevant factors in its investigations.  
  • The CQCs review into the way NHS Trusts review and investigate the deaths of patients in England, was published in December 2016.

Recommendation No 58:

Confirm what governance arrangements will be put in place to support the delivery of this strategy. 

Response: 

  • From January 2017, an inter-Ministerial Group for Mental Health, chaired by the Secretary of State for Health, will be established to hold all departments to account for delivery against these recommendations.

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