NHS improvement scheme accused of ‘derisory’ investment in mental health

An NHS body tasked with driving improvements to England’s health and care system has been accused by campaigners of spending a ‘derisory’ amount on projects focused on improving mental health care.

NHS Improving Quality – which is hosted by NHS England – spent £224,700 on projects dedicated to improving mental health and dementia care in 2013-14, equivalent to 0.38% of the organisation’s £59m budget. The organisation said it would increase its spend on focused mental health work to £300,000 in 2014-15. The figures were released in response to a Freedom of Information request by Community Care that asked for the agency’s investment in schemes to ‘improve the quality of NHS mental health services’.

Mental health charities labelled the investment ‘derisory’ and said it conflicted with the government’s commitment to parity of esteem between mental and physical health.

NHS Improving Quality denied those claims. It said that the figures it provided did not reflect its investment in large scale ‘transformational’ improvement programmes that included mental health elements. Examples include integrated care ‘pioneer’ sites, projects to improve access to seven day services and work to boost commissioning, the agency said. NHS England said both it and the improvement body “live and breathe parity of esteem”.

Paul Farmer, chief executive of charity Mind, said reassurances were needed that mental health was not being sidelined in integrated programmes and said he was surprised such a “derisory” amount had been allocated to specific mental health work by NHS Improving Quality.

“After years of inadequate funding, NHS mental health services are in more need than most of dramatic improvements to quality. It may be that mental health is included in some of the wider pieces of work being done by NHS Improving Quality but past experience of ‘integrated’ healthcare proposals warn us that we need to see evidence of this before we can be reassured,” he said.

“In any case, over and above any work where mental health is integrated into other plans, we also need to see it singled out as a focus for improving quality to bring it up to standard with the rest of the NHS. The government has repeatedly said it is committed to giving mental health equal priority with physical health, yet time and time again we see mental health services short-changed, subject to greater cuts than other parts of the NHS and not given sufficient resources to cope with increasing demand.”

Mark Winstanley, chief executive of charity Rethink mental illness, said NHS Improving Quality needed to bring mental health services up to “acceptable levels of care” after years of underfunding.

“That means introducing targeted, mental health focused initiatives. But this budget shows that NHS IQ is neglecting mental health, with the result that mental health services will continue to fall behind,” he said.

“It also makes a mockery of the Government’s promise to put mental health on a par with physical health in the NHS. For that to happen, we need to see large scale transformational change, which is what NHS IQ was set up to achieve in the first place. But equality for mental health can’t become a reality unless NHS IQ recognises the huge gulf in standards that currently exists between mental and physical health care.”

Steve Fairman, Managing Director at NHS Improving Quality, said: “Across every single one of our large scale improvement programmes, we work towards parity of esteem between physical and mental health services. Taking figures attributed to one small portion of this work alone is misleading.

“In order to truly make a significant impact and transform the NHS, we need to tackle nationally the big, system-wide challenges currently faced, such as integration, seven day services, safety, experience of care, and end of life care. Mental health underpins all of our efforts to improve quality in the NHS, as shown in the examples we have provided. Rather than view any physical or mental health condition in isolation we are working towards true parity.”

A spokesperson for NHS England said: “NHS England works very closely with NHS IQ and alongside us they live and breathe parity of esteem for mental health. We are all trying to stop mental health existing in a silo and therefore are seeking a culture where improvement is about the whole person, including their mental health.”

A Department of Health spokesperson said: “We have been very clear through the NHS Mandate that mental health must be on a par with physical health. NHS Improving Quality does valuable work through a range of projects which involve both physical and mental health care.”