Mental health network

What the planning guidance means for mental health services

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Guidance to help local health and care systems plan for the years ahead has for the first time prescribed a planning and contracting approach that will cover two financial years. 

Issued three months earlier than usual, NHS England and NHS Improvement's planning guidance will be underpinned by a two-year tariff and two-year standard contract.

The document, published on 22 September, reflects a 'significantly streamlined' planning and contracting round. It explains how the process has changed to support sustainability and transformation plans (STPs) and the financial reset issued in July. 

It also sets out nine must-do national priorities and additional measures to help the NHS deliver the Five Year Forward View.

Key proposals for mental health: 

  • Mental health remains one of the nine ‘must dos’.
  • Dedicated funding will be available to support the transformation of mental health services. This includes centrally-held transformation funding of £215m in 2017/18 and £180m in 2018/19.
  • In addition centrally held transformation funding to support delivery of the Mental Health Forward View will be allocated to CCGs for 2017/18 and 2018/19.
  • There are five CQUIN indicators for mental health.
  • The Quality Premium scheme will continue to be offered to CCGs and introduces two new indicators, with one to be selected from a mental health menu.

Mental health ‘must dos’

Organisations are required to deliver in full the implementation plan for the Mental Health Five Year Forward View for all ages: 

  • Additional psychological therapies so that at least 19 per cent of people with anxiety and depression access treatment, with the majority of the increase from the baseline of 15 per cent to be integrated with primary care.
  • More high-quality mental health services for children and young people, so that at least 32 per cent of children with a diagnosable condition are able to
  • access evidence-based services by April 2019, including all areas being part of CYP IAPT by 2018.
  • Expand capacity so that more than 53 per cent of people experiencing a first episode of psychosis begin treatment with a NICE-recommended package of care within two weeks of referral.
  • Increase access to individual placement support for people with severe mental illness in secondary care services by 25 per cent by April 2019 against 2017/18 baseline.
  • Commission community eating disorder teams so that 95 per cent of children and young people receive treatment within four weeks of referral for routine case, and one week for urgent cases.
  • Reduce suicide rates by 10 per cent against the 2016/17 baseline.
  • Ensure delivery of the mental health access and quality standards including 24/7 access to community crisis resolution teams and home treatment teams and mental health liaison services in acute hospitals.
  • Increase baseline spend on mental health to deliver the Mental Health Investment Standard.
  • Maintain a dementia diagnosis rate of at least two thirds of estimated local prevalence, and have due regard to the forthcoming NHS implementation guidance on dementia focusing on post-diagnostic care and support.
  • Eliminate out of area placements for non-specialist acute care by 2020/21.

Sustainability and transformation funding for mental health

To support the transformation of mental health services, dedicated funding will be available. This includes centrally-held transformation funding of £215m in 2017/18 and £180m in 2018/19.

CQUIN indicators

Continuing the arrangement of the current year, 1.5 per cent of the 2.5 per cent will be linked to delivery of nationally identified indicators. The remaining 1 per cent will be assigned to support providers locally. 0.5 per cent will be available subject to full provider engagement and commitment to the STP process.

The national CQUIN indicators include:
  1. NHS staff health and wellbeing (all providers)
  2. improving services for people with mental health needs who present to A&E (acute and mental health providers)
  3. physical health for people with severe mental illness (community and mental health providers)
  4. transition for children and young people with mental health needs (mental health providers)
  5. preventing ill health from risky behaviours (acute providers 2018/19 only; community and mental health providers both years)
NHS England will seek views over the next month on the measures and thresholds proposed for each indicator, through a new engagement exercise.

Measuring and assessing performance

Organisations are also expected to make improvements by 2020/21 as outlined in:

  • the NHS Mandate  (supplementary advice will be issued for any changes to mandated objectives for 2017 or 2018/19) 
  • the new CCG Improvement and Assessment Framework (CCG IAF)
  • the new NHS Improvement oversight framework for NHS providers 
  • publication of baseline STP metrics (for finance, quality and health out comes and care redesign.

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