The Education Policy Institute has published a new report, The performance of the NHS in England in transforming children’s mental health services, which examines the progress made by the Government in improving children and young people’s mental health services (CAMHS).
The report analyses NHS England’s new ‘Mental Health Five Year Forward View Dashboard’, which tracks the performance of local Clinical Commissioning Groups (CCGs).
You can read the report in full here.
Key findings
– When assessing the overall performance of children and young people’s mental health services, we find almost three quarters (73.2 per cent) of CCGs failed to meet NHS England’s own benchmark for improving services.
– In order to meet NHS England’s standard for crisis care performance CCGs must have an agreed plan to develop better local services. However, across England, less than a third of CCGs (31.6 per cent) had a fully funded plan to improve crisis care, with one in nine CCGs (10.5 per cent or 22 in total) having no agreed plan or funding set out.
– Government policy states that no one under 18 should be treated on an adult ward – yet children spent a total of 2654 nights on an adult ward between July and September 2016. This increased by over a third compared to the last quarter (April to June 2016), although it is not yet possible to establish whether this is due to fluctuation or a longer trend.
– There is wide variation between CCG’s planned spending per head – with those in the top quarter spending over £52 per capita, while those in the bottom quarter spend just £23, or less. This suggests that there is a postcode lottery in children and young people’s mental health care.
Policy recommendations
To tackle the wide variation in CCG performance across the country:
- NHS England should continue to scrutinise local CCG improvement plans over the five-year transformation period;
- The Government should set an expectation that every CCG has a clear and funded plan to improve crisis care;
- A clear strategy to reduce the number of children being treated in adult wards should be implemented; and
- The Government should set an expectation that every area increases investment in line with their share of the £1.4bn additional funding announced in 2015.
Other key findings:
Overall CCG performance:
- The NHS England benchmark is a score of 83.3 per cent. 73.2 per cent of CCGs failed to meet this benchmark for improving services. There has been a slight improvement in this score since Quarter One (April to June 2016), when around 79.4 per cent of CCGs failed to meet this standard.
- However, around a third of CCGs (34.6 per cent) fall significantly under the benchmark – scoring under 50 per cent.
- Regionally, the South of England performed highest, with 32.0 per cent meeting the set standard – while London had less than a fifth (18.8 per cent) meeting the same level – making it the worst performer.
Crisis care performance:
- The Midlands and East of England region was the highest performing, with 42.6 per cent of CCGs fully compliant. In the worst performing region, the North of England, only one in five (19.7 per cent) of CCGs had a fully funded crisis care plan.
Children on adult wards:
- The number of children spending the night on an adult ward increased by over a third compared to the last quarter (April to June 2016) – although it is not yet possible to establish whether this is due to fluctuation or a longer trend. When published, EPI will review data from the next quarter to establish whether this is the case.
- The problem of children being treated on adult wards is particularly prevalent in the North of England. This region accounts for 45 of the 90 young people under 18 staying on adult wards, with a total of 1,235 nights spent by children on adult wards.
- This compares to a total of 10 young people and a total of 150 nights in London.
Funding performance:
- The factors influencing the wide variation in spending are unclear – but are likely to relate to historic patterns of service provision, different levels of need, individual organisational priorities and, in some cases, difficulties in extracting data on individual programme spending from wider block contracts.
Mental Health Five Year Forward View Dashboard
Launched in 2016, NHS England’s ‘Mental Health Five Year Forward View Dashboard’ brings together data from across the broad range of mental health services to allow the Government to track performance at Clinical Commissioning Group (CCG) level. The Dashboard also gives local areas an understanding as to where they need to target their efforts to improve services.
The Education Policy Institute has used data from the second quarter of the Dashboard, which was published in February 2017. The Dashboard can be found here: https://www.england.nhs.uk/mental-health/taskforce/imp/mh-dashboard/
