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CCGs cutting spending on mental health despite NHS pledges


25 April 2017

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Five areas in England are planning to cut spending on mental health services in 2017/18, despite being told by NHS England to ensure that they increase spending in line with physical health spending.

A Pulse investigation has revealed that CCGs in South Sefton, Scarborough, Isle of Wight, St Helens and Walsall are collectively spending £4.5m less in 2017/18 than they spent on services in 2016/17.

Five areas in England are planning to cut spending on mental health services in 2017/18, despite being told by NHS England to ensure that they increase spending in line with physical health spending.

A Pulse investigation has revealed that CCGs in South Sefton, Scarborough, Isle of Wight, St Helens and Walsall are collectively spending £4.5m less in 2017/18 than they spent on services in 2016/17.

Mental health services in Walsall will be experiencing the largest cut, with the CCG reducing spending by £1.9m – or 3.2% – despite its overall budget increasing by 1.4%.

Freedom of information responses received from 127 CCGs in England reveal that the total CCG spend on mental health increased by 4.15%.

NHS England said in its Five Year Forward View for mental health in February 2016 that CCGs should spend an extra £1bn a year on mental health by 2020/21.

It also requires CCGs to increase their spend on mental health services in line with their budget increases – the so-called ‘parity of esteem’ standard.

But Pulse’s investigation reveals that some CCGs are even cutting funding for mental health, with a further 78 unable to provide their budgets for 2017/18.

Prof Simon Brake, chief officer for NHS Walsall CCG, said: ‘It has invested significantly more in previous years in mental health services than its CCG peers ahead of the national requirement to make investments in this area.

He added that this, combined with lower than average funding growth of only 1.4% compared to a national average uplift of 2.14% has resulted in the CCG working with its local mental health providers to develop services that meet national goals for patient care while working within available financial resources.

The think tank The Health Foundation had already found that 46 CCGs are not expected to meet the standard in 2016/17, with another £20.8m needed in mental health funding to meet the parity of esteem commitment.

However, a spokesperson from NHS South Sefton CCG said it is ‘difficult to compare us to other CCGs when simply looking at reported spend in mental health, as this does not fully reflect our local position and agreements to ensure investment in these services meets expected requirements’.

She added: ‘Additionally, it should be noted that we were allocated a 1.5% increase in our budget for 2017-2018 and 2018-2019, which is more than half a percent lower than the national average.

‘Whilst the figures show that mental health services will receive 2.5% less directly from us this year, they do not reflect further one off investments which are yet to be allocated in the new financial year.’

A spokesperson for NHS Scarborough and Ryedale CCG also said the data ‘does not take account of the collaborative approach NHS Scarborough and Ryedale Clinical Commissioning Group (CCG) is taking to mental health, particularly in services for young people and additional investment from partner agencies’.

NHS St Helens CCG is reducing its funding by £600,000 in 2017/18 as the CCG said ‘historic funding issues’ have meant the area has been paying for mental health services for neighbouring CCGs.

A spokesperson said the CCGs’ contract with the mental health provider has been adjusted with the other CCGs taking on their portion of the payment.

She said the adjustment has ‘no impact on the level of service provided to patients.’ However, the CCG only increased its investment in mental health by 1.93%, just shy of its allocation increase of 2%.

Dr Chaand Nagpaul, chair of the BMA’s GP Committee, said: ‘This goes against the pronouncements of Government that mental health will have priority, that we will see more support in the community, the promises we’ve had that there will be greater numbers of mental health workers in primary care. Cutting the mental health budget will have a reverse and damaging effect.

'This will simply result in patients, by default, turning to GPs when they have neither the capacity nor the expertise to deal with many of these patients. This goes against the grain of the pronouncements from NHS England and Government.’

How the CCGs are cutting mental health spending

NHS Walsall CCG

2016/17: £59.2m

2017/18: £57.3m

Overall cut: 3.2%

Overall CCG funding uplift: 1.4%

NHS South Sefton CCG

2016/17: £25m

2017/18: £24.5m

Overall cut: 2%

Overall CCG funding uplift: 1.5%

NHS Scarborough and Ryedale CCG

2016/17: £18.65m

2017/18: £18.15m

Overall cut: 2%

Overall CCG funding uplift: 2%

NHS Isle of Wight CCG

2016/17: £21m

2017/18: £19.98m

Overall cut: 0.5%

Overall CCG funding uplift: 0.5%

NHS St Helens CCG

2016/17: £23.5

2017/18: £22.9

Overall cut: 2%

Overall CCG funding uplift: 2%

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