National Service Framework

Jess which direction? (many signposts)The National Service Framework focuses on the mental health of working age adults. It applies to both health and social services, and includes health promotion, assessment and diagnosis, treatment, rehabilitation and care, including support to carers, and encompasses primary and specialist care and the roles of partner agencies.
Mental ill health is so common that at any one time around one in six people of working age have a mental health problem, most often anxiety or depression. One person in 250 will have a psychotic illness such as schizophrenia or bipolar affective disorder (manic depression).

The new NHS and Saving Lives: Our Healthier Nation set out a package of measures to drive up the quality of services to service users and to reduce unacceptable variations. A First Class Service explained how standards in the NHS would be:

Set by the National Institute for Clinical Excellence and National Service Frameworks.

Delivered by clinical governance, underpinned by professional self regulation and lifelong learning.

Monitored by the Commission for Health Improvement, the National Performance Assessment Framework and the National Survey of NHS Patients.

Similarly, A New Approach to Social Services Performance described a performance assessment framework for social services, outlining plans to strengthen assessment by the Department of Health and detailed proposals for national performance indicators for social services. Together with Modernising Social Services, it will apply Best Value principles to social services.

The National Service Framework for Mental Health sets national standards and defines service models for promoting mental health and treating mental illness in the five following areas: mental health promotion; primary care and access to services; effective services for people with severe mental illness; caring abut carers; and preventing suicide.

The National Service Framework's intention is to:

  • Clarify expectations about the future configuration of mental health services.
  • Set out arrangements for local implementation.
  • Puts into place national underpinning programmes to support local delivery.
  • Establishes milestones and a specific group of high-level performance indicators against which progress within agreed timescales will be measured.

The Standards

  • Mental health promotion.
  • Primary care and access to services.
  • Caring about carers.
  • Preventing suicide.
  • The Mental Health Act 1983 - some important information in summary
    Mental health promotion.

Standard one - health and social services should:

- promote mental health for all, working with individuals and communities.

- combat discrimination against individuals and groups with mental health problems, and promote their social inclusion.

Primary care and access to services.

Standard two - any service user who contacts their primary health care team with a common mental health problem should:

- have their mental health needs identified and assessed.

- be offered effective treatments, including referral to specialist services for further assessment, treatment and care if they require it.

Standard three - any individual with a common mental health problem should:

- be able to make contact round the clock with the local services necessary to meet their needs and receive adequate care.

- be able to use NHS Direct as it develops, for first-level advice and referral on to specialist helplines or to local services.

Standard four - all mental health service users of CPA should:

- receive care which optimises engagement, anticipates or prevents a crisis and reduces risk.

- have a copy of a written care plan which: includes the action to be taken in a crisis by the service user, their carer, and their co-ordinator; advises their GP how they should respond if the service user needs additional help; is regularly reviewed by their care co-ordinator.

- be able to access services 24 hours a day, 365 days a year

Standard five - each service user who is assessed as requiring a period of care away from their home should have:

- timely access to an appropriate hospital bed or alternative bed or place, which is: in the least restrictive environment consistent with the need to protect them and the public; as close to home as possible.

- a copy of a written care plan agreed on discharge which sets out the care to be provided, identifies the care co-ordinator, and specifies the action to be taken in a crisis.

Caring about carers.

Standard six - all individuals who provide regular and substantial care for a person on CPA should have:

- an assessment of their caring, physical and mental health needs, repeated on at least an annual basis.

- their own written care plan which is given to them and implemented in discussion with them.

Preventing suicide.

Standard seven - local health and social care communities should prevent suicide by:

- promoting mental health for all, working with individuals and communities. (Standard one)

- delivering high quality primary mental health care. (Standard two)

- ensuring that anyone with a mental health problem can contact local services via the primary care team, a helpline or an A&E department. (Standard three)

- ensuring that individuals with severe and enduring mental illness have a care plan which meets their specific needs, including access to services round the clock. (Standard four)

- providing safe hospital accommodation for individuals who need it. (Standard five)

- enabling individuals caring for someone with severe mental illness to receive the support which they need to continue to care. (Standard six)

In addition they should:

- support local prison staff in preventing suicides among prisoners.

- ensure that staff are competent to assess the risk of suicide among individuals at greatest risk.

- develop local systems for suicide audit to learn lessons and take any necessary action.

Further information