Thirty per cent of delayed mental health hospital discharges are associated with the absence of well-resourced community services an inquiry by The King's Fund has found.
Mental health under pressure, stated that mental health sevices are under strain, particularly in the provision of community services. Community crisis resolution and home treatment teams, were found to be unable to provide sufficient levels of support to compensate for reductions in beds in inpatient settings. This has impacted on patient’s experience of care, with just 14% of patients reporting that they received appropriate care in a crisis in the community. In 2015 28% of people rated their experience of community mental health care on a scale of 0 to 10 as 5 or lower. This is compared with 25 per cent in 2014.
‘Trusts looked to move care from the hospital to the community, focusing on self-management and recovery.’ said Helen Gilburt, Fellow of Mental Health Policy at The King’s Fund and author of the report. Few would dispute the intention and rationale for this – the problems arise with the scale and pace of the changes, which lack the necessary checks to evaluate their effectiveness and the impact on patient care.
The report shows that around 40% of mental health trusts experiencing a cut in income in 2013/14 and 2014/15, in contrast to the acute sector, where more than 85% of trusts saw their income increase over the same period.
‘Historically, mental health services have often been the first to see their funding cut, so many trusts felt forced to look at what savings could be made through transformation programmes to pre-empt this,’ Ms Gilburt added. ‘Mental health trusts now need the security of stable funding, supported by a national focus on evaluating the changes to date, improving practice and reducing variations in care.’
Stephen Dalton, chief executive of the Mental Health Network said: ‘Much of this is well known to policy makers and politicians and despite the rhetoric about giving equal importance to physical and mental health this hasn't translated into any new money. On the contrary, funding for mental health services has gone down. Many commissioners of NHS services don’t have the capacity to do the right thing and fund what works.’