Waiting time standards proposed by NHS England are not being met
“We support the clinical review of standards, but it does have to come with long-term, sustained investment and we also desperately need a robust government workforce plan.” Sean Duggan, chief executive of NHS Confederation’s mental health network
Three in four adult patients who need community mental health care are waiting more than four weeks for treatment, NHS Benchmarking data obtained by HSJ shows.
Two-thirds of children who need community care are also waiting more than four weeks from referral to treatment, figures from the Children’s Commissioner reveal.
Waiting time standards proposed by NHS England in 2021 say that no one should wait more than four weeks for mental health community care. This measure, it said, would “be a powerful lever to address key challenges in delivery of our NHS Long Term Plan ambition for adults with severe mental illnesses, including addressing historical underinvestment, disruption to delivery as a result of the pandemic and increasing concern about long waits”. The new standards have not been introduced, however, because of a lack of new funding, combined with data recording problems. No timeline has been set for implementation.
The data from NHS Benchmarking, an organisation that aims to be the “definitive reference point for benchmarking publicly funded Health & Social Care services” is based on an analysis of figures collected from mental health trusts. The aggregated data for 2021-22 show that 72% of adults and 67% of children waited longer than four weeks. In total, 51 mental health trusts which are also NHSBN members submitted figures for the collection. NHS Benchmarking says that different providers may use different definitions, affecting the reliability of the data.
The Children’s Commissioner figures show that the average waiting time between a child being referred to Children and Young People’s Mental Health Services (CYPMHS) and starting treatment increased from 32 days in 2020-21 to 40 days in 2021-22. There is wide variation in waiting times, however. Average waits last year ranged from 13 days in Leicester to 80 in Sunderland.
NHSE said it was working with integrated care systems to create a reliable picture of waiting times and set a baseline for future formal standards, which must be agreed with government.
Adrian James, the Royal College of Psychiatrists president, said the figures were “concerning”, adding the government needs to commit to doubling medical school places to 15,000 by 2028-29 to meet growing demand.
Sean Duggan, chief executive of NHS Confederation’s mental health network, said that it was wrong for investment packages to be given solely to the acute sector, as had happened in recent budgets. He added: “We support the clinical review of standards, but it does have to come with long-term, sustained investment and we also desperately need a robust government workforce plan.”
An NHS England spokesperson said: “NHS mental health services have been treating record numbers and this demand continues to grow with more than 500,000 people accessing community services over the last year.
“The NHS is matching this demand by expanding its workforce with hundreds more therapists employed in adult mental health services, while three million pupils in England will have access to NHS mental health support in schools from next month.”
These new figures confirm that, at a time when the number of adults with mental health problems is growing, many are facing lengthy waiting lists to receive treatment. We agree with Sean Duggan that the sector needs sustained investment, and that the government must publish a workforce plan as a matter of urgency. We do, however, encourage the NHS to keep looking at alternative methods of supporting people with mild-to-moderate mental health problems, such as digital apps, which have been shown to be effective. Earlier this year we launched a guide to digital mental health tools (https://futurecarecapital.org.uk/digital-mental-health-tools-guide/), to enable the public to know what digital support is available for their specific needs, as well as a commissioning tool to help medical professionals and commissioners better understand what digital mental health applications are available for the patients in their care.