In the first few months of the new government, a wide range of proposed policies have been set out regarding the future of the NHS, and other areas across government that relate to mental health and wellbeing. A short summary of the key developments we have noted are below.
In the context of those developments, the Future Vision Coalition is currently developing a set of shared priorities we will ask to be addressed as part of the new strategy. The Future Vision Coalition (FVC), which the Mental Health Network originally brought together and chaired, is a group of eleven national bodies with an interest in mental health policy, including Mind, Rethink, the Royal College of Psychiatrists, the Mental Health Foundation and the Centre for Mental Health. In 2009 we published our shared vision for mental health which fed into the development of the last government’s New Horizons policy.
The MHN are keen to seek member views to feed into that work, and also to inform our wider contact with government on the strategy.
In particular, we would like to hear views on the following three areas:
1. What were the strengths and weaknesses of the New Horizons strategy? Were there any particular gaps that the new strategy should address?
2. Given the proposed changes in the NHS White Paper, what views do members have on the development of mental health outcome measures? What sorts of indicators should be included in the outcomes frameworks for mental health services, the wider NHS (e.g. primary care) and for the new public health service?
3. With wider cross government policy initiatives in mind, what are the views of members on their impact on mental health and wellbeing, and what recommendations would they like to see the MHN and FVC take forward with government?
Please email any comments or views to Rebecca Cotton (Policy Manager for Mental Health at the NHS Confederation) at rebecca.cotton@nhsconfed.org
The MHN will be working with government over the coming months on the development of the strategy and will continue to keep members informed.
Summary of Key Policy Developments
Our monitoring of government activity over the past three months has highlighted a number of areas across a range of departments where opportunities exist for cross government action on mental health and wellbeing. Those include:
- Ministry of Defence
- Armed Forces Health Review
The coalition agreement contained a number of commitments to serving members of the armed forces, and to veterans. It states “we will work to rebuild the Military Covenant by……providing extra support for veteran mental health needs”. The Prime Minister has asked Dr Andrew Murrison MP to lead a review into the health of both serving and ex-service personnel to see what more can be done to assess and meet these needs, a key focus of which will be on mental health.
Department for Education
Various coalition agreement commitments, plus a Commission on Early Intervention,
The Coalition agreement contained a number of commitments, under section 14, relating to children and families policy that link in with the wider mental health and wellbeing agenda, particularly around the future role and purpose of Sure Start.
In a statement on the Coalition agreement on 30th July 2010, the DfE announced that the Prime Minister had established a Childhood and Families Task Force. It was announced that the Family Justice Review will produce a final report in 2011.
The DfE have also announced that an independent Commission into Early Intervention has been established as one of the first pieces of work to be remitted to the Social Justice Cabinet Committee.
It has also been announced that Children’s Trusts will no longer be a statutory requirement on schools
Department of Health
Equity and excellence: liberating the NHS
The Government’s white paper for health service reform was published on 12 July 2010. The NHS Confederation has published a series of online briefings on the White Paper, the associated consultations on outcomes, regulation, commissioning and democratic accountability, plus a summary of the Arms Length Bodies Review.
The following headlines are particularly relevant for mental health:
The future of commissioning: responsibility for commissioning most health care will be transferred from primary care trusts to consortia of GPs, supported nationally by a Commissioning Board. It is as yet not clear what capacity and capability GP consortia will have to commission mental health services, nor what specialist services should sit with the NHS Commissioning Board. The role of new Health and Wellbeing Boards in coordinating commissioning across health, social care and health improvement, and the potential for ‘place-based budgeting’ to pool resources for some groups of people, could also be significant.
Outcome measures: the NHS will be given a new Outcomes Framework to replace existing performance targets. The Government is now consulting on the development of ‘clinically credible and evidence-based outcome measures’, the first of which will be available in April 2011, with full implementation expected a year later. Among the outcome measures the Government suggests are ‘ability to work’ among people with long-term conditions and the creation of patient-reported outcome measures (PROMs) for people using mental health services.
Extension of choice into mental health from April 2011. A further tranche of Personal Health Budget (PHB) pilots will be encouraged with general roll out informed by evaluation in 2012.
Payment by Results: to bring mental health services into line with the way most other health services are commissioned, ‘currencies’ for adult mental health services will be introduced from 2012/13, and plans to develop currencies for child and adolescent services will follow. Payment mechanisms to support the commissioning of psychological therapies will also be formulated.
A white paper on public health, and an outcomes framework specific to public health, is expected later in the year.
In addition to this, on the 23rd June 2010, the Secretary of State announced the continued roll out of the Improving Access to Psychological Therapies programme.
Ministry of Justice
Various ministerial speeches on criminal justice reform
The government’s plans for criminal justice reform are still emerging. However, a number of statements and speeches have been made by MoJ ministers during the first few weeks in office that are potentially indicative of a direction of travel towards early intervention and the need for better support for vulnerable groups, including those with mental health problems.
Department for Work and Pensions
21st Century Welfare consultation
The DWP launched a consultation on welfare reform, 21st Century Welfare, at the end of July 2010. It states that:
“Complexity and poor financial incentives to work are a key factor in trapping people in worklessness. This is strongly linked with poverty and reduced well-being, poorer physical and mental health and an increased likelihood of becoming involved in the Criminal Justice System. Previous changes have failed to address the impact of benefits on these issues. Where parents have multiple disadvantages (such as low income, poor health, no qualifications), their children are also likely to experience disadvantage themselves”.
The consultation closes on October 1st 2010. In the meantime, plans for a new Work Programme to replace existing welfare-to-work schemes including Pathways to Work, are being developed.
The Coalition Agreement also pledges to reform the Access to Work scheme, which pays for adaptations to workplaces for disabled people, including to extend support to people with mental health problems.
Home Office
ALB Review: National Treatment Agency to be abolished by 2012
Drugs policy, and the National Treatment Agency, currently fall under the remit of the Home Office. As announced in the Department of Health’s report of the arm’s length bodies review, the National Treatment Agency will be abolished as a statutory organisation and its functions will be transferred to the DH as part of the new Public Health Service.