NAO report highlights pressure on mental health services

In its latest report, the National Audit Office (NAO) estimates that as many as 8 million people with mental health needs are not in contact with NHS services.

The NAO report Progress in improving mental health services in England explains that whilst the NHS has taken some important first steps towards closing the gap between mental and physical health services, these services remain under pressure and many people using them are reporting poor experiences.

NAO interviews with stakeholders highlighted that some groups, including children and young people, ethnic minorities, LGBT people, and those with more complex needs or more than one diagnosis, had poorer experiences accessing or using services.

A survey of NHS mental health trusts revealed that in response to demand and service pressures, they had allowed waiting times and lists to increase, while a minority had raised treatment thresholds (15 out of 33) and reduced provision in some service areas (6 out of 33).

The NHS mental health workforce increased by 22 per cent between 2016-17 and 2021-22, but staff shortages and the speed of expanding the existing workforce remain a major constraint. Retaining staff is also becoming an increasing challenge: during 2021-22, 17,000 staff (13%) left the NHS mental health workforce. The NAO’s survey of NHS mental health trusts highlighted specific concerns about shortages of medical and nursing staff, and psychologists. Reasons for shortages include difficulties recruiting and retaining staff, high turnover between service areas, and competition from health and non-health sectors.

Gareth Davies, the head of the NAO, said:

"The Department for Health and Social Care and NHS England have made a series of clear commitments and plans to improve mental health services, but they have not defined what achieving full parity of esteem for mental health services will entail. It is therefore unclear how far the current commitments take the NHS towards its end goal, and what else is needed to achieve it and match the increasing public awareness and need.

“While funding and the workforce for mental health services have increased and more people have been treated, many people still cannot access services or have lengthy waits for treatment. With demand for mental health services having increased since the pandemic and being expected to increase further in the coming years, it is vital that DHSC and NHSE define what is required to meet the growing demand.”