Several Clinical Commissioning Groups (CCGs) have been found to have made false claims about how much they have spent on mental health services in the 2018/19 financial year, according to the HSJ.
The information from NHS England and NHS Improvement, seen by the HSJ, shows that in the 2018/19 funding period auditors found that 16 CCGs had falsely claimed that they had spent sufficient on mental health services in their areas and met the targets set under the Mental Health Investment Standard (MHIS).
The MHIS was put in place in 2015, following years of mental health service funding dragging a long way behind that of physical health services. The MHIS is the requirement for CCGs to increase investment in mental health services in line with their overall increase in allocation each year.
HSJ revealed the 16 CCGs as; Brighton and Hove, East Sussex, Milton Keynes, Ashford (now Kent and Medway), Canterbury and Coastal (now Kent and Medway), Thanet (now Kent and Medway), North East Hampshire and Farnham, North Hampshire, Hastings and Rother (now East Sussex), Gloucestershire, Mansfield and Ashford (Now Nottingham and Nottinghamshire), Nottingham North and East (now Nottingham and Nottinghamshire), Salford, and Trafford.
These 16 CCGs will have published a statement at the end of the financial year in which they stated that the CCG had followed the planning guidance in 2018/19 and achieved the MHIS. However, the independent audits that are carried out on the CCGs found that these were false claims.
Letters have been sent to the CCGs by NHSE/I national mental health director Claire Murdoch and finance director for NHS England and Improvement Julian Kelly, according to the HSJ, which stated that NHSE/I was “disappointed to see that the independent review by reporting accountants found that you had not, in fact, met the standard.”
NHS England reports that since it was introduced in 2015, the MHIS has been met nationally. However, this may be the case, but looking at the reality of mental health service provision in England, it appears to have had little impact against the effect of ten years of budgetary restraints and increased need.
At the end of 2019 and the start of 2020, there was a flurry of reports on the escalating crisis in mental health services, in particular in Child and Young Adult Mental Health Services (CAMHS). These showed that tighter restrictions on access to mental health services have been introduced and as a result, thousands of young patients are being denied care, which in turn has led to a large rise in the numbers turning up in A&E and patients being directed to private care.
Staff and bed numbers have fallen and infrastructure is poor and in dire need of renovation. In 2013 there was one mental health doctor for every 186 patients accessing services, and one mental health nurse for every 29 patients. By 2018 those figures had dropped to one for every 253, and one for every 39, respectively.
In November 2019 the Royal College of Psychiatry (RCP) published a report claiming that, to offer appropriate levels of care to patients in their local community, more than a thousand extra mental inpatient beds were needed.
The evidence is clear that the MHIS has had little impact on mental health services and they have continued to deteriorate.
In January 2019, the NHS’s Long Term Plan contained another commitment to increasing funding for mental health care; from 2019/20 onwards the MHIS also includes a commitment that local funding for mental health will grow by an additional percentage increment to reflect additional mental health funding being made available to CCGs. More recently the government has given £5 million to tackle the massive requirement for more mental health services due to the Covid-19 pandemic.
It remains to be seen whether this is sufficient to pull mental health services out of a crisis.
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