NHS Citizen Assembly Stocktake (March 2015) Mental health and parity of esteem. Version 1
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1 NHS Citizen Assembly Stcktake (March 2015) Mental health and parity f esteem Versin 1 1
2 Mental health and parity f esteem Parity f Esteem Objective 1. In line with the cmmitment in the Mandate, 2013 t 2015, NHS England is wrking twards putting mental health n a par with physical health, and f clsing the gap between peple with mental health prblems and the ppulatin as a whle. 2. NHS England has established a Parity f Esteem Prgramme cmprising 5 wrk areas: data, infrmatin and intelligence; develpment f capabilities and skills in cmmissining; imprvements t clinical services; imprvements t crisis care; and imprvements t physical health fr peple with serius mental illness. Actins Agreed at NHS Citizen Assembly Stcktake - September The fllwing actins were agreed at the NHS Citizens assembly: Parity f Esteem Dashbard - NHS England cmmitted, as part f the business plan pririties fr 2014/15, t prducing a dashbard t track prgress in achieving parity with physical health. This has been built and the expectatin is that it will be handed ver t Public Health England t run and develp further as part f the Mental Health Intelligence Netwrk. Radmap t parity between nw and A new all age, Five Year Frward View fr Mental Health will be develped. Mental Health Intelligence Netwrk (NHS England and Public Health England) the Mental Health Intelligence Netwrk was launched in May Public Health England are leading a wrk prgramme t: develp Psychsis Care Pathway indicatrs; develp the Cmmn Mental Health Disrders Care Pathway indicatrs; cmplete the develpment f the Children and Yung Peple prfiling tls; and develp the dual diagnsis prfiling tl. This wrk will be taken frward in cnjunctin with the Strategic Clinical Netwrks, Public Health England Centres, and ther relevant Stakehlder and Partners. Mental Health and Parity f Esteem Wider Wrk Prgramme Prgress Update 4. Key pririties that are currently being delivered in supprt f the Mental Health and Parity f Esteem Wrk Prgramme are: 2
3 Mental Health Access and Waiting Time Standards 5. In 2015/16 mental health access and waiting time standards will be intrduced. Imprvements twards meeting the first standards will cme int effect frm 1 April 2015, fr achievement by 1 April 2016, and are fcussed n three areas: mre than 50% f peple experiencing a first episde f psychsis will be treated with a NICE apprved care package within tw weeks f referral. This standard will apply t peple f all ages; 75% f peple referred t the Imprved Access t Psychlgical Therapies prgramme will be treated within 6 weeks f referral, and 95% will be treated within 18 weeks f referral. This standard will apply t adults; 30m investment is t be targeted n effective mdels f liaisn psychiatry in a greater number f acute hspitals. 6. The new standards fr 2015/16 will be supprted by an 80m funding package: 40 millin recurrent funding t supprt delivery f the early interventin in psychsis standard; 10 millin t supprt delivery f the IAPT standard; and 30 millin t supprt delivery f the liaisn psychiatry standard. 7. In additin, an additinal 30 millin will be prvided recurrently fr 5 years t be invested in a central NHS England prgramme, t imprve access fr children and yung peple t specialist evidence-based cmmunity CAMHS eating disrder services. Part f this prgramme funding will be used t develp an access and waiting time standard. 8. The ambitin is t intrduce access and waiting time standards acrss all mental health services between 2016 and 2020, subject t future resurcing decisins fllwing the next Spending Review. Children and Adlescent Mental Health Services (CAMHS) 9. The Children and Adlescent Mental Health service (CAMHS) transfrmatin prgramme (Children and Yung Peple Imprving Access t Psychlgical Therapies - CYP IAPT) will embed cllabrative, evidence-based and utcmes fcused care. The participatin f children and yung peple and nw parents/carers is, and will cntinue t be, integral t the wrk f the prgramme at a natinal and lcal level. 10. In 2014, in additin t the wrk with yung peple, the prgramme cmmissined YungMinds t cnsult with parents/carers, and develp a resurce tlkit that CAMHS partnerships culd use t supprt the participatin f parents/carers at a natinal and lcal level. The Parents Say tlkit will be available n the YungMinds website frm April The utcmes frm the wrk that was dne with yung peple and parents/carers includes at a: 3
4 natinal level, yung peple c-chair, and parents are members f, the prgramme s natinal grups, and are invlved in develping: CAMHS service specificatin linked t CAMHS values and standards Delivering with, Delivering well ; guidance n cmplaints and cnsent frms; 10 tp tips fr recruitment; infrmatin passprt, develped by yung peple and parents/carers, fr them t use and cmplete in partnership with their Clinician, and keep s that they can cntrl the sharing f infrmatin with thers they are receiving treatment frm nw r in the future; vide yung peple s views and recmmendatins fr imprving integratin between services; and participatin partners (GIFT) and yung sessinal wrkers develped and maintained an nline resurce t disseminate best practice, infrmatin and blgswww.myapt.rg.uk. lcal level: wrking with cmmissiners; recruitment f new staff in services; recruitment f new CAMHS partnerships t jin CYP IAPT; service redesign; imprving infrmatin and envirnment f the service; wrking t supprt regular use f regular feedback and utcmes measurement. 12. In additin, NHS England c-chaired the Children and Yung peple s Mental Health Taskfrce, and there was substantial service user, parent and prfessinal engagement ver 1700 peple were invlved in cnsultatins abut hw t imprve child and adlescent mental health services. The recmmendatins f the taskfrce will be taken frward ver the next 5 years. Participatin by children, yung peple and parents in their wn treatment and in service design was an underpinning principle expressed in Future in mind, the CAMHS Task Frce reprt. 13. The recent annuncement in the budget f extra resurces fr CAMHS t build capacity, linked the use f resurces t lcal Transfrmatin Plans. The participatin f children, yung peple and parents in lcal plans will be part f the assurance prcess. In additin, the engagement with children, yung peple and families will be built int natinal planning. Dementia Prgramme 14. NHS England has fcused n wrking with GP practices t make sure that as many peple as pssible, wh may have dementia, have their dementia recgnised. Since September abut 10,000 new peple a mnth have been identified as having dementia. Once smene has a diagnsis f dementia it is mre likely that they and their families will be able t be supprted t live well with dementia. 15. The NHS Chices Website has increased the amunt f infrmatin available t the public regarding dementia. 4
5 16. NHS England has been actively supprting the Dementia Friends campaign run by Public Health England. NHS England has als been wrking with a number f vluntary rganisatins t lk at ways f imprving the lives f peple living with memry lss and dementia. 17. Over the next 6 mnths NHS England intends t: cntinue t wrk with a range f different services t ensure that peple wh might have dementia have their needs assessed withut having t wait t lng; wrk with GPs and ther staff wh might visit peple with dementia wh live in their wn hmes t be ffered a chance t say what care and supprt they want t receive, bth immediately fllwing their diagnsis and in the lnger term; cntinue t wrk with a number f vluntary sectr rganisatins t cntinue t imprve the care and supprt peple with dementia expect t receive; and. build up an understanding f what peple with dementia need frm health services and t identify the best ways f prviding these services. IAPT (Imprved Access t Psychlgical Therapies) Requirements 18. The IAPT prgramme was established in Octber 2008 in rder t supprt the NHS t cmmissin primary care mental health services t deliver NICE apprved and evidence based psychlgical therapies fr the treatment f depressin and anxiety disrders. The current NHS mandate cnfirms the ambitin fr a minimum f 15% f the adult ppulatin with depressin and anxiety disrders t access treatment in lcal IAPT services in each CCG area and fr at least 50% f thse cmpleting a curse f treatment t recver. 19. The NHS mandate fr next year additinally asks that 75% f peple gain access t treatment within 6 weeks f referral and 95% access treatment within 18 weeks. 20. In additin the NHS mandate set ut a requirement fr transfrmatin f CAMHS (Child & Adlescent Mental Health Services) via the Children & Yung Peple s IAPT prgramme. By the end f March 2015 NHS England expects t rll ut this prgramme t 60% f services cvering the 0-19 ppulatin. Perfrmance 21. IAPT services are pen access services. Referrals fr treatment can be made by yur GP, r ther agencies like Jb Centre Plus, Adult Scial Care departments, faith and cmmunity grups. Many IAPT services ffer self referral. 22. Since Octber 2008, ver 2.8millin peple have gained access t treatment with ver 1.6millin cmpleting treatment, nearly 600,000 reaching recvery and many mre achieve significant imprvement in their symptms. 23. IAPT services prvide fast access t treatment. At present, ver 64% f peple using IAPT services get access t treatment within 28 days f referral. 5
6 24. IAPT als prvides emplyment supprt fr thse peple with depressin and anxiety wh need supprt t keep their jb r find new wrk. IAPT has supprted ver 93,000 peple t mve ff f sick pay and benefits. 25. The current recvery rate within IAPT services is just ver 45%. This is less than the 50% recvery rate required t meet the NHS Mandate requirements. Crisis Care Cncrdat 26. As ne f the signatries t the Crisis Care Cncrdat, NHS England is cmmitted t wrking alngside ther agencies t imprve the system f care and supprt fr peple in crisis because f a mental health cnditin, and t imprve preventin and early interventin t prevent crisis whenever pssible. 27. NHS England s Strategic Clinical Netwrks and Academic Health Science Netwrks have been raising the prfile and imprtance f delivering gd crisis care by meeting with partner agencies and wrking directly with CCG cmmissiners. 28. NHS England has aligned the wrk f the cncrdat with the ambitins f NHS England s Urgent and Emergency Care Review. 29. A dedicated wrk prgramme fr NHS 111 has been established t imprve the utcme fr peple with mental health needs when accessing the service. As part f this wrk, a series f listening events with users f mental health services and healthcare prfessinals. 30. In 2014/15 an additinal 30 millin nn-recurrent funding was allcated t CCGs fr crisis care. This funding will supprt imprvements in early interventin in psychsis and mental health crisis services. Frward Lk Mental Health and Parity f Esteem Wrk Prgramme ver the next 6 Mnths 31. The key pririties fr the next six mnths are t: cntinue the wrk t ensure the NHS is prepared fr the intrductin f access and waiting time standards, frm 1 April 2016; wrk with thers t develp the plan t increase access t CAMHS, supprted by the 250 millin annunced as part f the new budget cmmitment; maintain the fcus n the number f peple with depressin and anxiety wh have access t IAPT; and cntinue t fcus n diagnsing dementia and prviding effective aftercare. Cllabratin and Partnership Wrking 32. The apprach t develping and implementing all f the abve wrk streams and all future wrk prgrammes, is ne f cllabratin and c-prductin with key stakehlders, partners and service users. 6
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