The NHS Long-term plan – what does it mean for you?


You might have seen the coverage today about £billions more for the NHS with a big focus on improving mental health services. But with people who are most ill waiting the longest for mental health treatments, will this new money stretch far enough to help those most in need?

Mental health services have been a binary picture – on the one hand we’ve seen huge improvements to support for people with mild and moderate mental health problems in need of Cognitive Behavioural Therapy (CBT) through the rollout of Improving Access to Psychological Therapies (IAPT). There has also been much needed investment into early interventions for new mothers and people with their first experience of psychosis.

Yet a recent Rethink Mental Illness report, Right Treatment, Right Time, found that people severely affected by mental illness, for example with schizophrenia or personality disorder, have been facing a bleak picture. They have been unable to access the services they need in the time they need them with people on average waiting 14 weeks for an assessment and a further 19 weeks for treatment.

We have therefore been on tenterhooks for months now waiting to hear about what the NHS decision makers were planning to do about this significant inequality.

In November 2018 we voiced our concerns through a piece published in The Sunday Telegraph. The piece outlined our call for there to be a focus on core community services for people severely affected by mental illness in the NHS Long-term plan, supported by increased funding, workforce and data.

We’re delighted that we’ve been listened to and there’s a lot to be pleased about.

Overall there’s a strong reaffirmation to achieving parity of esteem between mental and physical health and a clear focus, for the first time, on severe mental illness. In particular:

  • Aims to give 370,000 people severely affected by mental illness more choice and control over their care by transforming community services and increase their access to mental health therapies and trauma-informed care, and physical health and practical support. Directly linked to Rethink Mental Illness’ calls, we’re pleased to see a commitment to trial a four-week waiting time standard to community mental health teams.

  • 24-hour mental health crisis support in the community and improved access to ‘safe havens’ in the community, like the crisis houses and cafes Rethink Mental Illness provide. There will be specific waiting time targets introduced from 2020.

  • Continued commitments to end out of area placements for people needing hospital care by 2021 as well as funding to upgrade hospitals themselves following calls in the recent Independent Review of the Mental Health Act.

  • Increased overall funding for children’s mental health to deliver expansions to CAMHS services from ages 0-25 and ensuring there’s mental health support in every school.

  • Improved specialist perinatal mental health care from preconception to 24 months after birth for mothers and fathers.

These ambitions are bold and promising, particularly within the constraints of how much extra funding NHS England were provided by the Government and considering the acute workforce shortage.

In response to the announcement of the upcoming NHS Long Term Funding Plan, Mark Winstanley, Chief Executive of Rethink Mental Illness said:

  • We are delighted that the Prime Minister and the Chief Executive of the NHS are prioritising mental health in the Long Term Plan. Rethink Mental Illness and numerous other organisations have been campaigning for many years to ensure there is parity between mental and physical health. For all those people who are severely affected by mental illness we now have the prospect of getting access to good quality treatment, quickly, near home for the first time.

Overall there will be proportionately more funding for mental health than other areas with £2.3bn a year more until 2023/24. However, following research we carried out with the Institute for Public Policy Research (IPPR), we know this still won’t be enough to achieve true parity of esteem.

We also know the 5-10 year timeframe for most of the ambitions can be seen as frustratingly long and a huge part of this is because there simply isn’t enough NHS staff available. However, we are encouraged by the focus on improving supply and the skill mix of the mental health workforce. It is crucial this is made a priority as only then will we see delivery on the other commitments within the timeframes set out in the NHS Long Term Plan.

Overall, this plan goes a long way to address the needs of people with complex mental health problems like schizophrenia and bipolar disorder. That’s a first and something we have long campaigned for. Like all plans, it’s about what action comes next that really matters.

Rethink Mental Illness will now be working closely with NHS England, the Government and local commissioners to ensure the new focus on community services is rooted in the needs of people severely affected by mental illness and provides mental health care fit for the 21st Century. We’ll keep you posted…