Next steps on the NHS Five Year Forward View: NHS acts to cut inappropriate out of area placements for children and young people in mental health crisis

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NHS England will today announce the next steps in the drive to ensure children and young people don’t have to travel far from home for mental health care, funding between 150-180 new beds.

The increase will be focused on those who are most unwell, be dependent on need and placed in under-served parts of the country.

It remains an NHS priority to stop children and young people reaching crisis point by diagnosing and treating them at the earliest opportunity and the number receiving treatment has increased by 20,000 over the last three years.

A programme of work is underway to improve timely treatments in the community for those needing urgent or emergency assessment to reduce the number of hospital admissions, with an expected increase of 35,000 treated through community services next year compared with 2014/15, with an extra 49,000 in two years.

Alongside this there are 67 newly established community eating disorders services being developed and recruitment to get the teams up to full capacity is well under way. This means at least 3,350 children and young people a year will receive swift, effective eating disorder treatment in the community – for many this will mean they will be treated earlier and no longer need to go into hospital.

While this work ramps up, the introduction of the new beds for children and young people will reduce the need to travel long distances for specialist inpatient care, rebalancing beds from parts of the country where the local CAMHS can reduce inpatient use.

Claire Murdoch, National Director for Mental Health at NHS England, said: “We are committed to ending the need for children and young people travelling long distances for the right care. By increasing the availability of services in the community and ensuring the right beds are in the right place, we aim to ensure that those who need it will be able to receive the best care and treatment at home or as close to home as possible.

“Around 120,000 more people are now getting the mental health care they need than three years ago. I believe we now have the biggest programme for talking therapies in the world, with more people receiving treatment than ever before. There will be more support for adults with expanded new crisis resolution home treatment teams, mental health professionals in GP practices and A&Es, and increased transparency on spending and performance with the new dashboard for mental health.

“Over the last year we have made some huge strides forward to ensure mental and physical health are on an equal footing, but there is much more work to do and we won’t rest on our laurels and we will continue to drive further improvements to ensure the right care is available across the country at the right time.”

Chief Executive of Mind, Paul Farmer, said: “We’re a year into the Five Year Forward View for Mental Health, so it’s still early days, but we are pleased to see various agencies and Government working together to try to improve the care people with mental health problems experience. Mental health services have been chronically underfunded for years and still get a raw deal when it comes to funding, yet demand is increasing. That’s why it’s so important that we urgently invest in quality mental health services.

“We welcome the additional funding being made available for extra beds for young people in crisis. When you’re experiencing a mental health crisis, you’re likely to feel scared, vulnerable and alone, so your support network of family and friends are instrumental to recovery. Being far from home can negatively impact on an individual’s mental health and can increase the risk of someone taking their own lives.”

Chief Executive of YoungMinds, Sarah Brennan, said: “We welcome the progress being made towards ending inappropriate out of area care. For young people who are hospitalised, being separated from loved ones doesn’t help with recovery and makes a frightening situation even worse. It’s also extremely distressing for parents who can’t easily visit their child because of long travel distances.

“While progress is being made, there is still a long way to go. It’s crucial that there are continued improvements not only to inpatient care, but also to community services that help prevent young people becoming so ill that they need to be hospitalised.”

President of the Royal College of Psychiatrists, Dr Simon Wessely, said: “This is a leap in the right direction for the future of mental health provision in this country especially in regards to ending out of area placements for children and young people facing mental health crisis. We know that we can only provide adequate care for children and young people with beds and well-trained staff.

“Recent figures show a 10% drop in child and adolescent psychiatrists, so we welcome proactive steps to address this. It is vital that a concerted effort is required to attract the best and the brightest into mental health services – from nurses, to therapists, to specialised psychiatrists. Just as you would expect a specialised medical professional if you needed cancer or heart treatment, you must also expect to receive specialised medical treatment for serious mental disorders.”

Also announced by health chief Simon Stevens today, new mothers will also be amongst those to benefit from a broad package of measures for mental health patients across the country. The new Next steps on the NHS Five Year Forward View will set out the range of measures NHS England is undertaking to improve mental health services, outlining how over the next two years the NHS will build on significant progress already made.

This will also include further details on workforce and the following:

New and expectant mums – opening four new mental health Mother & Baby Units, as well as increasing bed numbers in the current 15 units, expanding capacity by 49 per cent by 2018/19.

As many as one in five women experience mental ill health during pregnancy or in the year after birth, covering a wide range of conditions including severe depression, anxiety or in some cases post-partum psychosis. This affects about two in every 1000 new mothers and suicide is a leading cause of maternal death.

There are currently 15 dedicated mother and baby units and NHS England is procuring four new eight-bedded units, plus extra beds in existing units, expanding the current capacity by 49 per cent by the end of 2018/19.

The new units will be in East Anglia, North West, South West and South East Coast – putting resources in areas with the most need.

Mother and Baby units provide specialist care for mothers who are experiencing severe mental illness such as schizophrenia or psychosis. They enable the treatment and recovery of the mother whilst ensuring the developing relationship with the baby and its physical and emotional well being.

Last year Simon Stevens also announced an additional £40m for 20 new specialist community perinatal mental health services for new and expectant mums. These will help reach at least 2,000 women with severe and complex mental health problems over the next year and 9,000 more women by 2018/19.

It will fund new perinatal consultants, specialist nurses, occupational therapists, psychologists and nursery nurses as well as community peer support for mothers, babies and families. There will also be more buddying and telephone support where mothers who have had experience of similar issues help other mums in need.

Talking therapies – significantly increasing the availability of psychological talking therapies with 200,000 more people set to receive treatment for common mental health conditions a year by the end of the two years by end of 2018/19.

The NHS has the biggest ‘talking’ therapies programme in the world and this will continue to grow, with 60,000 more people with common mental health conditions accessing services a year by the end of 2017/18 and 200,000 more by the end of 2018/19 – an increase of over 20%.

The expansion will include a further £20m investment in new integrated services – supporting people with mental health problems and long term physical health conditions. For a list of all the new and existing sites, please contact nhsengland.media@nhs.net

Specialist mental health liaison care in A&E – people with mental ill health are three times more likely to end up in A&E than the general population and five times more likely to be admitted to general hospital wards in an emergency.

NHS England has offered £30m funding to 74 sites who have successfully bid to achieve the ‘Core 24’ standard for mental health liaison, meaning a fully staffed team operating 24/7 in a hospital, offering 1hr response to emergency referrals in A&E.

So that by 2019, 46% of A&Es will be staffed with mental health staff offering specialist, 1hr response on a 24/7 basis to people with urgent & emergency mental health needs.

This is being complemented with £400m over four years in adult crisis resolution and home treatment teams, providing a 24/7 urgent and emergency response in communities for people experiencing mental health crisis, and intensive home-based treatment as an alternative to acute admission. This will be a key enabler in the drive to eliminate inappropriate out of area placements for adults and provide better care closer to home.

For a list of the new sites, please contact nhsengland.media@nhs.net

‘Global Digital Exemplars for Mental Health’

These organisations are amongst the most advanced IT hospitals in the NHS and have committed to work to become world class exemplars for the rest of the NHS to learn from.

They will exploit the potential of digital technology to ensure care is more personalised and responsive to patient need, by providing seamless integration across the entire local health and care community.

For the first time, all those involved in a patient’s care will have access to real time records, which will transform the patient’s experience – from triage and initial assessment, through to admissions or referrals, as well as any transfer between services and follow up care.

The Exemplars will showcase the best ways of using remote, mobile and assistive technologies to empower patients and service users to manage their conditions and will enable family and carers to provide the best possible support.

Subject to HM Treasury capital approvals, successful ‘Global Digital Exemplars for Mental Health’ organisations will be:

  • Berkshire Healthcare NHS Foundation Trust
  • Birmingham and Solihull Mental Health NHS Foundation Trust
  • Mersey Care NHS Foundation Trust
  • Northumberland, Tyne and Wear NHS Foundation Trust
  • Oxford Health NHS Foundation Trust
  • South London and Maudsley NHS Foundation Trust
  • Worcestershire Health and Care NHS Trust

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