Mental health misses out in ‘unambitious’ NHS vanguards

18 May 17

Opportunities to make mental health a key priority in some flagship NHS 'vanguard' schemes are being missed, the King’s Fund and Royal College of Psychiatrists have said.

Their report, Mental Health and New Models of Care, looks at mental health in the vanguard programme, which was introduced by the NHS Five Year Forward View.

In vanguard areas, GP surgeries and other NHS organisations collaborate and bring services together.

The report stated: “Sustainability and Transformation Plans are the main mechanism for delivering the Forward View.

"It is essential that all STPs set out ambitious but credible plans for improving mental health and integrating mental health into new models of care.”

Researchers found from the initial results of the 50 vanguard areas, which were supported by an investment of more than £330m over the past three years, that addressing mental and physical health needs together offered more value for money and was better for patients.

Between 12% and 18% of all NHS expenditure on long-term conditions is linked to poor mental health and wellbeing. Between £8bn and £13bn is spent on both of these in England each year.

The study also noted the detrimental health effects of mental illness, compared to the general population.

People with severe mental illnesses are 4.7 times more likely to die from liver disease, 4.6 times more likely to die from respiratory disease, 3.2 times more likely to die from cardiovascular disease, 1.7 times more likely to die from cancer and, overall, die 10–20 years earlier on average.

Successful work by the Tower Hamlets Together vanguard in East London was highlighted in the report, where the number of bed-days accounted for by people with dementia, serious mental illness and depression was reduced by 12.7%.

However, not all the vanguards were found to be “sufficiently ambitious” enough in bringing mental and physical care together.

Chris Ham, chief executive of the King’s Fund, said: “Some of the vanguards have made real progress on mental health but, overall, we need to go much further. The approaches being developed in the vanguards are intended to be a blueprint for the future of the NHS, so mental health needs to be at their core.”

The report urges areas that are developing new ways of working, particularly through STPs, to offer more mental health support in GP surgeries and in hospitals, and to consider mental health as a key part of their approach to public health.

Royal College of Psychiatrists president Simon Wessely said: “These integrated care models offer a pathway to revolutionised health services in this country – but the report’s findings are worrying.

“In addition to giving health providers greater incentives to fully integrate mental health into all their physical health services, we need to properly evaluate these models so we know what works and what doesn’t.”

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