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Carter Review of mental health and community services makes important recommendations but misses bigger picture and biggest challenges

25 May 2018

Lord Carter’s review of productivity in NHS mental health and community services provides some welcome support for action to address the wellbeing of staff and to improve efficiency but marks a missed opportunity to tackle some of the biggest productivity issues of all in the NHS, Centre for Mental Health chief executive Sarah Hughes said today.

Responding to the report, published this week by NHS Improvement, Sarah Hughes said: “The Carter Review makes important observations about high levels of staff sickness in mental health services and concerns about the wellbeing of the workforce. Our report on the mental health workforce last year noted similar concerns and called for all NHS mental health service providers to become ‘compassionate organisations’ that support the wellbeing of their staff. This is essential for the success of the Five Year Forward View for Mental Health.

“We also welcome the report’s call for continued action to address costly out of area hospital placements. For people of any age, being admitted to a hospital far from home can add to the distress of a mental health crisis; and for those spending months and sometimes years in secure or rehabilitation beds leads to a growing sense of dislocation from home.

“The report rightly notes that one of the biggest challenges facing mental health services is the high level of unmet need, among both children and adults of all ages. This challenge cannot be met simply by squeezing more efficiency out of mental health services. It can only be addressed by working across the NHS as a whole, locally and nationally, and reinvesting in effective mental health support: where possible to prevent problems in the first place or to intervene as early as possible when people first seek help.

One of the biggest challenges facing mental health services is the high level of unmet need… This challenge cannot be met simply by squeezing more efficiency out of mental health services. It can only be addressed by… reinvesting in effective mental health support

“The NHS still spends as much on the consequences of not dealing with mental health problems as it does on all mental health care. Much of this relates to poor mental health among people with long-term physical conditions, which adds some £10 billion to the costs of physical health care as well as leaving people in distress for lack of effective emotional and psychological support.

“The NHS must address these major inefficiencies by working across local health systems to reinvest in mental health support. From working with young families and schools to preventing loneliness among older people and offering better help to people with unexplained medical symptoms, there are opportunities for large scale change with large scale benefits for the NHS, for individuals, families and communities.”


Read Lord Carter’s review here

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