Designing better mental healthcare facilities

NHS England proposes new mental health access standards

The NHS is set to take another major step towards improving patient access to mental health services with the introduction of five new waiting time guarantees, under plans recently set out.

The proposals could ensure that patients requiring urgent care will be seen by community mental health crisis teams within 24 hours of referral, with the most urgent getting help within four hours. Mental health liaison services for those who end up in A&E departments would also be rolled out to remaining sites across the country. The NHS is consulting on the new standards, which have been piloted by mental health providers in collaboration with acute NHS Trusts, and are backed by clinical and patient representatives. They are part of overall service expansion and improvement for mental health outlined in the NHS Long Term Plan.

NHS CEO, Simon Stevens, said: “Together with the guarantee that mental health investment will increase each year as a share of the growing NHS budget – as has been the case each year since 2015 – these new waiting times standards are another key milestone in the journey to putting mental health on an equal footing with physical health, so-called ‘parity of esteem’.”

Claire Murdoch, the NHS’s National Mental Health director, said: “These new standards will ensure that people who need care know when they can expect to receive it, and will support more rapid access to evidence-based treatment and support. They will help with work already underway, with the NHS turning the tide in mental health for a range of conditions as part of the Long Term Plan. This includes thousands of women benefitting from specialist perinatal mental health care last year, and improvements to our children and young people’s services, meaning more children and young people are accessing treatment than ever before, including timely, evidence-based care for eating disorders.”

Paul Farmer, CEO of Mind, said: “A huge number of people have developed a mental health problem since the start of the pandemic, and some groups have been hit particularly hard, including young people, those on low incomes, and people from racialised communities, but not got help early on. With increasing numbers of people reaching crisis point, it is critical that they get the right mental health support quickly, which these standards would help to achieve.

“Many thousands of people will be left with long-term impacts from this period, whether because of bereavement, unemployment, trauma, or the weathering effect of life during lockdown. Knowing that the NHS is committed to timely access to support could make all the difference as we emerge from the pandemic and plan for the future.”

The proposed new standards are:

  • For an ‘urgent’ referral to a community based mental health crisis service, a patient should be seen within 24 hours from referral, across all ages.
  • For a ‘very urgent’ referral to a community-based mental health crisis service, a patient should be seen within four hours from referral, for all age groups.
  • Patients referred from Accident and Emergency should be seen face to face within one hour, by mental health liaison or children and young people‘s equivalent service.
  • Children, young people, and their families/carers presenting to community-based mental health services should start to receive care within four weeks from referral. This may involve immediate advice, support or a brief intervention, help to access another more appropriate service, the start of a longer-term intervention or agreement about a patient care plan, or the start of a specialist assessment that may take longer.
  • Adults and older adults presenting to community-based mental health services should start to receive help within four weeks from referral. This may involve the start of a therapeutic intervention or a social intervention, or agreement about a patient care plan.

The new standards come on top of existing measures of mental health access which are:

  • 75% of people referred to the Improving Access to Psychology Therapies (IAPT) programme should begin treatment within six weeks of referral, and 95% of people referred to the IAPT programme should begin treatment within 18 weeks of referral.
  • More than 60% of people experiencing a first episode of psychosis will start treatment within a NICE-recommended package of care with a specialist early intervention in psychosis service within two weeks of referral.
  • 95% of children and young people referred for assessment or treatment for an eating disorder should receive NICE-approved treatment with a designated healthcare professional within one week for urgent cases and four weeks for every other case.

Responses to the consultation can be submitted through the consultation form on the NHS England website, or by email to [email protected] The consultation period will run to 1 September 2021.

 

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