Next government faces a tough challenge to turn rhetoric into reality for children and young people with mental health problems

A new report from the Health Foundation analysing the quality of NHS care over this parliament, suggests the next government will face a tough challenge, in a time of austerity, to improve services for children and young people with mental health problems.

The independent health care charity’s report, launched today (Friday 20 March), brings together data from a range of sources to assess the quality of care over the last five years.

The report highlights a dearth of data on the quality of care in children and adolescent mental health services. What information there is suggests huge problems in accessing care alongside rising demand for mental health services to treat and support young people.

Last year a lack of available beds within local mental health services in some parts of the country meant young people had to travel 50 miles to access the right treatment and support. Similarly, less than 40% of local areas offered specific services to help children and young people experiencing a mental health crisis and in urgent need of care.

This week’s Budget commitment of an additional £250m a year for mental health, much of which will be focused on children and young people, is a positive development. The government’s new taskforce report on child and adolescent mental health, which sets out an ambitious vision for tackling these problems, is also welcome. However, this progress is against a backdrop of an 8% fall in real terms in mental health funding over this parliament, according to research published today by the BBC and Community Care.

Other findings from the report include:

• The government’s approach to assessing and managing performance of NHS services has gone backwards and needs to be overhauled.
• A shift is needed from a focus on a narrow set of targets to a broad set of measures, including health care providers’ long term outcomes, their approach to learning and quality improvement, and their contribution to the local health economy.
• There are unacceptable and worrying gaps in national quality data. Large areas of NHS care have little or no national data at all, allowing unwarranted variation to flourish and hindering attempts to improve services. For example, we know very little about safety in primary care, where 90% of all patient contacts take place.

The report covers: safety, person-centred care, mental health, waiting times as well as an analysis of how the NHS compares internationally.

Richard Taunt, Director of Policy at the Health Foundation, said:

'Over the past five years the NHS has done extremely well to maintain quality in many areas in the face of a significant financial squeeze. However, the government’s approach to assessing the quality of NHS care has gone backwards: a focus on outcomes quickly reverted to a focus on a narrow set of targets.

'To support improvement in the NHS, it is critical that whoever forms the new government in May makes a break from a target-driven style of performance management to focus on a broader more balanced way of assessing quality.'

Felicity Dormon, Senior Policy Fellow at the Health Foundation, said:

'Undoubtedly extra funding and the taskforce’s recommendations represent progress for children’s mental health. The question is whether this is enough to treat our children and young people in need.

'Honest conversations will need to be had about the trade-offs to be made by investing in children’s mental health over other services – but the human and economic cost of failing to improve the quality of care for children and young people with mental health problems will be enormous for individuals and for society.'

Note to editors

Below are some key facts from a range of sources including national bodies, parliamentary committees and well-known universities, which are referenced in the report:

• In 2010, over three quarters of GPs said they could rarely get access to needed psychological therapy for their young patients, and in 2004 (the latest data available) only 25% of children with mental health problems were in treatment, and only 13% of adolescent males.
• Providers report year on year increases in referrals for all CAMHS services, some as high as 20% annual increases in referrals since 2010, and referrals for inpatient care rose between 2012 and 2013. Providers also report that children and young people being referred currently have greater levels of need than their predecessors.
• Inpatient provision is geographically variable, and in 2014 some areas had no beds available within a 50 mile radius for some CAMHS specialties.
• Partial information from providers suggests that children and young people waited an average of 15 weeks for treatment in 2013, and less than 40% of areas offered crisis pathways for those in urgent need.

The Health Foundation’s quality briefing is available for download. There are also factual resources available for the following areas: patient safety, person-centred care, mental health, waiting times and how the NHS compares internationally.

The Health Foundation’s Three tests for a credible health policy is also available.

Media contact

Lewis Pickett
T: 020 7257 8017
E: lewis.pickett@health.org.uk