Opening Doors: NHS review and constitution

The NHS Constitution - what does it say?

• Mental health  - the NHS is " there to improve our health, supporting us to keep mentally and physically well". Rethink is very pleased that mental health is mentioned alongside physical health. It is important that the NHS in the future recognises its responsibilities on mental health as it is too often sidelined.
• Access to services - everyone has "the right not to be unlawfully discriminated against in the provision of NHS services including on grounds of gender, race, religion, sexual orientation, disability (including learning disability or mental illness)". Rethink is very pleased that discrimination on mental health grounds is specifically mentioned as discrimination leads to thousands of people with severe mental illness not getting the physical healthcare that everyone needs.
• Access to treatment - more rights to people with severe mental illness will be given in getting treatments recommended by the National Institute for Clinical Excellence. This is particularly important as, for years, there has been a postcode lottery in prescribing of newer anti-psychotic medication. Thousands of people with severe mental illness can't even get on waiting lists for psychological therapies, even though we know they work and are cost effective.

Read Rethink's press release on NHS Constitution

Lord Darzi's NHS review - what does it say?

The Darzi NHS next stage review has some recommendations that could really improve the lives of people affected by severe mental illness. We now need to make sure they become a reality:

• Primary Care Trusts will provide wellbeing and prevention services. One of the six key goals for these services is mental health, alongside obesity, alcohol harm, drug addiction, smoking and sexual health. It is great that mental health is mentioned alongside these other issues, which often get more public and political attention. Rethink wants to make sure that all these services also include targeted help for people with severe mental illness as all these issues have higher rates for people with severe mental illness than many other groups.
• Mental health services will be funded through a form of Payment by Results for mental health. This would mean that mental health is funded in the same way as other health services, which would help to bring it into the mainstream and ensure that funds aren’t taken from mental health to smooth over funding problems in other parts of the health service.
• GP-led health centres (also known as polyclinics) will be linked to mental health services. 150 GP-led services will be funded with new resources. These will be open 8am-8pm, registration will not be necessary for people to use these services. Rethink wants to make sure that these new services have a mental health lead to put mental health at the heart of them. 95% of people with a mental illness are cared for in primary care.
• The Care Programme Approach (CPA) will be used as a basis for individual care plans for all people with long-term conditions and to include choice of treatment and provider. This could be a solution to the problems many Rethink members have been facing as a result of the planned changes to CPA.
• The measures in the GP contract will be looked at by an independent body, working with patient groups like Rethink. Rethink will suggest improvements to this new body for people affected by severe mental illness.
• More information will be given to service users about primary and community care services and people will be able to choose between them.

What did Rethink do towards this?

Rethink organised the only service user metnal health event with Lord Darzi. Discrimination on mental health grounds was one of the 3 top themes of the day. Read more about this event.  Rethink also wrote a letter to The Times to argue that mental health should be mentioned equally with physical health in the constitution - and it happened!

What can YOU do now to make these commitments a reality? 

Are you a member of a LINKs or patient or carer forum? Ask at your next meeting:

• whether the GP-led health centres are going to happen in your area – do the contracts specify that the new centres have responsibility for mental health?
• for any new GP-led health centres to have a mental health lead within the centre
• how will the impact of changes to CPA expected in the autumn be monitored locally?
• when the PCT’s strategic plan will be published and how mental health service users and carers have been involved in its development
• If you're not a member of a LINKs or a forum? Then write to a local councillor and ask if the local Overview and Scrutiny Committee or health panel will look at the issue. Tell us what happens through the form below.