Mental Health Network Policy update - September 2008

Mental health publications: Mental Health Act; acute care workforce redesign

DH, 17 September; CSIP 23 September 2008

Most of the amendments made in 2007 to the Mental Health Act 1983 will come into effect in November this year. This 340 page reference guide sets out the main provisions of the Act but does not substitute for the text of the legislation itself.

The Care Services Improvement Partnership has published a workbookto help those running acute mental health services (including inpatient services) to redesign their workforce. It provides examples of 15 organisations which have succeeded in improving recruitment and retention as well as patient care through workforce development. Key success factors in creating a capable, sustainable acute care staff team are identified as being:

Use of workforce planning methodologies such as the Creating Capable Teams Approach

Recognition of existing skills of staff and identification of gaps

Board level buy in for change, senior management leadership, and a can-do attitude

Complementing managerial leadership with 'bottom up' levers such as service user help in defining objectives of re-design

Getting rid of professional territoriality and boundaries

The main message is that there is no 'right' number of staff for acute services; the starting point should be the configuration of services and local needs.

To download the workbook visit CSIPs virtualward website

Lib Dems carry motion for equality and fairness in mental health care

Liberal Democrats, 17 September 2008

Shadow Health Secretary Norman Lamb proposed, and gained his party's support for, plans to improve equality and fairness in mental health care. He asserted that 'only the Liberal Democrats will transform mental health services, with faster access, safer wards, and genuine equality of treatment.'

The motion asserted that 'mental health trusts have suffered real term cuts in funding,' that 'conditions in many mental health wards are completely unacceptable,' and condemned 'existing discrimination within the NHS.' The LibDems call for the following within existing NHS budgets:

Mental health service users entitled to treatment within treatment-specific waiting times, after which they will be entitled to have private treatment paid for by the NHS.

Personal care budgets for those 'able to make informed choices.'

Additional investment in clinician capacity, and in mental health infrastructure.

Extra capacity for intensive care and forensic units.

Mental health guarantee standard also applied to mentally ill prisoners.

To read Norman Lambs proposals in full visit the Liberal Democrats website.

Healthcare Commission survey of mental health service users - incremental improvement

Healthcare Commission- 11 September

68 providers of mental health services in the NHS surveyed mental health service users during early 2008. They received 14,000 completed surveys from those between 16 and 65 who used services in the community (as opposed to inpatient services). Overall the Commission finds incremental improvements in most measures, but there is still much to be done.

The Commission highlights some problems with services fully involving service users in decisions about their care, and informing them about treatments they are receiving. In particular:

24 per cent had not been involved in deciding what went into their care plan

almost one third had not been told about possible side-effects of new medication

16 per cent said their diagnosis had not been discussed with them

Improvements have been seen in users' opinions of psychiatrists, the proportion being told who their care co-ordinator is (although 26 per cent had not been told), and the proportion having a care review in the past 12 months (at 55 per cent, up 4 per cent since 2006).

Bringing mental health under the NHS wing

HSJ- 11 September

In the run up to his party's annual conference in Bournemouth, Liberal Democrat leader Nick Clegg has outlined his vision for mental health services in an HSJ article. He argues that the Government has failed to deliver the radical improvements required over the past decade, with mental health funding increasing at a smaller rate than for other conditions. Furthermore, while the widening of access to psychological therapies is welcomed, Clegg contends that current commitments will merely bring us about a third of the way towards the necessary level of provision.

This week party members will debate a motion that, if passed, would commit a future Liberal Democrat administration to guarantee access to mental health treatment within 13 weeks by 2012. In line with previous pledges, in the event that the NHS could not provide care within that timeframe, patients would be able to obtain NHS-funded treatment on the private sector. Clegg states that this guarantee would form one element of a patient's contract, which would also encompass areas such as access to information, patient advocacy rights and availability of treatment.

Other policy priorities include the following:

• Ensuring that there would be no mixed-sex wards within mental health units
• A complete ban on under 18s being accommodated on adult wards
• 'Every service user will be entitled to safe and secure accommodation that meets their needs'
• Independent patient advocates for those with mental health problems, as opposed to the statutory advocates to be introduced from 2009
• Care budgets allocated to those in the position to make 'informed choices'
• More action to help those with mental health conditions to gain employment. Clegg suggests that the DWP could make payments to the NHS when people successfully return to work following therapy.