Mental health services are ‘at a crossroads’ where they must opt to modernise and improve, as the Care Quality Commission (CQC) published its comprehensive review for England.
In the report, inspectors expressed concerns physical environments are not designed to keep people safe, care is over-restrictive and institutional in nature, and poor recording and sharing of information undermines the efforts of staff.
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Overall, 68% of core services provided by NHS trusts and 72% of independent mental health locations were rated as good; with 6% of NHS and 3% of independent core services rated as outstanding, but the deficiencies were found to be consistent across the board.
Given the increasing demand for mental health services, the CQC is concerned that more people risk receiving care that is not good enough, or no care at all.
Royal College of Nursing (RCN) chief executive Janet Davies said: ‘Despite promises of investment, there are 4,800 fewer mental health nurses under this government, which helps to explain why patients in some areas are being failed.
‘Across the NHS, patient care deteriorates when the number of nurses drops. Without the right number of staff, mental health care will continue to lag behind physical health services. The NHS needs hard cash to deliver election pledges on mental health made by politicians.’
Safety was the area in which services were most likely to perform poorly, with 4% of NHS core services and 5% of independent mental health core services rated as inadequate for safety and only 59% and 61% respectively rated as good.
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On many wards, the combination of a high number of detained patients who pose a risk to themselves and sometimes to others, old and unsuitable buildings, staff shortages and a lack of basic training, made it more likely that patients and staff risked suffering harm.
Mental health services are under significant and increasing pressure, as national figures show a 12% decline in the number of mental health nurses since 2010. The number of inpatient psychiatric beds has fallen by 4% since 2014 while the number of detentions under the Mental Health Act rose by 26%.
CQC deputy chief inspector Dr Paul Lelliott said: ‘More people than ever are receiving treatment and care for mental health conditions, in part due to a reduction in the stigma associated with mental ill health.
‘The mental health sector is at a crossroads. The Five Year Forward View for Mental Health points the way to a future where people have easy access to high quality care close to home and are able to exercise choice.
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‘To achieve this vision, the sector must overcome an unprecedented set of challenges – high demand, workforce shortages, unsuitable buildings and poor clinical information systems.’
In the report, the CQC made several recommendations to providers so they can take the right turn at the current ‘crossroads’, including treating people as active participants in their own care, investing in better services locally and investing in information technology that enables staff to enter and retrieve clinical information while on the move.