How to get mental health at the heart of STPs

How to get mental health firmly on the STP agenda

The publication of the 2017 – 2019 NHS Operational Planning & Contracting document suggests the future is bright for mental health services in England, as delivering fundamental improvements in service provision is one of the core baseline metrics that will be used to measure the success of the Sustainability and Transformation Plans. 

However, while this gives cause for optimism, to get mental health firmly on the STP agenda may still prove challenging [1]. There is much work to be done to radically improve the experiences of people who use mental health services. This can only be achieved by developing a robust strategy that can increase capacity to provide access to an additional 1 million service users by 2021.

  • Increasing IAPT access from 15 to 25% of need, embedded within primary care
  • A&E Liaison meeting the new CORE24 standard
  • Increasing access to perinatal services and CAMHS
  • Crisis teams meeting the CORE standard and ending OATs

The moral case for improving mental health services may have been won, yet, in this time of scare resources empirical evidence is needed to truly enable service transformation.  To address this challenge, we believe STP mental health leads require intelligence about the current state of need, services and funding so transformation scenarios can be modelled, tested and prioritised.  This requires three tasks

1) Ensuring everyone is clear on the benefits of integrating physical and mental healthcare

The King’s Fund has estimated a national opportunity of £11 billion rising from better management of physical and mental healthcare. This presents opportunity on a scale which other STP initiatives are unlikely to match. Mental health therefore has an important role to play in ensuring this is well understood across the STP footprint and to stimulate the second and third steps below

2) Gathering and analysing local evidence to create a clear model of these benefits

The second step needs to move from national principle to a detailed local case.  This requires high quality local evidence to analyse the actual number of people using both mental and physical health services, developing scenarios for new services, pathways or organisational arrangements, modelling and testing the potential impact of those scenarios within agreed financial constraints and creating an optimised model for more integrated mental and physical health services across the STP footprint.

3) Agreeing a prioritised local framework for developing integrated care

The resulting detail of mental health STP aligned integration plans will vary.  Possible projects transformation projects ranging from large scale mergers and the formation of joint ventures to much smaller scale individual changes for patients with a range of needs, joint consultations, case supervision, multi-disciplinary care and treatment plans.

Analysis and modelling will enable these projects to be planned, prioritised, and resourced realistically – ensuring that real progress is made in delivering integrated care.

[1]  The July NHSI board highlighted that mental health’s importance still needs to be reflected in STP development

[2] “Bringing together physical and mental health” (2016) The King’s Fund