Five Year Forward View for Mental Health

Five Year Forward View for Mental Health
Title	Five Year Forward View for Mental Health
Type	Policy document
Published	2016
Publisher	NHS England
Language	English

Five Year Forward View for Mental Health

The Five Year Forward View for Mental Health was a strategic plan released in 2016 that set out ambitions for transforming mental health services across England, aligning with national healthcare reforms and international mental health priorities. It sought to integrate community, acute, and specialist services while addressing workforce, access, and parity of esteem for mental health alongside physical health, drawing on prior reports and collaborations among leading health institutions.

Background and Development

The document was developed through collaboration between NHS England, Public Health England, the Department of Health and Social Care, and advocacy organisations such as Mind (charity), Rethink Mental Illness, and Samaritans (charity), building on prior reviews including the Parliamentary and Health Service Ombudsman findings and recommendations from the Five Year Forward View original NHS strategy. Key contributors included senior figures from Royal College of Psychiatrists, Royal College of Nursing, and Health Education England, with stakeholder engagement involving local authorities such as Manchester City Council and national bodies like Care Quality Commission. The plan drew upon precedent initiatives including the Cameron–Clegg coalition health reforms, lessons from the Improving Access to Psychological Therapies programme, and international comparisons with models from World Health Organization guidance and the Commonwealth Fund analyses.

Objectives and Strategic Priorities

The plan articulated ambitions to expand access, reduce variation, and improve quality by 2021, emphasising early intervention and crisis care coordination alongside parity of esteem advocated by organisations such as Royal College of Psychiatrists and National Institute for Health and Care Excellence. Strategic priorities included investment in child and adolescent mental health services influenced by reports from Children and Young People Mental Health Taskforce, improvements in perinatal mental health echoing guidance from NICE, and better access for older adults referenced against work by Age UK. It also prioritised liaison psychiatry in acute hospitals informed by models from NHS England's urgent and emergency care review and targeted workforce expansion proposals consistent with Health Education England's training plans.

Implementation and Service Models

Implementation proposed integrated service models combining community teams, crisis resolution and home treatment teams, and liaison psychiatry services linked to acute trusts such as King's College Hospital and Guy's and St Thomas' NHS Foundation Trust. The plan promoted stepped-care models akin to Improving Access to Psychological Therapies delivery and multidisciplinary approaches reflecting competencies from Royal College of Psychiatrists and British Psychological Society, with digital triage and telepsychiatry pilots inspired by programmes in NHS Digital and learning from Veterans Health Administration telehealth initiatives. Local sustainability and transformation partnerships, including Sustainability and Transformation Plans regions and integrated care systems exemplified by Greater Manchester Combined Authority, were cited as operational vehicles alongside commissioning frameworks used by clinical commissioning groups like NHS North Central London.

Funding and Resource Allocation

The document outlined targeted investment commitments, proposing increased mental health funding within the wider NHS financial plan and earmarked funds for child and adolescent services, perinatal care, and crisis teams; these allocations referenced budgetary frameworks used by HM Treasury and spending reviews that followed Chancellor of the Exchequer decisions. Funding mechanisms involved redistribution through NHS England allocations and leveraging initiatives coordinated with Local Government Association partners, while workforce funding drew on Health Education England postgraduate training budgets and recruitment campaigns informed by trade unions including Royal College of Nursing and Unison (union). The plan also recommended capital investments in inpatient and community facilities modelled on developments at trusts such as Cambridge University Hospitals NHS Foundation Trust.

Outcomes and Evaluation

Evaluation frameworks proposed performance indicators tied to waiting times, access rates, and quality metrics aligned with NICE standards and oversight by regulators like the Care Quality Commission, with national dashboards managed by NHS Digital and reporting to parliamentary committees including the Health and Social Care Select Committee. Early monitoring reported increases in access to psychological therapies and liaison psychiatry coverage per national datasets, with comparative analysis drawing on metrics used by the Organisation for Economic Co-operation and Development and case studies from integrated sites such as Greater Manchester Health and Social Care Partnership. Outcome assessment aimed to measure reductions in emergency admissions, improvements in patient-reported outcomes similar to Patient Reported Outcome Measures, and progress toward parity of esteem benchmarks.

Criticisms and Responses

Critics including campaign groups like Mind (charity) and parliamentary commentators from the Health and Social Care Select Committee argued that commitments lacked enforceable timelines and that funding was insufficient relative to need, echoing concerns raised by professional bodies such as the British Medical Association. Responses from NHS England and ministers in the Department of Health and Social Care emphasised iterative implementation, supplementary investment announcements, and strengthened oversight by the Care Quality Commission and NHS regional directors, while independent analyses by think tanks like the King's Fund and Nuffield Trust offered mixed assessments and recommended further reforms to workforce planning and local commissioning.

Category:Mental health in the United Kingdom