Sainsbury Centre for Mental Health

The Care Quality Commission has published its first annual report to parliament on the on the state of health care and adult social care.

It says that services have steadily improved overall but rising demand and pressure on finances make reform essential. The Commission applauds overall improvements over recent years, but cautions that some services were lagging behind the pack and that there were areas of common concern across health and social care, notably keeping people safe and staff training.

The Department of Health has published the operating framework for the NHS for 2010/11 which sets out their priorities for the year ahead. For the third year in a row, the national priorities in the operating framework remain the same.

It suggests steps that NHS organisations can take to implement the Boorman Review (p. 19) and references the Bradley report (p. 48) as a way to support PCTs in understanding and addressing the needs of offenders.

Commissioning high quality modern mental health services presents real challenges - but help is at hand for commissioners in a new guide. NMHDU's Commissioning Friend for Mental Health Services is designed to support primary care trusts and local authorities and assist them in developing their mental health commissioning practice.

This is the new five-year plan to reshape the NHS to meet the challenge of delivering high quality health care in a tough financial environment. The report describes practical measures to meet the demands of an aging population and the increased prevalence of lifestyle diseases.

The vision is for an NHS that is organised around patients whether at home, in a community setting or in hospital. There will be a renewed focus on prevention with the ambition of delivering cost-effective high quality care across the service.

The government has published New Horizons: a shared vision for mental health. It is the successor to the National Service Framework in that it sets out the ‘blue-print’ for English mental health services in the future.

The strategy seeks to improve services and help prevent people developing mental illness. Its three main priorities are:

1. Better prevention
2. Better treatment, including for women with post-natal depression, ex-servcemen and older people
3. Reducing the impact of mental health conditions – reducing stigma and suicide prevention

This is the new cross-government national mental health and employment strategy. It addresses wellbeing at work for everyone and better employment outcomes for people with mental health conditions, both in and out of work.

This practical framework sets out a series of commitments from government and what it expects from health professionals, employers, organisations and individuals.

It identifies 6 key areas for action:

• Changing attitudes to mental health
• Improving health and wellbeing at work
• Early intervention
• Tailoring support (individualised) in and out of work
• Building resilience from early years
• Coordinating action across government

A companion guide to the strategy is available from SHIFT.

The Final Report of the independent NHS Health & Well-being Review reiterates the business case for change laid out in the Interim Report, and provides a comprehensive set of recommendations for improvement in provision of health and well-being across the NHS.

The Department of Health has also published the Government’s response to this report, setting out how it intends to implement the review’s recommendations.

The Care Quality Commission has published its 2009 survey of people who had recently had an inpatient stay for acute mental health problems. The survey asked people all about their experiences of services. It found that:

• 86% reported having physical health checks in hospital – but only 44% of those with physical health problems ‘definitely’ felt that enough care was taken of theses.
• The survey showed limited access to talking therapies, with 29% receiving these overall and less than half of those who wanted talking therapies getting them.
• There was a lack of activities available for inpatients, with 35% saying that there was too little to do on weekdays and over half (54%) reporting that there were not enough activities available to them at weekends or evenings.
• Patients were often not involved in their care as much as they wanted to be, with 34% saying that they were “definitely” involved as much as they wanted to be in decisions about their care and treatment.
• Many patients felt that they were not given understandable explanations about their care and treatment,– 48% said that the potential side effects of medicines that they were prescribed whilst in hospital were not explained to them in a way they could understand.

This report, by NMHDU, looks at the challenges posed to the NHS by people who have either developed problems with alcohol or drugs because of a pre-existing mental health condition, or have had a mental health condition caused by misusing alcohol or drugs.

It addresses the way provision of services for mental health and drug and alcohol misuse have developed separately and looks at how stronger links between the two, along with better workforce development and awareness, can provide a better service and potentially save money.

Guidance from the Department of Health that sets out some of the issues relating to the exchange of information between mental health trusts and outside organisations and individuals.

The government has published New Horizons, its' consultation on the future of mental health policy after the National Service Framework. The consultation is open until 15 October 2009.

The Mental Health Act Commission has published a final report on the Mental Health Act and the care provided to people detained under the Act. The report claims that while there were good examples of people receiving good care during their visits to services there were variation across services. The Care Quality Commission (CQC) has published a response (also at the link above).

The NMHDU has published a briefing to support commissioners of both adult and child and adolescent mental health services to prepare to accommodate patients under 18 in a suitable hospital environment.

The Government has committed to commencing this duty in April 2010, with the purpose of preventing the inappropriate admission of children and young people to adult psychiatric wards.

The Department of Health has published a guide to help local areas get ready for payment by results in mental health.

This report sets out the overall results of the follow-up of the review of NHS adult specialist community mental health services in England. The report explores the extent to which services have improved since the original review in 2005/06. It provides recommendations aimed at all staff working in specialist community mental health services.

A Healthcare Commission survey of people using community mental health services has shown continued improvements in care.

A larger percentage of service users say that they have confidence in mental health professionals, receive copies of their care plan and have a number to contact out-of-hours when in a crisis situation.

The survey also shows there is still some way to go before community mental health services are accessible to all people who need them and include all service users in decisions about their care.

This report by the Healthcare Commission says the quality of the services varies widely across the country. It identifies areas for action, particularly improving the involvement of patients in their care.

It concludes that better co-ordination is needed to ensure that service users do not spend any longer in hospital than necessary and are supported when they move from hospital to community services.

This is the second national audit of violence in mental health services conducted on behalf of the Healthcare Commission by the Royal College of Psychiatrists.

There are about 30,000 in-patients in mental health units in NHS and independent organisations in England and Wales. The audit involved 211 units at 69 of those organisations and for the first time looked separately at services for working-age adults and wards for people over 65.

The Department of Health has published a new handbook that reports on the progress of the STR implementation programme and updates the original 2003 policy implementation guide.