Mental heath funding gap grows larger despite income growth in 2016/17

Its research showed that 84% of mental health trusts received an increase in funding in cash terms – in the previous two years, almost 50% of providers had seen a decrease in income.

However, with priority given to reducing deficits and improving A&E performance, funding for acute and specialist trusts grew more quickly than their mental health counterparts.

The government has committed to ensuring parity of esteem between mental and physical healthcare, providing workforce support and greater equality in funding for mental health services. The latter measure is being driven through the investment standard for commissioners, which requires clinical commissioning groups to increase spending on mental health services each year in line with their own budget rise.

The fund’s report, Funding and staffing of NHS mental health providers: still waiting for parity, said mental health trust income rose by 2.5% in 2016/17, while in acute and specialist trusts it grew by 6%. Funding for mental health providers increased by 5.6% since 2012/13, compared with 16.8% for acute trusts.

The King’s Fund said this squeeze on mental health trust funding, combined with a shortage of available staff, had led to workforce pressures that put the safe staffing of services in jeopardy. It added that the number of mental health nurses had fallen by 13% since 2009 and 10% of all posts in specialist mental health services are vacant.

The fund’s analysis of Care Quality Commission inspection reports for all 54 mental health trusts showed staff shortages were identified as a problem in more than half of the providers. This led to a higher risk of inpatient self-harm and suicide, delays in treatment, reduced access to care and bed closures.

It also looked at a small sample of board papers, finding that trusts had difficulties staffing wards on a day-to-day basis, relying on agency and bank workers and staff substitutions – putting in a healthcare assistant when a registered nurse could not be found for a shift, for example.

Helen Gilburt (pictured), King’s Fund fellow in health policy and lead author of the paper, said it was difficult to deliver parity of esteem when the whole of the NHS was under huge pressure. While most CCGs had met their commitments to raise spending on mental health, their focus was on relieving pressure on acute hospitals.

‘Unless funding grows more quickly, mental health providers may end up implementing improvements to some services at the expense of others,’ she said. ‘Despite the commitment of national leaders, the funding gap between mental health and acute NHS services is continuing to widen, while growing staff shortages are affecting the quality and safety of care.

‘As long as this is the case, the government’s aim to tackle the burning injustices faced by people with mental health problems will remain out of reach.’