Wales Audit Office report points to slow progress in improving mental health services
A Wales Audit Office follow-up report to its 2005’s baseline review of services has concluded that although improvements have been made to adult mental health services in Wales during the last six years inequalities remain. Key findings from the report, entitled “Adult Mental Health Services – Follow up Report” include:
· Many GPs and practice staff have not received mental health training within the last three years, and limited progress has been made in increasing the number of GPs with specialist skills in mental health.
· Psychology therapy services waiting times can be very long and in excess of Welsh Government targets although services have improved in some parts of Wales.
· Information provided to service users is not kept up to date in some parts of Wales and service users are not being consistently supported and involved in their care.
· Too many targets and key actions for mental health services which have been set as a result of external reviews have not been co-ordinated and prioritised effectively at a local level.
· It is not yet clear whether the Welsh Government’s attempts to protect NHS mental health expenditure have been successful. Expenditure on adult mental health has varied across Wales and there is a lack of information on which to assess the impact of different expenditure and service patterns on the outcomes for people using services.
The report makes a number of recommendations for the Welsh Government including:
· focusing its new mental health strategy on embedding key services elements in all parts of Wales and ensuring these services have appropriate capacity and operate effectively;
· placing service outcomes at the heart of the new mental health strategy, including in relation to target setting, information gathering and performance management; and
· examining the potential for investing in those mental health services that will deliver a net saving to the NHS and the public sector as a whole.
Revised commencement dates for the Mental Health (Wales) Measure 2010
The commencement dates of key parts of the Mental Health (Wales) Measure have been put back.
In a letter to the Chief Executives of Local Health Boards and Directors of Social Services, the Welsh Government states that:
· Part 1 of the Measure, concerning local primary mental health support services, will commence in October 2012;
· Parts 2 and 3 of the Measure, concerning assessment, care and treatment planning and care coordination within secondary mental health services, will commence in June 2012;
· Part 4 of the Measure, concerning the expansion of the independent mental health advocacy scheme under the Mental Health Act 1983, will commence in two phases. The first phase (concerning patients subject to sections 4 or 5 of the 1983 Act) will commence in January 2012. The second phase (concerning informal inpatients) will commence in April 2012.
Commenting on the Wales Audit Office report Hafal Expert Patient Trainer Dave Smith said: : “Although the Audit Office report says progress has been made when you read the detail there’s quite a lot to be disappointed about. We need the new Welsh Government to provide strong leadership to ensure good health and social care services are delivered across Wales to people with a mental illness.
We are particularly concerned about what the Auditor General had to say about funding for mental health services. Despite the Welsh Government’s commitment to protecting expenditure on mental health services through ring-fencing, the Auditor General found that not all NHS organisations have complied with this requirement. Equally worrying is the finding that cost savings within mental health services have not always been reinvested back into those services as required by Welsh Government guidance. Hafal is writing formally to the National Assembly’s Public Accounts Committee asking them to investigate this matter.”
Commenting on the delay in implementation of the Measure, Hafal Chief Executive Bill Walden-Jones said: “In the absence of new money the Measure is the “only show in town” for mental health services. Successful implementation of Part 2 of the Measure could transform mental health services for people with a serious mental illness by ensuring that they have a quality Care and Treatment Plan. The Measure is the main driver for the improvement of mental health services in Wales so it is regrettable that its full implementation is being put off.
“In creating the Measure the Welsh Government is to be congratulated for listening to patients; and their officials in Cardiff have kept their implementation timetable up to date. Unfortunately the delay is down to the fact that in the field the NHS and local authorities are not ready to go in terms of implementing the Measure. It’s very important that local authorities and Local Health Boards don’t now relax and do nothing because of the delay. When the time comes for implementation they must be ready to go.
“In a nutshell, in respect of both the Wales Audit Office report and the Measure the Government has got its approach right but the delivery on the ground needs to catch up.”
To read the Wales Audit Office report go to:
http://www.wao.gov.uk/assets/englishdocuments/Adult_Mental_Health_2011_English.pdf
For information on the Measure please visit: http://www.assemblywales.org/bus-home/bus-legislation/bus-leg-measures/business-legislation-measures-mhs-2.htm