Source · Select Committees · Public Accounts Committee
Recommendation 18
18
Accepted
Most Integrated Care Boards lack sufficient capacity, resources, and staff to improve local mental health services.
Conclusion
We, and many stakeholders, agree that the introduction of ICSs offers opportunities to improve local mental health services. But many of the challenges they face involve longstanding and unresolved issues which we have repeatedly highlighted, most recently in our April 2023 report on the introduction of ICSs.33 Only four out of 29 ICBs responding to the NAO survey agreed they had the capacity, resources and staff required to improve their mental health services. As the Department acknowledged, “the proof will be in the pudding”.34 On workforce, NHSE told us that local ICSs are responsible for their own workforce planning. It recognised that there is a tension between central and local decision making, although it is not yet clear where the appropriate balance lies.35
Government Response Summary
The government agrees with the Committee's observations, outlining existing measures like the NHS Oversight Framework, ICB reporting requirements, and Health and Care Act mandates to ensure accountability and support for mental health services within ICBs.
Government Response
Accepted
HM Government
Accepted
3.1 The government agrees with the Committee’s recommendation Target implementation date: Summer 2024 3.2 The NHS Oversight Framework outlines NHS England’s approach to overseeing Integrated Care Boards (ICBs) and trusts, utilising 63 metrics, 6 of which relate to mental health. NHS England will continue to undertake delivery assurance within the new model outlined in the NHS Operating Framework, which is complemented by central data repositories that provide an overview of performance at a national, regional, ICB and sub-ICB level. NHS England segments ICBs and NHS trusts on a scale of 1 to 4 and provides mandated support for the most challenged providers and systems. NHS England also conducts annual performance evaluation of ICBs. 3.3 From 2023-24, all ICBs are also required to include a statement of the amount and proportion of expenditure incurred by the ICB in relation to mental health in their annual report, increasing ICBs’ public accountability for their decisions on mental health investment. NHS England will assure ICB spending plans and actual spend. To ensure mental health is sufficiently prioritised, the Health and Care Act 2022 requires that ICBs must have a member who has mental health expertise on the Board. 3.4 NHS England is working within the new operating model to ensure systems are empowered to self-assure spending and delivery, but significant risks and issues will continue to be escalated to support a strategic response. 3.5 NHS England and the department will continue to monitor this approach to ensure that appropriate support is being offered to ICBs.